Prognostic value of the TCGA molecular classification in uterine carcinosarcoma. Issue 1 (11th October 2021)

• Record Type: Journal Article
• Authors: Travaglino, Antonio; Raffone, Antonio; Raimondo, Diego; Arciuolo, Damiano; Angelico, Giuseppe; Valente, Michele; Scaglione, Giulia; D'alessandris, Nicoletta; Casadio, Paolo; Inzani, Frediano; Mollo, Antonio; Santoro, Angela; Seracchioli, Renato; Franco Zannoni, Gian
• Is Part Of: International journal of gynaecology and obstetrics. Volume 158:Issue 1(2022)
• Page Start: 13
• Page End: 20
• Publication Date: 2021-10-11
• Subjects: cancer -- endoscopic surgery -- gyne‐oncology -- laparoscopy -- mortality; Gynecology -- Periodicals; Obstetrics -- Periodicals; Electronic journals; 618
• DOI: 10.1002/ijgo.13937
• Languages: English
• ISSNs: 0020-7292

Abstract

Abstract: Background: The TCGA molecular groups of endometrial carcinoma are "POLE‐mutated" (POLEmut), "microsatellite‐instable/mismatch repair‐deficient" (MSI/MMRd), "TP53‐mutated/p53‐abnormal" (TP53mut/p53abn), and "no specific molecular profile" (NSMP). Objective: Prognostic assessment of the TCGA groups in uterine carcinosarcoma (UCS). Search strategy: Systematic review from January 2000 to January 2021. Selection criteria: Studies assessing the TCGA groups in UCS. Data collection and analysis: Progression‐free survival (PFS) and overall survival (OS) were assessed by Kaplan–Meier and Cox analyses (reference: TP53mut/p53abn group) and compared with endometrioid and serous carcinomas (original TCGA cohort), with a significant P < 0.050. Main results: Five studies with 263 UCS were included. Compared with TP53mut/p53abn UCS, MSI/MMRd UCS showed significantly better PFS ( P < 0.001) but similar OS ( P = 0.788), whereas NSMP UCS showed similar PFS ( P = 0.936) and OS ( P = 0.240). Compared with their endometrioid/serous counterparts, NSMP and TP53mut/p53abn UCS showed significantly worse PFS ( P < 0.001 and P = 0.004) and OS ( P < 0.001 and P < 0.001), while MSI/MMRd UCS showed similar PFS ( P = 0.595) but significantly worse OS ( P < 0.001). The POLEmut group showed neither recurrences nor deaths in both the UCS and the endometrioid/serous carcinoma cohorts. Conclusion: POLEmut UCS show excellent prognosis, whereas TP53mut/p53abn and NSMP UCS show a prognosis even worse than that of TP53mut/p53abn endometrioid/serous carcinomas. The prognosis of MSI/MMRd UCS remains to be defined. Abstract : POLEmut UCS show the same excellent prognosis as POLEmut endometrioid carcinomas, while TP53mut/p53abn and NSMP UCS show a prognosis even worse than TP53mut/p53abn endometrioid/serous carcinomas.