Escola Superior de Saúde
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Browsing Escola Superior de Saúde by Author "Abu-Rustum, Nadeem"
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- Prognosis of polymerase epsilon (POLE) mutation in high-grade endometrioid endometrial cancer: Systematic review and meta-analysisPublication . Casanova, Joao; Duarte, Gonçalo Silva; da Costa, Ana Gomes; Catarino, Ana; Nave, Mónica; Antunes, Telma; Serra, Sofia Silvério; Dias, Sara Simões; Abu-Rustum, Nadeem; Lima, JorgeBackground. POLE mutated endometrial carcinomas may represent a subspecific type of tumors harboring a more favorable prognosis. Grade 3 (G3 or high-grade) endometrioid endometrial carcinomas remain a clinical dilemma, with some tumors behaving as the low-grade counterparts and others presenting a more aggressive behavior. Objectives. To determine the association between POLE mutational status and the overall-survival (OS) and progression-free-survival (PFS) of patients with G3endometrioidendometrial cancer(EC). Wealsoaimed todetermine the prevalence of POLE mutations in G3 endometrioid EC. Methods. We conducted a systematic review in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines (PROSPERO No: CRD4202340008). We searched the following electronic databases: PubMed/Medline, EMBASE, Cochrane Library, Scopus, and Webof Science. For time-to-event data, the effect of POLE mutation in G3 EC was described using hazard ratios (HRs) and corresponding 95% confidence intervals (CIs). Individual patient data for each study was investigated if available from the study authors. If individual patient data were not available, information regarding time-to-event outcomes was extracted usinganappropriatemethodology.OSandPFSwereanalyzed using both one-stage and two-stage approaches, the Kaplan-Meier method, and Cox-proportional hazards models. Results. This systematicreviewandmeta-analysisincluded19studieswith3092patientswhohadhighgrade endometrioid EC. Patients with POLE mutations had lower risks of death (HR = 0.36, 95% CI 0.26 to 0.50, I2 = 0%, 10 trials) and disease progression (HR = 0.31, 95% CI 0.17 to 0.57, I2 =33%,10trials).The pooled prevalence of POLE mutation was 11% (95% CI 9 to 13, I2 = 68%, 18 studies).