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Meta-Analysis
. 2020 Feb;99(8):e19281.
doi: 10.1097/MD.0000000000019281.

Clinicopathological characteristics and prognostic value of POLE mutations in endometrial cancer: A systematic review and meta-analysis

Ya He  1   2 , Tian Wang  2 , Na Li  2 , Binkai Yang  1   2 , Yuanjing Hu  2
Affiliations
Meta-Analysis

Clinicopathological characteristics and prognostic value of POLE mutations in endometrial cancer: A systematic review and meta-analysis

Ya He et al. Medicine (Baltimore). 2020 Feb.

Abstract

Background: The aim of this meta-analysis was to assess the clinicopathological features and to confirm prognostic value of POLE exonuclease domain mutations (EDM) in endometrial carcinoma patients.

Methods: The PubMed, Web of Science, the data of China National Knowledge Infrastructure, and Wan fang Medical Network were systematically searched for relevant articles without a cut-off date. The keywords for the search were "endometrial cancer," "endometrial carcinoma," "EC," "POLE mutations," "POLE exonuclease domain mutations," "POLE-mutant," "clinical characteristics" "prognostic." Pooled hazard ratios (HRs) and odds ratios (ORs) with 95% confidence intervals (CIs) were calculated by using Review manager 5.3 and Stata 14.0 statistical software.

Results: Six cohort studies assessing 179 EC patients with POLE EDMs were included. The results indicated a favorable progression-free survival in POLE-mutant patients (HR = 0.32; 95% CI: = [0.09-1.18]). Furthermore, the overall survival was great in patients with POLE-mutant (HR = 0.68; 95% CI = [0.41-1.13]). It was shown that a significantly higher incidence of POLE mutations with Federation of International of Gynecologists and Obstetricians (FIGO) I group compared to FIGO II-IV group (pooled ORs: 0.34, 95% CI: [0.12-0.94], P = .04), POLE-mutant EC was not significantly associated with histology (OR = 0.56,95% CI: 0.29-1.23), tumor grade (OR = 1.22,95% CI:0.85-1.74), lymph-vascular space invasion (OR = 0.40,95% 0.06-2.42), depth of myometrial invasion (OR = 0.70,95% CI: 0.41-1.18), lymph node status (OR = 0.41, 95% 0.04-4.50), and European Society for Medical Oncology risk groups (OR = 0.68,95% CI: 0.37-1.26).

Conclusion: This meta-analysis has confirmed POLE EDMs may serve as a predictive biomarker of favorable prognosis. Further studies are needed to explore the appropriate clinical utility of POLE EDMs in EC.

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Conflict of interest statement

The authors have no conflicts of interest to disclose.

Figures

Figure 1
Figure 1
Flowchart showing the literature search and selection process.
Figure 2
Figure 2
Forest plot of HR for the relationship between POLE mutations and OS. HR = hazard ratios, OR= odds ratios.
Figure 3
Figure 3
Forest plot of HR for relationship between POLE mutations and PFS. HR = hazard ratios, PFS = progression-free survival.
Figure 4
Figure 4
Histology type in POLE-mutant endometrial cancer.
Figure 5
Figure 5
Tumor grade in POLE-mutant endometrial cancer.
Figure 6
Figure 6
FIGO stage in POLE-mutant endometrial cancer.
Figure 7
Figure 7
LVSI in POLE-mutant endometrial cancer. LVSI = lymph-vascular space invasion.
Figure 8
Figure 8
Myometrial invasion in POLE-mutant endometrial cancer.
Figure 9
Figure 9
Lymph node status in POLE-mutant endometrial cancer.
Figure 10
Figure 10
ESMO risk stratification in POLE-mutant endometrial cancer. ESMO = European Society for Medical Oncology.
Figure 11
Figure 11
Quality assessment.
See this image and copyright information in PMC

References

    1. Siegel RL, Miller KD, Jemal A. Cancer statistics, 2018. CA Cancer J Clin 2018;68:7–30. - PubMed
    1. McConechy MK, Talhouk A, Leung S, et al. Endometrial carcinomas with POLE exonuclease domain mutations have a favorable prognosis. Clin Cancer Res 2016;22:2865–73. - PubMed
    1. Gilks CB, Oliva E, Soslow RA. Poor interobserver reproducibility in the diagnosis of high-grade endometrial carcinoma. Am J Surg Pathol 2013;37:874–81. - PubMed
    1. Werner HM, Trovik J, Marcickiewicz J, et al. A discordant histological risk classification in preoperative and operative biopsy in endometrial cancer is reflected in metastatic risk and prognosis. Eur J Cancer 2013;49:625–32. - PubMed
    1. Kandoth C, Schultz N, Cherniack AD, et al. Integrated genomic characterization of endometrial carcinoma. Nature 2013;497:67–73. - PMC - PubMed