Antonio Travaglino1, Antonio Raffone2, Antonio Mollo3, Giorgio Borrelli1, Pasquale Alfano4, Gian Franco Zannoni5, Luigi Insabato1, Fulvio Zullo4. 1. Anatomic Pathology Unit, Department of Advanced Biomedical Sciences, School of Medicine, University of Naples Federico II, Naples, Italy. 2. Gynecology and Obstetrics Unit, Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II, 80131, Naples, Italy. anton.raffone@gmail.com. 3. Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", University of Salerno, Baronissi, Salerno, Italy. 4. Gynecology and Obstetrics Unit, Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II, 80131, Naples, Italy. 5. Pathology Unit, Department of Woman and Child Health, Agostino Gemelli University Polyclinic, Catholic University of the Sacred Heart, Rome, Italy.
Abstract
BACKGROUND: International Federation of Gynecology and Obstetrics (FIGO) grade is a crucial factor in the current system for the risk stratification of endometrial endometrioid carcinoma (EC). The Cancer Genome Atlas (TCGA) demonstrated four molecular prognostic subgroups for EC: POLE (good prognosis), microsatellite-instable (MSI, intermediate prognosis), copy-number-high (CNH, poor prognosis), and copy-number-low (CNL, variable prognosis). OBJECTIVE: To assess how the prevalence of the TCGA molecular subgroups changes from low-grade (G1-2) to high-grade (G3) EC, to understand how it may affect the current risk-assessment system. METHODS: A systematic review and meta-analysis was carried out by searching seven electronic databases from January 2013 to September 2019 for studies assessing the TCGA classification G1-2 and G3 EC. Pooled prevalence of the TCGA subgroups was calculated in EC. The association of each subgroup with grade was assessed using odds ratio (OR), with a significant p value < 0.05. RESULTS: Nine studies with 3185 patients were included. G3 EC showed significantly higher prevalence of the POLE subgroup (12.1% vs 6.2%; OR = 2.13; p = 0.0001), of the MSI subgroup (39.7% vs 24.7%; OR = 2.15; p = 0.0003) and of the CNH subgroup (21.3% vs 4.7%; OR = 5.25; p < 0.00001), and significantly lower prevalence of the CNL subgroup (28% vs 63.5%; OR = 0.2; p < 0.00001) than G1-2 EC. CONCLUSION: The prevalence of the TCGA subgroups is not in accordance with the prognostic value of FIGO grade, indicating that the current risk stratification of EC will be heavily affected by molecular signature.
BACKGROUND: International Federation of Gynecology and Obstetrics (FIGO) grade is a crucial factor in the current system for the risk stratification of endometrial endometrioid carcinoma (EC). The Cancer Genome Atlas (TCGA) demonstrated four molecular prognostic subgroups for EC: POLE (good prognosis), microsatellite-instable (MSI, intermediate prognosis), copy-number-high (CNH, poor prognosis), and copy-number-low (CNL, variable prognosis). OBJECTIVE: To assess how the prevalence of the TCGA molecular subgroups changes from low-grade (G1-2) to high-grade (G3) EC, to understand how it may affect the current risk-assessment system. METHODS: A systematic review and meta-analysis was carried out by searching seven electronic databases from January 2013 to September 2019 for studies assessing the TCGA classification G1-2 and G3 EC. Pooled prevalence of the TCGA subgroups was calculated in EC. The association of each subgroup with grade was assessed using odds ratio (OR), with a significant p value < 0.05. RESULTS: Nine studies with 3185 patients were included. G3 EC showed significantly higher prevalence of the POLE subgroup (12.1% vs 6.2%; OR = 2.13; p = 0.0001), of the MSI subgroup (39.7% vs 24.7%; OR = 2.15; p = 0.0003) and of the CNH subgroup (21.3% vs 4.7%; OR = 5.25; p < 0.00001), and significantly lower prevalence of the CNL subgroup (28% vs 63.5%; OR = 0.2; p < 0.00001) than G1-2 EC. CONCLUSION: The prevalence of the TCGA subgroups is not in accordance with the prognostic value of FIGO grade, indicating that the current risk stratification of EC will be heavily affected by molecular signature.
Authors: Antonio Travaglino; Antonio Raffone; Diego Raimondo; Damiano Arciuolo; Giuseppe Angelico; Michele Valente; Giulia Scaglione; Nicoletta D'alessandris; Paolo Casadio; Frediano Inzani; Antonio Mollo; Angela Santoro; Renato Seracchioli; Gian Franco Zannoni Journal: Int J Gynaecol Obstet Date: 2021-10-11 Impact factor: 4.447
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Authors: Vanessa M López-Ozuna; Liron Kogan; Mahmood Y Hachim; Emad Matanes; Ibrahim Y Hachim; Cristina Mitric; Lauren Liu Chen Kiow; Susie Lau; Shannon Salvador; Amber Yasmeen; Walter H Gotlieb Journal: Front Oncol Date: 2021-07-07 Impact factor: 6.244
Authors: Diego Raimondo; Antonio Raffone; Antonio Travaglino; Manuela Maletta; Paolo Casadio; Marco Ambrosio; Anna Chiara Aru; Angela Santoro; Gian Franco Zannoni; Luigi Insabato; Antonio Mollo; Fulvio Zullo; Renato Seracchioli Journal: Int J Gynaecol Obstet Date: 2021-07-18 Impact factor: 4.447
Authors: Antonio Raffone; Diego Raimondo; Antonio Travaglino; Giulia Rovero; Manuela Maletta; Ivano Raimondo; Marco Petrillo; Giampiero Capobianco; Paolo Casadio; Renato Seracchioli; Antonio Mollo Journal: Int J Environ Res Public Health Date: 2022-03-21 Impact factor: 3.390
Authors: Antonio Raffone; Antonio Travaglino; Diego Raimondo; Dominga Boccia; Martino Vetrella; Paolo Verrazzo; Marcello Granata; Paolo Casadio; Luigi Insabato; Antonio Mollo; Renato Seracchioli Journal: Int J Gynaecol Obstet Date: 2021-06-19 Impact factor: 4.447