Introduction: Recent studies suggested that microsatellite instability/mismatch repair deficiency (MSI/MMR-d) might define a clinicopathologically distinct subset of uterine carcinosarcomas (UCSs). Objective: The aim of this study was to compare clinicopathological features between MSI/MMR-d and microsatellite-stable/mismatch repair-proficient (MSS/MMR-p) UCSs. Methods: A quantitative systematic review was performed by searching electronic databases from January 2000 to January 2021. All studies assessing MSI/MMR status in UCS were included. Odds ratio (OR) with a significant two-tailed p value Results: Eleven studies with 783 patients were included. MSI/MMR-d was directly associated with endometrioid (pure: p < 0.001; pure + mixed: p < 0.001), undifferentiated/dedifferentiated (p < 0.001), and clear cell carcinoma component (p = 0.046), and inversely associated with age > 60 (p = 0.034), serous carcinoma component (pure: p < 0.001; pure + mixed: p < 0.001), heterologous sarcoma component (p = 0.027), TP53-mutation/p53-abnormal expression (p < 0.001), and recurrence (p < 0.001). MSI/MMR-d showed no significant association with advanced FIGO stage (OR = 1.259; p = 0.517), low-grade carcinoma component (pure: p = 0.596; pure + mixed: p = 0.307), mixed carcinoma component (p = 1), and proportion of patients "dead of disease " (p = 0.352), "alive with disease " (p = 1) or with "no evidence of disease " (p = 0.458). Conclusion: MSI/MMR-d UCSs show younger age, more common endometrioid, undifferentiated or clear cell carcinoma component, and less common serous carcinoma component, heterologous sarcoma component, and TP53 mutation than MSS/MMR-p UCSs. Given the discrepancy between recurrence rate and oncologic outcomes at the last follow-up, further studies are necessary to define whether MSI/MMR-d UCSs have better prognosis. (c) 2022 S. Karger AG, Basel

Clinicopathological Features Associated with Microsatellite Instability/Mismatch Repair Deficiency in Uterine Carcinosarcoma: A Quantitative Systematic Review / Travaglino, Antonio; Raffone, Antonio; Santoro, Angela; Raimondo, Diego; Orsini, Benedetta; Casadio, Paolo; Zullo, Fulvio; Seracchioli, Renato; Zannoni, Gian Franco; Insabato, Luigi; Mollo, Antonio. - In: PATHOBIOLOGY. - ISSN 1015-2008. - ELETTRONICO. - 89:4(2022), pp. 198-204. [10.1159/000521876]

Clinicopathological Features Associated with Microsatellite Instability/Mismatch Repair Deficiency in Uterine Carcinosarcoma: A Quantitative Systematic Review

Raffone, Antonio;Raimondo, Diego;Orsini, Benedetta;Casadio, Paolo;Seracchioli, Renato;
2022

Abstract

Introduction: Recent studies suggested that microsatellite instability/mismatch repair deficiency (MSI/MMR-d) might define a clinicopathologically distinct subset of uterine carcinosarcomas (UCSs). Objective: The aim of this study was to compare clinicopathological features between MSI/MMR-d and microsatellite-stable/mismatch repair-proficient (MSS/MMR-p) UCSs. Methods: A quantitative systematic review was performed by searching electronic databases from January 2000 to January 2021. All studies assessing MSI/MMR status in UCS were included. Odds ratio (OR) with a significant two-tailed p value Results: Eleven studies with 783 patients were included. MSI/MMR-d was directly associated with endometrioid (pure: p < 0.001; pure + mixed: p < 0.001), undifferentiated/dedifferentiated (p < 0.001), and clear cell carcinoma component (p = 0.046), and inversely associated with age > 60 (p = 0.034), serous carcinoma component (pure: p < 0.001; pure + mixed: p < 0.001), heterologous sarcoma component (p = 0.027), TP53-mutation/p53-abnormal expression (p < 0.001), and recurrence (p < 0.001). MSI/MMR-d showed no significant association with advanced FIGO stage (OR = 1.259; p = 0.517), low-grade carcinoma component (pure: p = 0.596; pure + mixed: p = 0.307), mixed carcinoma component (p = 1), and proportion of patients "dead of disease " (p = 0.352), "alive with disease " (p = 1) or with "no evidence of disease " (p = 0.458). Conclusion: MSI/MMR-d UCSs show younger age, more common endometrioid, undifferentiated or clear cell carcinoma component, and less common serous carcinoma component, heterologous sarcoma component, and TP53 mutation than MSS/MMR-p UCSs. Given the discrepancy between recurrence rate and oncologic outcomes at the last follow-up, further studies are necessary to define whether MSI/MMR-d UCSs have better prognosis. (c) 2022 S. Karger AG, Basel
2022
Clinicopathological Features Associated with Microsatellite Instability/Mismatch Repair Deficiency in Uterine Carcinosarcoma: A Quantitative Systematic Review / Travaglino, Antonio; Raffone, Antonio; Santoro, Angela; Raimondo, Diego; Orsini, Benedetta; Casadio, Paolo; Zullo, Fulvio; Seracchioli, Renato; Zannoni, Gian Franco; Insabato, Luigi; Mollo, Antonio. - In: PATHOBIOLOGY. - ISSN 1015-2008. - ELETTRONICO. - 89:4(2022), pp. 198-204. [10.1159/000521876]
Travaglino, Antonio; Raffone, Antonio; Santoro, Angela; Raimondo, Diego; Orsini, Benedetta; Casadio, Paolo; Zullo, Fulvio; Seracchioli, Renato; Zannoni, Gian Franco; Insabato, Luigi; Mollo, Antonio
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11585/907221
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