TY - JOUR
T1 - Mismatch repair status and clinical outcome in endometrial cancer
T2 - A systematic review and meta-analysis
AU - Diaz-Padilla, Ivan
AU - Romero, Nuria
AU - Amir, Eitan
AU - Matias-Guiu, Xavier
AU - Vilar, Eduardo
AU - Muggia, Franco
AU - Garcia-Donas, Jesus
N1 - Funding Information:
I.D.-P. is supported by: “Programa de Formacion Avanzada en Oncologia” of the Asociación Española Contra el Cáncer (AECC); and by the 2nd “Jan B. Vermorken” Research Grant in Gynecological Cancer, provided by the Grupo Español de Investigación en Cáncer de Ovario (GEICO).
Funding Information:
E.V. is supported by the Conquer Cancer Foundation of the American Society of Clinical Oncology (Young Investigator Award to E. Vilar).
PY - 2013/10
Y1 - 2013/10
N2 - Background: The association between the deficiency in mismatch repair (MMR) genes and prognosis in women with endometrial cancer is unclear. Here we report a systematic review and meta-analysis exploring this association. Methods: We searched literature databases (MEDLINE, EMBASE, and Cochrane) from 1980 until December 2011 to identify studies evaluating the association between MMR status and clinical outcome in endometrial cancer. The main outcome measures were overall survival (OS) and disease-free survival (DFS). Results: Twenty-three studies met the inclusion criteria. The median sample size of studies was 112, 74% were retrospective case-series and 70% performed microsatellite instability (MSI) analysis to evaluate the status of MMR. Only 22% of studies used the panel of five microsatellite markers recommended by the National Cancer Institute. Seven studies used immunohistochemistry to define MMR deficiency, but only two of them determined the expression of all four MMR proteins. Overall, significant associations between MMR and outcome were observed in 32% of studies. There was marked inter-study heterogeneity for estimates of OS and DFS. Pooled analysis did not show any significant association between deficiency in MMR and worse OS (6 studies, hazard ratio [HR] 2.0, p=0.11) or DFS (4 studies, HR ratio 1.31, p=0.66). Conclusion: There is no definitive evidence of a significant association between MMR status and detrimental survival in endometrial cancer.
AB - Background: The association between the deficiency in mismatch repair (MMR) genes and prognosis in women with endometrial cancer is unclear. Here we report a systematic review and meta-analysis exploring this association. Methods: We searched literature databases (MEDLINE, EMBASE, and Cochrane) from 1980 until December 2011 to identify studies evaluating the association between MMR status and clinical outcome in endometrial cancer. The main outcome measures were overall survival (OS) and disease-free survival (DFS). Results: Twenty-three studies met the inclusion criteria. The median sample size of studies was 112, 74% were retrospective case-series and 70% performed microsatellite instability (MSI) analysis to evaluate the status of MMR. Only 22% of studies used the panel of five microsatellite markers recommended by the National Cancer Institute. Seven studies used immunohistochemistry to define MMR deficiency, but only two of them determined the expression of all four MMR proteins. Overall, significant associations between MMR and outcome were observed in 32% of studies. There was marked inter-study heterogeneity for estimates of OS and DFS. Pooled analysis did not show any significant association between deficiency in MMR and worse OS (6 studies, hazard ratio [HR] 2.0, p=0.11) or DFS (4 studies, HR ratio 1.31, p=0.66). Conclusion: There is no definitive evidence of a significant association between MMR status and detrimental survival in endometrial cancer.
KW - Endometrial cancer
KW - Microsatellite instability
KW - Mismatch repair
KW - Prognosis
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U2 - 10.1016/j.critrevonc.2013.03.002
DO - 10.1016/j.critrevonc.2013.03.002
M3 - Review article
C2 - 23562498
AN - SCOPUS:84884161920
SN - 1040-8428
VL - 88
SP - 154
EP - 167
JO - Critical Reviews in Oncology/Hematology
JF - Critical Reviews in Oncology/Hematology
IS - 1
ER -