Meta-analysis of the ability of mutational profiles on the cancer genome atlas to predict prognosis in endometrial carcinoma.

BACKGROUND

In 2013, The Cancer Genome Atlas Research Network suggested that endometrial carcinoma patients may be reclassified into four molecular prognostic groups.

OBJECTIVE

To compare survival of endometrial carcinoma patients with different mutational profiles.

SEARCH STRATEGY

Studies reporting survival of endometrial carcinoma patients were identified through systematic searches of four databases.

SELECTION CRITERIA

We included relevant studies based on the literature type, data integrity and the methodological quality.

DATA COLLECTION AND ANALYSIS

The pooled survival data were compared among patients with different mutational profiles. Heterogeneity in the pooled data was assessed using the I statistic.

MAIN RESULTS

Data were meta-analyzed from nine studies involving 4755 patients, who were classified into the following mutational profiles: p53abn, 745 patients (15.6%); MMRd, 1454 patients (30.6%); POLEmut, 351 patients (7.4%); and p53wt, 2205 patients (46.4%). Compared to the p53wt group, the p53abn group showed significantly worse overall survival (OS) (HR 2.31, 95% CI: 1.67-3.19), progression-free survival (PFS) (HR 2.86, 95% CI: 1.45-5.64) and disease-specific survival (HR 2.60, 95% CI: 1.41-4.79); and the MMRd group showed significantly worse OS (HR 1.30, 95% CI: 1.11-1.53) and PFS (HR 1.27, 95% CI: 1.01-1.59). The POLEmut group, in contrast, showed similar survival as the p53wt group.

CONCLUSIONS

The four mutational profiles for patients with endometrial carcinoma in the Cancer Genome Atlas for Endometrial Cancer are associated with worse to better survival in the trend: p53abn < MMRd < POLEmut ≈ p53wt. Mutational profiling may be useful for stratifying endometrial carcinoma patients by survival risk, which in turn may improve their management.