Author(s): Casanova, João ; Ramos, Ana Sofia ; Babiciu, Alexandru ; Moutinho, Filipa ; Tripepi, Marta ; da Costa, Ana Gomes ; Serra, Sofia Silvério ; Costa, Teresa ; Abu-Rustum, Nadeem R ; Martins, João ; Lima, Jorge
Date: 2025
Persistent ID: http://hdl.handle.net/10362/191196
Origin: Repositório Institucional da UNL
Subject(s): SDG 3 - Good Health and Well-being
Copyright © 2025 The Author(s). Published by Elsevier B.V. All rights reserved.
BACKGROUND: Endometrial cancer of no specific molecular profile (NSMP) represents the most prevalent molecular subtype of endometrial cancer, comprising over 50 % of all diagnoses. Although studies have explored the prevalence of the NSMP subtype, to our knowledge, no systematic review or meta-analysis has specifically targeted grade 3 (G3, high-grade) tumors. OBJECTIVES: We aimed to determine the prevalence of G3 endometrioid endometrial cancer of NSMP and assess regional variations in this prevalence. We also sought to synthesize available data concerning oncologic outcomes, including overall survival, progression-free survival, and disease-specific survival. METHODS: We conducted a systematic review following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines (PROSPERO No: CRD42024544247). We searched the electronic databases: PubMed/Medline, Scopus, Web of Science, Cochrane Library, and EMBASE. To estimate the overall prevalence of the NSMP subtype, we performed a meta-analysis using the proportions method with the Freeman-Tukey (arcsine) transformation. For estimating oncologic outcomes, we conducted a meta-analysis using hazard ratios (HRs) when available. In the absence of HRs, we utilized Kaplan-Meier curves. All pooled estimates and their corresponding 95% confidence intervals (CIs) were calculated using a random-effects model with the inverse variance method and restricted maximum likelihood estimator. RESULTS: We analyzed 31 studies, encompassing 2,660 patients. The pooled prevalence of NSMP within G3 endometrioid endometrial cancer was 0.29 (95 %CI: 0.23-0.34, I 2 = 80.8 %). This prevalence was highest in North America (0.43, 95 %CI: 0.17-0.71) and lowest in Europe (0.23, 95 %CI: 0.19-0.28). The random-effects pooled estimate indicated that the NSMP subtype was associated with intermediate oncologic outcomes compared to other molecular subtypes. CONCLUSION: The pooled prevalence of G3 endometrioid endometrial cancer of NSMP is 29 %. The oncologic outcomes for this molecular subtype seem intermediate, though further refinement and research are needed for a more precise understanding.
