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Prognosis of polymerase epsilon (POLE) mutation in high-grade endometrioid endometrial cancer: Systematic review and meta-analysis
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Advisor(s)
Abstract(s)
Background. 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).
Description
Supplementary data to this article can be found online at https://doi.org/10.1016/j.ygyno.2024.01.018.
Funding: This work in the context of the “Women's Health and Maternal Fetal Research Group” was partially co-financed by Hospital da Luz Lisboa under the initiative “Luz Investigação”. Dr. Abu-Rustum was supported in part by a National Cancer Institute/National Institutes of Health Cancer Center Support Grant (P30 CA008748). The funding sources were not involved in study design; collection, analysis and interpretation of data; the writing of the report; or the decision to submit the paper for publication.
Funding: This work in the context of the “Women's Health and Maternal Fetal Research Group” was partially co-financed by Hospital da Luz Lisboa under the initiative “Luz Investigação”. Dr. Abu-Rustum was supported in part by a National Cancer Institute/National Institutes of Health Cancer Center Support Grant (P30 CA008748). The funding sources were not involved in study design; collection, analysis and interpretation of data; the writing of the report; or the decision to submit the paper for publication.
Keywords
Endometrial cancer Endometrioid High-grade Meta-analysis POLE Prognosis Systematic review
Citation
Casanova, J., Duarte, G. S., da Costa, A. G., Catarino, A., Nave, M., Antunes, T., Serra, S. S., Dias, S. S., Abu-Rustum, N., & Lima, J. (2024). Prognosis of polymerase epsilon (POLE) mutation in high-grade endometrioid endometrial cancer: Systematic review and meta-analysis. Gynecologic Oncology, 182, 99–107. https://doi.org/10.1016/j.ygyno.2024.01.018
Publisher
Elsevier