Researchers assessed FRα expression by immunohistochemistry and classified a tumor as having high expression when at least 25% of its cells showed moderate-to-strong membranous staining. This criterion identified high FRα expression in 29.8% of cases. High and low expression were not statistically associated with the clinicopathological variables examined in the study.

Progression-free survival was the outcome significantly associated with FRα status. In multivariable Cox regression analysis, high FRα expression remained independently associated with shorter progression-free survival after adjustment for the variables included in the model. The estimated hazard ratio was 3.91, with a 95% confidence interval of 1.54–9.94 and a p-value of 0.004.

The wide confidence interval indicates uncertainty around the magnitude of the estimated association. The analysis did not detect a statistically significant difference in overall survival between the FRα groups (p = 0.08). The reported evidence therefore supports an association between high FRα expression and progression-free survival, but it does not demonstrate an association with overall survival at the study’s conventional threshold for statistical significance.

The study also does not establish that FRα expression causes disease progression or that FRα-directed treatment improves clinical outcomes. These findings support further investigation of FRα as a potentially biologically relevant marker in endometrial serous carcinoma, including in molecularly characterized cohorts. The retrospective design, small sample of 47 patients and restricted scope to one histopathological cancer type limit the precision and broader applicability of the results.

Patients in the cohort all underwent hysterectomy and received systemic therapy, so the findings describe the prognostic association within that treatment setting rather than a test of targeted therapy.

Subject of Research: Association of folate receptor alpha expression with progression-free survival in endometrial serous carcinoma

Article Title: Prognostic significance of folate receptor alpha expression in endometrial serous carcinoma: implications for patient stratification and targeted therapy

Article References: Demir, T., Okur, S. N., Demir, A. R. A., Demirağ, G., & Kefeli, M. (2026). Prognostic significance of folate receptor alpha expression in endometrial serous carcinoma: implications for patient stratification and targeted therapy. BMC Cancer. https://doi.org/10.1186/s12885-026-16927-x

Image Credits: AI Generated

DOI: 10.1186/s12885-026-16927-x

Keywords: folate receptor alpha, endometrial serous carcinoma, progression-free survival, overall survival, immunohistochemistry, Cox regression, retrospective cohort, tumor biomarker, Prognostic, significance, folate, receptor