Prognostic role of hormone receptors in endometrial cancer: a systematic review and meta-analysis

Research

Yanli Zhang^1?, Dong Zhao^1?, Changguo Gong^3?, Fengmei Zhang³, Jing He³, Wei Zhang³, Yulan Zhao^2* and Jing Sun^1*

• *
  Corresponding authors: Yulan Zhao [email protected] – Jing Sun [email protected]

• ? Equal contributors

Author Affiliations

¹ Department of Minimally Invasive Gynecologic Surgery, Shanghai First Maternity and Infant Hospital, Tongji University School of Medicine, Changle Road #536, Shanghai 200040, People¿s Republic of China

² School of Life Science, East China Normal University, North Zhongshan Road #3663, Shanghai, People¿s Republic of China

³ Institutes for Advanced Interdisciplinary Research, East China Normal University, Shanghai, People¿s Republic of China

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World Journal of Surgical Oncology 2015, 13:208 
doi:10.1186/s12957-015-0619-1

Yanli Zhang, Dong Zhao and Changguo Gong contributed equally to this work.

Published: 25 June 2015

Abstract (provisional)

Background The aim of this study was to summarize the global predicting role of hormone
receptors for survival in endometrial cancer. Methods Eligible 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. Results A 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. Conclusions In 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.