The prognostic value of hypoxia-inducible factor-1α in advanced cancer survivors: a meta-analysis with trial sequential analysis

Background: Expression of hypoxia-inducible factors (HIFs) has been observed, but their prognostic role in advanced cancers remains uncertain. We conducted a meta-analysis to establish the prognostic effect of HIFs and to better guide treatment planning for advanced cancers. Methods: Pooled hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated. Trial sequential analysis (TSA) was also performed. The clinical outcomes included overall survival (OS), disease-free survival (DFS), progression-free survival (PFS), cancer-specific survival (CSS), relapse/recurrence-free survival (RFS), and metastasis-free survival (MFS) in patients with advanced tumors according to multivariate analysis. Results: A total of 31 studies including 3453 cases who received chemotherapy, radiotherapy, or chemoradiotherapy were identified. Pooled analyses revealed that HIF-1α expression was correlated with worse OS (HR = 1.61, p < 0.001), DFS (HR = 1.61, p < 0.001), PFS (HR = 1.49, p = 0.01), CSS (HR = 1.65, p = 0.056), RFS (HR = 2.10, p = 0.015), or MFS (HR = 2.36, p = 0.002) in advanced cancers. HIF-1α expression was linked to shorter OS in the digestive tract, epithelial ovarian, breast, non-small cell lung, and clear cell renal cell carcinomas. Subgroup analysis by study region showed that HIF-1α expression was correlated with poor OS in Europeans and Asians, while an analysis by histologic subtypes found that HIF-1α expression was not associated with OS in squamous cell carcinoma. No relationship was found between HIF-2α expression and OS, DFS, PFS, or CSS. Conclusions: Targeting HIF-1α may be a useful therapeutic approach to improve survival for advanced cancer patients. Based on TSA, more randomized controlled trials are strongly suggested.

Download Full-text

The Prognostic Roles and Clinical Features of CD44v9 in Human Solid Cancers—A Meta-Analysis

10.21203/rs.3.rs-54020/v1 ◽

2020 ◽

Author(s):

Yuanxiu Deng ◽

Jie Wang ◽

Shenhui Ji ◽

Lu Huang ◽

Meijiang Feng

Keyword(s):

Clinical Features ◽

Meta Analysis ◽

Prognostic Significance ◽

Disease Free Survival ◽

Progression Free Survival ◽

High Expression ◽

Cochrane Library ◽

Cancer Specific Survival ◽

Free Survival ◽

Diagnosis And Prognosis

Abstract Background: CD44 is the primary receptor for hyaluronic acid and serves as a marker for cancer stem cells. CD44v9 is one of CD44’s variants and takes part in cancer’s growth and metastasis. However, the prognostic roles and clinical features of CD44v9 in cancers remain unclear. Therefore, we conducted this meta-analysis to summarize the prognostic significance and clinical features of CD44v9 in human solid cancers.Methods: we systematically searched all of related studies in PubMed, the Web of Science, Embase and Cochrane library up to June 2020. We analyzed the pooled hazard ratios (HRs) and odds ratios (ORs) with corresponding 95% confidence intervals (CIs) to assess the prognostic functions and clinical features of CD44v9 in various human solid cancers.Results: In this meta-analysis, we included 1705 cancer patients among 12 studies. Results indicated that high expression of CD44v9 was significantly related to poorer overall survival (OS) (HR=1.60, 95%CI 1.28-1.99, P<0.0001), recurrence-free survival/progression-free survival/disease-free survival (RFS/PFS/DFS).( HR=1.81, 95%CI 1.16-2.84, P=0.009) and disease-specific survival/cancer-specific survival (DSS/CSS) (HR=2.93, 95%CI 1.69-5.10, P<0.001). At the same time, we also found that high expression of CD44v9 increased the possibility of lymphoid infiltrates (OR=1.59, 95%CI 1.16-2.20, P=0.005), vascular invasion (OR=1.57, 95%CI 1.11-2.22, P=0.010) and higher TNM stage (OR=1.63, 95%CI 1.19-2.23, P=0.002).Conclusion: Our results demonstrate that CD44v9 overexpression is associated with worse OS, RFS/PFS/CFS and DSS/CSS in patients with solid cancers, which might be a biomarker in the diagnosis and prognosis of cancers in the future.

Download Full-text

Prognostic Impact of Tumor Length in Esophageal Cancer: A Systematic Review and Meta-analysis

10.21203/rs.3.rs-38181/v2 ◽

2020 ◽

Author(s):

Zhao Yang Wang ◽

Yuanzhu Jiang ◽

Wen Xiao ◽

Xianbiao Xue ◽

Xiangwei Zhang ◽

...

Keyword(s):

Overall Survival ◽

Meta Analysis ◽

Disease Free Survival ◽

Progression Free Survival ◽

Disease Specific Survival ◽

Cancer Specific Survival ◽

Free Survival ◽

Tumor Length ◽

Disease Free ◽

Disease Specific

Abstract Background: In clinical work, it has been increasingly found that the prognosis is still very different even for esophageal cancer (EC) patients with the same TNM stage. Tumor length has been analysed as a possible independent prognostic factor in many studies, but no unanimous conclusion has been reached. Therefore, this review used a meta-analysis to evaluate the association between tumor length and prognosis in EC patients.Methods: A systematic search for relevant articles was performed in PubMed, Web of Science, and Embase. Hazard ratios (HRs) and 95% conﬁdence intervals (CIs) were used as effective measures to estimate the correlation between tumor length and prognosis, including overall survival, disease-free survival, progression-free survival, disease-specific survival, and cancer-speciﬁc survival. STATA 15.0 software was used to perform the meta-analysis and the data synthesis.Results: Finally, 41 articles with 28,973 patients were included in our study. The comprehensive statistical results showed that long tumors are an independent prognostic parameter associated with poor overall survival (OS) (HR=1.30; 95% CI: 1.21-1.40, p<.001) and disease-free survival (DFS) (HR=1.38; 95% CI: 1.18-1.61, p<.001) in EC patients. Subgroup analyses also suggested a significant correlation between long tumors and poor OS. Sensitivity analysis and publication bias evaluation confirmed the reliability and stability of the results. Similar results were obtained in the analyses of progression-free survival (PFS), disease-specific survival (DSS), and cancer-specific survival (CSS).Conclusion: The results of this meta-analysis showed that long tumors were related to poor OS, DFS, PFS, DSS and CSS in EC patients. Tumor length might be an important predictor of prognosis in EC patients, and it can be used as an independent staging index. Further well-designed and large-scale prospective clinical studies are needed to confirm these findings.

Download Full-text

Prognostic Role of Pretreatment Plasma D-Dimer in Patients with Solid Tumors: a Systematic Review and Meta-Analysis

Cellular Physiology and Biochemistry ◽

10.1159/000487734 ◽

2018 ◽

Vol 45 (4) ◽

pp. 1663-1676 ◽

Cited By ~ 10

Author(s):

Wenhan Li ◽

Yao Tang ◽

Yongchun Song ◽

Szu Hao Chen ◽

Navard Sisliyan ◽

...

Keyword(s):

Solid Tumors ◽

Meta Analysis ◽

Disease Free Survival ◽

Progression Free Survival ◽

Prognostic Indicator ◽

High Plasma ◽

Cancer Specific Survival ◽

Free Survival ◽

Comprehensive Search ◽

D Dimer

Background/Aims: Elevated pretreatment plasma D-dimer level has been reported as an unfavorable prognostic indicator in several malignancies. The aim of this meta-analysis was to evaluate the prognostic value of elevated D-dimer level in solid tumors. Methods: A comprehensive search of electronic databases up to June 10, 2017 was carried out by two independent reviewers. We included studies exploring the association between pretreatment plasma D-dimer level and patients’ survival outcomes in solid tumors. Overall survival (OS) was regarded as primary outcome and progression-free survival (PFS), disease-free survival (DFS) as well as cancer-specific survival (CSS) were chosen as secondary outcomes. Hazard ratio and 95% confidence interval (CI) were extracted directly or indirectly from included studies. Results: 49 studies with 13001 patients were included in our meta-analysis. Elevated D-dimer was markedly associated with poor OS (pooled HR = 1.90, 95% CI = 1.63 - 2.20, P < 0.001). The effect was observed in all different tumor sites, disease stages, cut-off values and ethnicities. Meanwhile, patients with a high plasma D-dimer had a shorter PFS (HR = 1.46, 95% CI = 1.22–1.76; P < 0.001), DFS (HR = 2.02, 95% CI = 1.56–2.62) and CSS (HR = 2.04, 95% CI= 1.58 – 2.64). Conclusions: Analysis of the pretreatment plasma D-dimer might provide useful information to predict prognosis in patients with solid tumors.

Download Full-text

Prognostic Significance of Pretreatment Albumin to Alkaline Phosphatase Ratio in Human Cancers: A Meta-Analysis

10.21203/rs.3.rs-34796/v1 ◽

2020 ◽

Author(s):

Yanwen Wang ◽

Yuwen Sun ◽

Wenying Xu ◽

Yan Wang

Keyword(s):

Alkaline Phosphatase ◽

Cancer Patients ◽

Prognostic Value ◽

Meta Analysis ◽

Prognostic Significance ◽

Disease Free Survival ◽

Progression Free Survival ◽

Cancer Specific Survival ◽

Free Survival ◽

Human Cancers

Abstract Purpose: To investigate the prognostic value of pretreatment albumin to alkaline phosphatase ratio (AAPR) in human cancers.Methods: Several electronic databases were searched up to Jan 4, 2020 for relevant studies. The prognostic value of AAPR were assessed by pooled hazard ratios (HRs) with their corresponding 95% confidence intervals (CIs). The endpoint events included the overall survival (OS), disease-free survival (DFS), cancer-specific survival (CSS) and progression-free survival (PFS).Results: A total of 15 articles involving 20 studies with 6062 cancer patients were included. Our results proved that low pretreatment AAPR was related with poor OS (HR=1.83, 95% CI: 1.66-2.02; P＜0.001), DFS (HR=1.97, 95% CI: 1.49-2.61; P＜0.001), CSS (HR=1.88, 95% CI: 1.37-2.56; P＜0.001) and PFS (HR=1.74, 95% CI: 1.24-2.43; P=0.001). In addition, the significant correlation between pretreatment AAPR and OS was not affected by the treatment strategy and tumor pathological type.Conclusion: Low pretreatment AAPR is related to poor prognosis in human cancers, and AAPR could be served as a promising prognostic indicator in cancer patients.

Download Full-text

Prognostic impact of tumor length in esophageal Cancer: a systematic review and Meta-analysis

BMC Cancer ◽

10.1186/s12885-021-08728-1 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Zhao Yang Wang ◽

Yuan Zhu Jiang ◽

Wen Xiao ◽

Xian Biao Xue ◽

Xiang Wei Zhang ◽

...

Keyword(s):

Overall Survival ◽

Meta Analysis ◽

Disease Free Survival ◽

Progression Free Survival ◽

Disease Specific Survival ◽

Cancer Specific Survival ◽

Free Survival ◽

Tumor Length ◽

Disease Free ◽

Disease Specific

Abstract Background In clinical studies, it has been observed that esophageal cancer (EC) patient prognosis can be very different even for those patients with tumors of the same TNM stage. Tumor length has been analysed as a possible independent prognostic factor in many studies, but no unanimous conclusion has been reached. Therefore, this review used a meta-analysis to evaluate the association between tumor length and prognosis in EC patients. Methods A systematic search for relevant articles was performed in PubMed, Web of Science, and Embase. Hazard ratios (HRs) and 95% confidence intervals (CIs) were used as effective measures to estimate the correlation between tumor length and prognosis, including overall survival, disease-free survival, progression-free survival, disease-specific survival, and cancer-specific survival. STATA 15.0 software was used to perform the meta-analysis and the data synthesis. Results Finally, 41 articles with 28,973 patients were included in our study. The comprehensive statistical results showed that long tumors are an independent prognostic parameter associated with poor overall survival (OS) (HR = 1.30; 95% CI: 1.21–1.40, p < .001) and disease-free survival (DFS) (HR = 1.38; 95% CI: 1.18–1.61, p < .001) in EC patients. Subgroup analyses also suggested a significant correlation between long tumors and poor OS. Sensitivity analysis and publication bias evaluation confirmed the reliability and stability of the results. Similar results were obtained in the analyses of progression-free survival (PFS), disease-specific survival (DSS), and cancer-specific survival (CSS). Conclusion The results of this meta-analysis showed that long tumors were related to poor OS, DFS, PFS, DSS and CSS in EC patients. Tumor length might be an important predictor of prognosis in EC patients, and it can be used as an independent staging index. Further well-designed and large-scale prospective clinical studies are needed to confirm these findings.

Download Full-text

Prognostic and Clinicopathologic Significance of Neutrophil-to-Lymphocyte Ratio in Esophageal Cancer: An Update Meta-Analysis

Technology in Cancer Research & Treatment ◽

10.1177/15330338211070140 ◽

2022 ◽

Vol 21 ◽

pp. 153303382110701

Author(s):

Binfeng Li ◽

Fei Xiong ◽

Shengzhong Yi ◽

Sheng Wang

Keyword(s):

Esophageal Cancer ◽

Poor Prognosis ◽

Meta Analysis ◽

Clinical Stage ◽

Disease Free Survival ◽

Progression Free Survival ◽

Cochrane Library ◽

Clinicopathologic Characteristics ◽

Cancer Specific Survival ◽

Free Survival

Background: Esophageal cancer is one of the most common cancers with significant morbidity and mortality. It is important to predict the prognosis of patients. The purpose of this study was to comprehensively assess the prognostic and clinicopathologic significance of NLR in patients with esophageal cancer. Methods: A systematic literature search was performed using PubMed, Cochrane Library, Embase, Web of Science, MEDLINE, and CNKI. This meta-analysis was conducted in accordance with PRISMA guidelines. Hazard ratio (HR) with 95% confidence interval (CI) was used as the effect estimation to evaluate the prognostic role of NLR. Odds ratio (OR) was used to evaluate the relation between NLR and clinicopathologic characteristics. Results: A total of 8431 patients from 32 studies were included in this meta-analysis. The pooled results showed that elevated NLR might predict poor prognosis: The factors considered included overall survival (OS) (HR, 1.57; 95% CI, 1.40-1.75; P < .001), cancer-specific survival (CSS) (HR, 1.28; 95% CI, 1.09-1.49; P < .001), progression-free survival (PFS) (HR, 1.45; 95% CI, 1.29-1.72; P < .001), and disease-free survival (DFS) (HR,1.58; 95% CI, 1.27-1.97; P < .001). High NLR was also associated with tumor differentiation, tumor length, tumor invasion depth, lymph node metastasis, and clinical stage. No significant association was observed between NLR and metastasis stage (OR, 1.69; 95% CI, 0.98-2.98; P = .058). Conclusions: The results of this meta-analysis suggest that elevated NLR value might predict poor prognosis (OS, CSS, PFS, and DFS), according to abnormal clinicopathologic parameters.

Download Full-text

The Prognostic Significance of Combined Pretreatment Fibrinogen and Neutrophil-Lymphocyte Ratio in Various Cancers: A Systematic Review and Meta-Analysis

Disease Markers ◽

10.1155/2020/4565379 ◽

2020 ◽

Vol 2020 ◽

pp. 1-10

Author(s):

Rongqiang Liu ◽

Shiyang Zheng ◽

Qing Yuan ◽

Peiwen Zhu ◽

Biao Li ◽

...

Keyword(s):

Prognostic Value ◽

Meta Analysis ◽

Prognostic Significance ◽

Disease Free Survival ◽

Progression Free Survival ◽

Regression Analyses ◽

Free Survival ◽

Neutrophil Lymphocyte Ratio ◽

Lymphocyte Ratio ◽

Meta Regression

Purpose. The prognostic value of a new scoring system, termed F-NLR, that combines pretreatment fibrinogen level with neutrophil-lymphocyte ratio has been evaluated in various cancers. However, the results are controversial. The purpose of this study was to comprehensively analyze the prognostic value of F-NLR score in patients with cancers. Methods. An integrated search of relevant studies was conducted by screening the PubMed and Embase databases. Pooled hazard ratios, with 95% confidence intervals (CIs), for overall survival (OS) and disease-free survival (DFS)/progression-free survival (PFS) were calculated to estimate the prognostic significance of F-NLR score in patients with various tumors. A random effects model was used for comprehensive analysis, and subgroup and meta-regression analyses were used to explore sources of heterogeneity. Results. Thirteen articles reporting data from of 4747 patients were included in the study. Pooled analysis revealed that high F-NLR score was significantly associated with poor OS ( HR = 1.77 ; 95% CI, 1.51–2.08) and poor DFS/PFS ( HR = 1.63 ; 95% CI, 1.30–2.05). Subgroup and meta-regression analyses did not alter the prognostic role of F-NLR score in OS and DFS/PFS. Conclusions. Increased F-NLR score is significantly associated with poor prognosis in patients with cancers and can serve as an effective prognostic indicator.

Download Full-text

HOTAIR as a Prognostic Predictor for Diverse Human Cancers: A Meta- and Bioinformatics Analysis

Cancers ◽

10.3390/cancers11060778 ◽

2019 ◽

Vol 11 (6) ◽

pp. 778 ◽

Cited By ~ 3

Author(s):

Halil Ibrahim Toy ◽

Didem Okmen ◽

Panagiota I. Kontou ◽

Alexandros G. Georgakilas ◽

Athanasia Pavlopoulou

Keyword(s):

Overall Survival ◽

Cancer Patients ◽

Bioinformatics Analysis ◽

Meta Analysis ◽

Disease Free Survival ◽

Progression Free Survival ◽

Predictive Biomarker ◽

Free Survival ◽

Human Cancers ◽

Potential Biomarker

Several studies suggest that upregulated expression of the long non-coding RNA HOX transcript antisense RNA (HOTAIR) is a negative predictive biomarker for numerous cancers. Herein, we performed a meta-analysis to further investigate the prognostic value of HOTAIR expression in diverse human cancers. To this end, a systematic literature review was conducted in order to select scientific studies relevant to the association between HOTAIR expression and clinical outcomes, including overall survival (OS), recurrence-free survival (RFS)/disease-free survival (DFS), and progression-free survival (PFS)/metastasis-free survival (MFS) of cancer patients. Collectively, 53 eligible studies including a total of 4873 patients were enrolled in the current meta-analysis. Pooled hazard ratios (HRs) with their corresponding 95% confidence intervals (CIs) were calculated to assess the relationship between HOTAIR and cancer patients’ survival. Elevated HOTAIR expression was found to be significantly associated with OS, RFS/DFS and PFS/MFS in diverse types of cancers. These findings were also corroborated by the results of bioinformatics analysis on overall survival. Therefore, based on our findings, HOTAIR could serve as a potential biomarker for the prediction of cancer patient survival in many different types of human cancers.

Download Full-text

Prognostic Value of Tumor-Stroma Ratio in Rectal Cancer: A Systematic Review and Meta-analysis

Frontiers in Oncology ◽

10.3389/fonc.2021.685570 ◽

2021 ◽

Vol 11 ◽

Author(s):

Yuzhou Zhu ◽

Zechuan Jin ◽

Yuran Qian ◽

Yu Shen ◽

Ziqiang Wang

Keyword(s):

Rectal Cancer ◽

Web Of Science ◽

Meta Analysis ◽

Disease Free Survival ◽

Tumor Stroma ◽

Pathologic Feature ◽

Cancer Specific Survival ◽

Free Survival ◽

Risk Predictor ◽

Disease Free

BackgroundTumor-stroma ratio (TSR) is a promising new prognostic predictor for patients with rectal cancer (RC). Although several studies focused on this pathologic feature, results from those studies were still inconsistent.MethodsThis research aimed to estimate the prognostic values of TSR for RC. A search of PubMed, EMBASE, and Web of Science was carried out. A meta-analysis was performed on disease-free survival, cancer-specific survival, and overall survival in patients with RC.ResultsThe literature search generated 1,072 possible studies, of which a total of 15 studies, involving a total of 5,408 patients, were eventually included in the meta-analysis. Thirteen of the 15 articles set the cutoff for the ratio of stroma at 50%, dividing patients into low-stroma and high-stroma groups. Low TSR (rich-stroma) was significantly associated with poorer survival outcome. (DFS: HR 1.54, 95% CI 1.32–1.79; OS: HR 1.52 95% CI 1.34–1.73; CSS: HR 2.05 95% CI 1.52–2.77).ConclusionPresent data support TSR to be a risk predictor for poor prognosis in RC patients.

Download Full-text

Prognostic Role of High Stathmin 1 Expression in Patients with Solid Tumors: Evidence from a Meta-Analysis

Cellular Physiology and Biochemistry ◽

10.1159/000493958 ◽

2018 ◽

Vol 50 (1) ◽

pp. 66-78 ◽

Cited By ~ 3

Author(s):

Qingyan Mao ◽

Zhen Chen ◽

Kun Wang ◽

Renfang Xu ◽

Hao Lu ◽

...

Keyword(s):

English Literature ◽

Meta Analysis ◽

Disease Free Survival ◽

Progression Free Survival ◽

Free Survival ◽

Online Databases ◽

Stathmin 1 ◽

Tumor Types ◽

Disease Free

Background/Aims: Several recent studies have demonstrated that Stathmin 1expression may be closely associated with prognosis in patients with various types of cancers. In the present study, we conducted a meta-analysis of all available studies in the English literature to assess the prognostic value of Stathmin 1expression in patients with solid cancers. Methods: The online databases PubMed, Embase, and Web of Science were searched for literature regarding Stathmin 1 and its association with patient outcomes associated with solid cancers. Results: A total of 23 articles including 26 studies that contained 5 335 patients were retrieved and analyzed. Our results indicated that high Stathmin 1 expression yielded a worse overall survival (OS) (hazard ratio [HR] = 2.17, 95% confidence interval [CI]: 1.81–2.60), disease-free survival (DFS) (HR = 2.46, 95% CI: 2.00–3.02), disease-specific survival (DSS) (HR = 1.98, 95% CI: 1.58– 2.47) and progression-free survival (PFS)/recurrence-free survival (RFS) (HR = 2.09, 95% CI: 1.51–2.89). Furthermore, the association of high Stathmin 1 expression with poor survival was significant even for sub-group analyses of different tumor types, ethnicities, methods used to calculate HRs, detected methods, and analysis types. Conclusion: In summary, this meta-analysis determined that high Stathmin 1 expression is associated with poor prognosis in patients with solid cancers and expression of this protein could be a clinically useful prognostic biomarker.

Download Full-text