SynthesisPloS one2022
The clinicopathology and survival characteristics of patients with POLE proofreading mutations in endometrial carcinoma: A systematic review and meta-analysis.
Synthesis in PloS one, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers.
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15 citing papers in PubMed, 27 citations in OpenAlex.
- Adjuvant chemoradiotherapy versus radiotherapy alone in women with high-risk endometrial cancer (PORTEC-3): 10-year clinical outcomes and post-hoc analysis by molecular classification from a randomised phase 3 trial.The Lancet. Oncology · 2025Trial
- Molecular Testing in Primary Advanced or Recurrent Endometrial Cancer: A Cost-Effectiveness Analysis.JCO precision oncology · 2026Article
- Advances in Cancer Immunotherapy for Solid Tumors.Advanced science (Weinheim, Baden-Wurttemberg, Germany) · 2026Review
- Promising survival prospects and immunotherapy potential in polymerase epsilon-mutated endometrial cancer: a comprehensive systematic review and meta-analysis unveiling future therapeutic opportunities.Obstetrics & gynecology science · 2026Article
- Prognostic Impact of POLE Exonuclease-Domain Mutations in Endometrial Cancer: A Systematic Review and Meta-Analysis.Cancers · 2026Review
- Molecular classification of endometrial cancer in fertility-sparing-treatment: toward a personalized clinical approach.Frontiers in oncology · 2026Review
- Functions, interactions and prognostic role ofJournal of gynecologic oncology · 2025Article
- Clinicopathological and Molecular Characterization of Non-Endometrioid Endometrial Carcinoma.Journal of Cancer · 2025Article
- Review
- Analysis of Predictive Factors Associated with Unsuccessful Sentinel Lymph Node Mapping in Endometrial Carcinoma.Cancers · 2024Article
- Unsolved Issues in the Integrated Histo-Molecular Classification of Endometrial Carcinoma and Therapeutic Implications.Cancers · 2024Review
- Analysis of patients with endometrial carcinoma using the ProMise classifier: a pilot study from India.Archives of gynecology and obstetrics · 2024Article
- Article
- Molecular-based classification of endometrial carcinoma in Northern Thailand: impact on prognosis and potential for implementation in resource-limited settings.BMC women's health · 2023Article
- Sentinel lymph node biopsy in high-risk endometrial cancer: performance, outcomes, and future avenues.Obstetrics & gynecology science · 2022Article
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Authors and funding
4 authors at 3 institutions in 2 countries.
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No grant is acknowledged in the PubMed record.
Abstract
backgroundEndometrial carcinoma (EC) is classified into four distinct molecular subgroups. Patients with polymerase epsilon exonuclease domain mutated (POLE-EDM) tumors have the best prognosis of all. This meta-analysis consolidated the clinicopathology variations reported in the POLE-mutant subtype and survival parameters in patients with EC.
methodsThe following internet data bases were searched: PubMed, Web of science, Embase and Scimage directory. Data was extracted from eligible studies including sample size, number of positive POLE-mutant cases, EDM sequencing information, clinicopathologic, and survival data. Meta-analysis and a random-effects model produced pooled estimates of POLE prognostic parameters using 95% confidence intervals (CI), hazard ratios (HR), and odds ratios (OR).
resultsThe meta-analysis included 11 cohort studies comprising 5508 EC patients (442 POLE EDM tumors). Patients with POLE mutant EC were associated with improved disease specific survival (HR = 0.408, 95% CI: 0.306 to 0.543) and progression-free survival (HR = 0.231, 95% CI: 0.117 to 0.456). POLE-mutated tumors were mostly endometrioid histology (84.480%; 95% CI: 77.237 to 90.548), although not significantly more than wild type tumors (OR = 1.386; p = 0.073). The POLE mutant tumors significantly present (p<0.001) at Federation of International of Gynecologists and Obstetricians (FIGO) lower stages I-II (OR = 2.955, p<0.001) and highest grade III (OR = 1.717, P = 0.003). The tumors are significantly associated with invasion less than half (<50%) of the myometrium (OR = 1.765, p = 0.001), but not deeply invasive EC (MI>50%, OR = 0.83, p = 0.34). POLE mutations significantly protected against lymph node metastases (OR = 0.202, p = 0.001), and have no clear association with lymph-vascular space invasion (OR = 0.967, 95% 0.713-1.310, p = 0.826). The tumors are predominantly of low ESMO risk stratification distribution (40.356%; 95% CI: 27.577 to 53.838).
conclusionsPOLE mutations serve as an important biomarker of favorable prognosis in EC. The tumors are characteristically high grade, early stage, and remain localized in the endometrium with reduced likelihood of lymph node metastasis for improved survival prospects and the lowest risk classification. These findings have implications for medical management of EC.
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