Abstract
BackgroundThe aim of this study was to summarize the global predicting role of hormone receptors for survival in endometrial cancer.MethodsEligible studies were identified and assessed for quality through multiple search strategies. Data were collected from studies comparing overall survival (OS), cancer-specific survival (CSS), or progression-free survival (PFS) in patients with elevated levels of estrogen receptor (ER), progesterone receptor (PR), or human epidermal growth factor receptor 2 (HER2) with those in patients with lower levels. The combined hazard ratios of ER, PR, and HER2 for survival were calculated.ResultsA total of 98 studies were included for meta-analysis (44 for ER, 38 for PR, and 16 for HER2). Higher levels of either ER or PR could significantly indicate better survival. The pooled hazard ratios (HRs) of ER for OS, CSS, and PFS were 0.75 (95 % CI, 0.68–0.83), 0.45 (95 % CI, 0.33–0.62), and 0.66 (95 % CI, 0.52–0.85), respectively. The combined HRs of PR for OS, CSS, and PFS reached 0.63 (95 % CI, 0.56–0.71), 0.62 (95 % CI, 0.42–0.93), and 0.45 (95 % CI, 0.30–0.68), respectively. In contrast, elevated levels of HER2 could predict worse outcome with a HR of 1.98 (95 % CI, 1.49–2.62) for OS, and a HR of 2.26 (95 % CI, 1.57–3.25) for PFS.ConclusionsIn patients with endometrial cancer, higher level of ER and PR predicted favorable survival, and increased level of HER2 was associated with poorer survival. All of the three hormone receptors had prognostic value for survival.
Highlights
The aim of this study was to summarize the global predicting role of hormone receptors for survival in endometrial cancer
Of the 65 reports selected for detailed evaluation, 1 study was excluded for being duplicated; 20 others were excluded for lack of key data, such as hazard ratios (HRs)
Elevated levels of human epidermal growth factor receptor 2 (HER2) could predict worse outcome with a HR of 1.98 for overall survival (OS), and a HR of 2.26 for progression-free survival (PFS) (Fig. 2g, h). Such results indicated that in patients with Endometrial cancer (EC), higher level of estrogen receptors (ER) and progesterone receptors (PR) predicted favorable survival, and increased level of HER2 was associated with poorer survival
Summary
The aim of this study was to summarize the global predicting role of hormone receptors for survival in endometrial cancer. Hormone receptors are attractive because of their physiological functions. Through binding to their receptors, estrogen drives epithelial proliferation, and progesterone inhibits growth and causes cell differentiation. HER2 is a member of the human epidermal growth factor receptor tyrosine kinase family, which regulates many processes that can promote tumor cell proliferation and survival [11]. With the development of molecular biology and immunologic method, all of the three hormone receptors have been introduced to refine outcome prediction of female cancers, such as breast cancer, ovarian cancer, and endometrial cancer
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