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

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.

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Prognostic significance of platelet-to-lymphocyte ratio in urothelial carcinoma patients: a meta-analysis

Cancer Cell International ◽

10.1186/s12935-019-1032-6 ◽

2019 ◽

Vol 19 (1) ◽

Cited By ~ 2

Author(s):

Yuhai Bao ◽

Yin Wang ◽

Xiaodong Li ◽

Mingjun Pan ◽

Hongze Zhang ◽

...

Keyword(s):

Urothelial Carcinoma ◽

Meta Analysis ◽

Prognostic Significance ◽

Disease Free Survival ◽

Cochrane Library ◽

Prognostic Impact ◽

Platelet To Lymphocyte Ratio ◽

Cancer Specific Survival ◽

Free Survival ◽

Lymphocyte Ratio

Abstract Background The prognostic value of pre-treatment platelet-to-lymphocyte ratio (PLR) in patients with urothelial carcinoma (UC) remains controversial. Therefore, this meta-analysis aimed to identify the prognostic impact of PLR on UC. Methods The PubMed, Embase, Web of Science, and Cochrane Library databases were systematically searched. Hazard ratios (HRs) with 95% confidence intervals (CIs) were used to summarize the correlations between PLR and overall survival (OS), progression-free survival (PFS), disease-free survival (DFS), and cancer-specific survival (CSS). Odds ratios (ORs) with 95% CIs were used to measure the association between PLR and tumor clinicopathological factors. Results The meta-analysis included 15 studies published from 2015 to 2019 with a total of 5354 patients. Overall, a high PLR was correlated to poorer PFS (HR = 1.81, 95% CI 1.28–2.56, p = 0.001) and DFS (HR = 1.09, 95% CI 1.31–2.16, p < 0.001) but not poor OS (HR = 1.23, 95% CI 0.95–1.59, p = 0.124) or CSS (HR = 1.000, 95% CI 0.998–1.002, p = 0.919) in UC. In addition, an elevated PLR was correlated with patient age > 65 years (OR = 1.72, 95% CI 1.25–2.38, p = 0.001) and hypertension (OR = 1.48, 95% CI 1.01–2.18, p = 0.046). However, no significant association was observed between PLR and sex (OR = 0.79, 95% CI 0.56–1.14, p = 0.206) or diabetes (OR = 1.29, 95% CI 0.77–2.15, p = 0.333). Conclusions Our results demonstrated a significant correlation between elevated PLR and poor prognosis in UC. The prognostic role of PLR may help guide the management and prognostication of UC patients.

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Prognostic Significance of Pretreatment Apolipoprotein A-I as a Noninvasive Biomarker in Cancer Survivors: A Meta-Analysis

Disease Markers ◽

10.1155/2018/1034037 ◽

2018 ◽

Vol 2018 ◽

pp. 1-9 ◽

Cited By ~ 3

Author(s):

Yi Zhang ◽

Xianjin Yang

Keyword(s):

Meta Analysis ◽

Prognostic Significance ◽

Disease Free Survival ◽

Cancer Prognosis ◽

Cochrane Library ◽

China National Knowledge Infrastructure ◽

Poor Overall Survival ◽

Cancer Specific Survival ◽

Free Survival ◽

Apolipoprotein A

Background. Numerous studies have reported the prognostic significance of serum apolipoprotein A-I (ApoA-I) in various cancers, but the results have been inconsistent. The current meta-analysis was performed to investigate the association between ApoA-I level and prognosis in human malignancies. Methods. A literature search was performed using the electronic platforms of the PubMed, Cochrane Library, Web of Science, Embase, Wanfang, and China National Knowledge Infrastructure (CNKI) databases to obtain eligible articles published up to May 20, 2018. Pooled hazard ratios (HRs) with 95% confidence intervals (95% CIs) were calculated to assess the prognostic values of the ApoA-I level in cancers using STATA 12.0 software. Results. A total of 14 studies involving 9295 patients were included. The results indicated that low ApoA-I level was significantly associated with poor overall survival (OS) (HR = 0.52, 95% CI: 0.44–0.61). Significant relationships between the ApoA-I level and OS were specifically detected in nasopharyngeal carcinoma (NPC, HR = 0.63, 95% CI: 0.54–0.73), colorectal cancer (CRC, HR = 0.48, 95% CI: 0.19–0.76), and hepatocellular carcinoma (HCC, HR = 0.46, 95% CI: 0.27–0.65). The subgroup analyses for OS also further confirmed the prognostic significance of the ApoA-I level in cancers. Moreover, lower Apo A-I was associated with unfavorable cancer-specific survival (CSS, HR: 0.47, 95% CI: 0.19–0.76) in cancers, and low ApoA-I level was clearly associated with inferior total time to recurrence (TTR, HR: 0.43, 95% CI: 0.29–0.58) in HCC, poorer locoregional recurrence-free survival (LRFS) and distant metastasis-free survival (DMFS) (HR: 0.58, 95% CI: 0.42–0.74 for LRFS; HR: 0.65, 95% CI: 0.41–0.89 for DMFS) in NPC, and shorter disease-free survival (DFS, HR: 0.64, 95% CI: 0.43–0.84) in cancers. Conclusions. Low ApoA-I level might be an unfavorable prognostic factor in multiple malignancies, and serum ApoA-I could serve as a noninvasive marker to predict cancer prognosis.

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Clinicopathological and prognostic significance of PD-L1 expression in colorectal cancer: a meta-analysis

International Journal of Colorectal Disease ◽

10.1007/s00384-020-03734-4 ◽

2020 ◽

Vol 36 (1) ◽

pp. 117-130

Author(s):

Shuxia Wang ◽

Bo Yuan ◽

Yun Wang ◽

Mingyang Li ◽

Xibo Liu ◽

...

Keyword(s):

Colorectal Cancer ◽

Meta Analysis ◽

Prognostic Significance ◽

Disease Free Survival ◽

Progression Free Survival ◽

Clinicopathological Features ◽

Cochrane Library ◽

Free Survival ◽

Meta Regression ◽

Disease Free

Abstract Purpose To systematically evaluate the correlation between PD-L1 expression and clinicopathological features and prognosis of colorectal cancer (CRC). Methods Seven databases (PubMed, Cochrane Library, EMBASE, Web of Science, CBM, Wanfang, and CNKI) were searched through May 2020. Risk of bias and quality of evidence were assessed by using the Newcastle–Ottawa scale (NOS), and meta-analysis was carried out by using the Review Manager 5.3 software on the studies with the quality evaluation scores ≥ 6. Meta-regression analysis was used to determine the independent role of PD-L1 expression on CRC prognosis after adjusting clinicopathological features and treatment methods. Results A total of 8823 CRC patients in 32 eligible studies. PD-L1 expression was correlated with lymphatic metastasis (yes/no; OR = 1.24, 95% CI (1.11, 1.38)), diameter of tumor (≥ 5 cm/< 5 cm; OR = 1.34, 95% CI (1.06, 1.70)), differentiation (high–middle/low; OR = 0.68, 95% CI (0.53, 0.87)), and vascular invasion (yes/no; OR = 0.80, 95% CI (0.69, 0.92)). PD-L1 expression shortened the overall survival (hazard ratio (HR) = 1.93, 95% CI (1.66, 2.25)), disease-free survival (HR = 1.76, 95% CI (1.50, 2.07)), and progression-free survival (HR = 1.93, 95% CI (1.55, 2.41)). Meta-regression showed that PD-L1 expression played a significant role on poor CRC OS (HR = 1.95, 95% CI (1.92, 3.98)) and disease-free survival (HR = 2.14, 95% CI (0.73, 4.52)). Conclusion PD-L1 expression independently predicted a poor prognosis of CRC.

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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.

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Low Pretreatment Albumin-to-Globulin Ratio Predicts Poor Prognosis in Gastric Cancer: Insight From a Meta-Analysis

Frontiers in Oncology ◽

10.3389/fonc.2020.623046 ◽

2021 ◽

Vol 10 ◽

Author(s):

Chengzhi Wei ◽

Zhu Yu ◽

Gonghe Wang ◽

Yiming Zhou ◽

Lei Tian

Keyword(s):

Gastric Cancer ◽

Poor Prognosis ◽

Meta Analysis ◽

Prognostic Significance ◽

Disease Free Survival ◽

Progression Free Survival ◽

Cochrane Library ◽

China National Knowledge Infrastructure ◽

Free Survival ◽

Albumin To Globulin Ratio

BackgroundIn recent five years, reports regarding albumin-to-globulin ratio (AGR) and the survival of gastric cancer (GC) have emerged rapidly, yet their association remains controversial. This meta-analysis was aimed to provide an insight into the prognostic significance of pretreatment AGR in GC.MethodsPubMed, Embase, Cochrane library, Web of Science, WanFang, China National Knowledge Infrastructure (CNKI) and VIP databases were searched for relevant studies, from inception to September 30, 2020. Individual hazard ratios (HRs) with their 95% confidence intervals (CIs) were combined by Stata 12.0 software to evaluate the association between pretreatment AGR and overall survival (OS) and disease-free survival/progression-free survival (DFS/PFS).ResultsA total of 8,305 patients with GC from 12 studies were included for further analysis. Pooled analyses indicated that low AGR was closely associated with worse OS (HR = 1.531, 95% CI: 1.300–1.803, P < 0.001) and worse DFS/PFS (HR = 2.008, 95% CI: 1.162–3.470, P = 0.012) in GC patients. Moreover, subgroup analyses demonstrated that the association between low AGR and worse OS remained constant despite variations in country, tumor stage, cut-off value, cut-off selection and treatment method.ConclusionAGR could act as an efficient prognostic indicator for GC, and that low pretreatment AGR predicts poor prognosis in GC.

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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.

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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.

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Sub-staging specific differences in recurrence-free, progression-free and cancer-specific survival for patients with T1 bladder cancer: a systematic review and meta-analysis

10.21203/rs.3.rs-17652/v1 ◽

2020 ◽

Author(s):

GuanQiu Chen ◽

Tao Yang ◽

Pu Zhang ◽

Meng-Zhao Zhang ◽

Bo Yang ◽

...

Keyword(s):

Bladder Cancer ◽

Prognostic Significance ◽

Treatment Strategies ◽

Progression Free Survival ◽

Staging System ◽

Cochrane Library ◽

Significant Prognostic Factor ◽

Cancer Specific Survival ◽

Free Survival ◽

Significant Difference

Abstract Background: The efficiency of the T1 sub-staging system on categorizing bladder cancer (BC) patients into subgroups with different clinical outcomes was unclear. We summarized relevant evidences, including recurrence-free survival (RFS), progression-free survival (PFS) and cancer-specific survival (CSS), to analyze the prognostic significance of T1 sub-stage.Methods: Systematic literature searches of MEDLINE, EMBASE and the Cochrane Library were performed. We pooled data on recurrence, progression, and CSS from 35 studies.Results: The pooled hazard ratios (HRs) and 95% confidence intervals (CIs) indicated the difference in RFS between T1a sub-stage and T1b sub-stage (HR1.28, 95%CI 1.14-1.43). The significant difference was observed in PFS between the two arms (HR 2.18, 95%CI 1.95-2.44). Worse CSS was found in T1b patients than T1a patients (HR 1.45, 95%CI 1.28-1.64).Conclusions: T1 sub-staging system based on the invasion depth into muscularis mucosae (MM) can be a significant prognostic factor for RFS, PFS, and CSS of patients with T1-BC. Urologists and pathologists are encouraged to work together to give a precise sub-stage classification of T1-BC, and T1 sub-staging system should be a routine part of any histopathological report when possible. Different treatment strategies need to be developed for both T1a-BC and T1b-BC.

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

Therapeutic Advances in Medical Oncology ◽

10.1177/1758835919875851 ◽

2019 ◽

Vol 11 ◽

pp. 175883591987585 ◽

Cited By ~ 2

Author(s):

Susu Han ◽

Tao Huang ◽

Fenggang Hou ◽

Liting Yao ◽

Xiyu Wang ◽

...

Keyword(s):

Advanced Cancer ◽

Sequential Analysis ◽

Meta Analysis ◽

Disease Free Survival ◽

Progression Free Survival ◽

Trial Sequential Analysis ◽

Advanced Cancer Patients ◽

Cancer Specific Survival ◽

Study Region ◽

Free Survival

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.

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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.

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