Abstract
We aimed to classify undifferentiated/dedifferentiated carcinoma (UDC/DDC) according to the four TCGA molecular subgroups of endometrial cancer: microsatellite-instable/hypermutated (MSI), POLE-mutant/ultramutated (POLE), copy-number-low/p53-wild-type (p53wt), and copy-number-high/p53-abnormal (p53abn), through a systematic review and meta-analysis. Electronic databases were searched from January 2013 to July 2019 for studies assessing the TCGA classification in endometrial UDC/DDC series. Pooled prevalence of each TCGA subgroup on the total UDC/DDCs was calculated. Three studies with 73 patients were included. Pooled prevalence of the TCGA subgroups were: 12.4% for the POLE subgroup, 44% for the MSI subgroup, 18.6% for the p53abn subgroup, 25% for the p53wt group. All TCGA groups are represented in UDC/DDC, with a predominance of the MSI group, indicating a biological heterogeneity. Hypermutated/ultramutated cancers constitute the majority of UDC/DDC, suggesting a crucial difference with other high-risk histologies of endometrial carcinoma.
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AT, AR and MG independently assessed electronic search, eligibility of the studies, inclusion criteria, risk of bias, data extraction and data analysis. Disagreements were resolved by discussion with MM, LI, GFZ and FZ. MG, MM and LI contributed to the elaboration of methods for risk of bias assessment, data extraction and analysis. AT, AR and FZ conceived the study; MM, MG, LI and FZ worked on the design of the study; AT, AR, MG, MM, LI, GFZ and FZ worked on the manuscript preparation; GFZ and FZ supervised the whole study.
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ESM 1
Molecular/immunohistochemical features and TCGA subgroup assigned for each patient in the included studies. (DOCX 21 kb)
ESM 2
Flow diagram of studies identified in the systematic review (Prisma template [Preferred Reporting Item for Systematic Reviews and Meta-analyses]). (PNG 68 kb)
ESM 3
Summary of risk of bias for each study; Plus sign: low risk of bias; minus sign: high risk of bias; question mark: unclear risk of bias. (PNG 31 kb)
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Travaglino, A., Raffone, A., Mascolo, M. et al. TCGA Molecular Subgroups in Endometrial Undifferentiated/Dedifferentiated Carcinoma. Pathol. Oncol. Res. 26, 1411–1416 (2020). https://doi.org/10.1007/s12253-019-00784-0
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DOI: https://doi.org/10.1007/s12253-019-00784-0