Introduction/Background The lymph node status (LNS) according to molecular classification (MC) in endometrial cancer is heterogenous and underreported. Thus, the role of MC to tailor pre-operatively surgical treatment remains unclear. We aimed to analyze LN metastasis (LNM) and histopathological features of the four MC groups.
Methodology Original articles including LN status according to MC with Leuven algorithm following the recommendations of ESGO-ESTRO-ESP guidelines were included in this systematic review and meta-analysis. Articles reporting MC following ProMise algorithm were excluded, except those in which information about tumors encompassing more than one mutation was available. Number of cases were extracted to calculate proportion and their 95%CI. Summary proportion estimates were obtained using Dersimonian-Lair random-effects meta-analysis. Statistical heterogeneity was assessed through Cochran’s Q-test and I2 statistic.
Results 5122 records were identified by combining ‘EC’, ‘MC’, ‘TCGA’, ‘p53’, ‘POLE’, ‘MSI’, ‘NSMP’. 16 studies with 4294 patients were included (figure 1): 260 (6.9%) POLE-mutated, 831 (31.9%) MSI, 795 (25.2%) p53-abnormal and 1127 (35.7%) non-specific-molecular-profile (NSMP). LN involvement was present in 6% of POLE-mut (I2=0%), 15% of MSI (I2=87%), 26% of p53-abnormal (I2=82.9%), and 9% of NSMP (I2=76.2%). Five articles reported 0% of LNM in POLE-mutated and had been excluded of the pooled-prevalence-calculation due to statistic incongruency. Grade3 tumors were found in 42% of POLE-mut (I2=80.6%), 32% of MSI (I2=95.6%), 66% of P53-abnormal (I2=99.4%), and 11% of NSMP (I2=80.1%). Lymphovascular-invasion was present in 33% of POLE-mutated (I2=84.2%), 40% of MSI (I2=89.7%), 48% of p53-abnormal (I2=91%), and 27% of NSMP (I2=94%). Deep myometrial invasion was present in 31% (I2=0%) of POLE-mutated, 32% of MSI (I2=77.4%), 37% of p53-abnormal (I2=93.7%), and 27% of NSMP (I2=93.2%).
Conclusion P53-abnormal presented the highest LNM rate, followed by MSI tumors, in contrast to POLE-mutated and NSMP cohort.
Statistics from Altmetric.com
If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.