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TCGA Classification of Endometrial Cancer: the Place of Carcinosarcoma

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  • Published:
Pathology & Oncology Research

Abstract

In 2013, The Cancer Genome Atlas (TCGA) Research Network found four novel prognostic subgroups of endometrial carcinoma: POLE/ultramutated (POLE), microsatellite-instable/hypermutated (MSI), copy-number-low/TP53-wild-type (CNL), and copy-number-highTP53-mutant (CNH). However, poor is known regarding uncommon histotypes of endometrial cancer. We aimed to assess the genetic profile of uterine carcinosarcoma (UCS) on the light of these findings. A systematic review and meta-analysis was performed through electronic databases searching (up to July 2019). All studies assessing UCS series for the TCGA classification were included. For each TCGA subgroup, pooled prevalence on the total UCS number was calculated. Four studies with 231 patients were included. Pooled prevalence of the TCGA subgroups were: 5.3% for the POLE subgroup, 7.3% for the MSI subgroup, 73.9% for the CNH subgroup, 13.5% for the CNL subgroup. The CNH subgroup predominates in UCS, while subgroups with high mutational load (POLE and MSI) are less common. UCS appears as a preferential evolution of CNH carcinomas.

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Authors and Affiliations

  1. Anatomic Pathology Unit, Department of Advanced Biomedical Sciences, School of Medicine, University of Naples Federico II, Naples, Italy

    Antonio Travaglino, Annarita Gencarelli & Luigi Insabato

  2. Gynecology and Obstetrics Unit, Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II, Via Sergio Pansini, 5, 80131, Naples, Italy

    Antonio Raffone, Antonio Mollo, Maurizio Guida & Fulvio Zullo

  3. Pathology Unit, Department of Woman and Child Health, Agostino Gemelli University Polyclinic, Catholic University of the Sacred Heart, Rome, Italy

    Angela Santoro & Gian Franco Zannoni

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  1. Antonio Travaglino
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Contributions

AT, AR and AM independently assessed electronic search, eligibility of the studies, inclusion criteria, risk of bias, data extraction and data analysis. Disagreements were resolved by discussion with other authors (AG, MG, LI, AS, GFZ, FZ). MG, AM and LI contributed to the elaboration of methods for risk of bias assessment, data extraction and analysis. AT, AR and FZ conceived the study; AG, MG, LI and FZ worked on the design of the study; AT, AR, AG, AM, LI, GFZ and FZ worked on the manuscript preparation; LI, GFZ and FZ supervised the whole study.

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Correspondence to Antonio Raffone.

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ESM 1

Flow diagram of studies identified in the systematic review (Prisma template [Preferred Reporting Item for Systematic Reviews and Meta-analyses]). (PNG 26 kb)

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Summary of risk of bias for each study. (PNG 7 kb)

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Travaglino, A., Raffone, A., Gencarelli, A. et al. TCGA Classification of Endometrial Cancer: the Place of Carcinosarcoma. Pathol. Oncol. Res. 26, 2067–2073 (2020). https://doi.org/10.1007/s12253-020-00829-9

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