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

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.

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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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Addition of Platinum Derivatives to Fluoropyrimidine-Based Neoadjuvant Chemoradiotherapy for Stage II/III Rectal Cancer: Systematic Review and Meta-Analysis

JNCI Journal of the National Cancer Institute ◽

10.1093/jnci/djz081 ◽

2019 ◽

Vol 111 (9) ◽

pp. 887-902 ◽

Cited By ~ 11

Author(s):

Felix J Hüttner ◽

Pascal Probst ◽

Eva Kalkum ◽

Matthes Hackbusch ◽

Katrin Jensen ◽

...

Keyword(s):

Rectal Cancer ◽

Pathological Complete Response ◽

Meta Analysis ◽

Neoadjuvant Chemoradiotherapy ◽

Disease Free Survival ◽

Complete Response ◽

Distant Recurrence ◽

Stage Ii ◽

Free Survival ◽

Disease Free

Abstract Background Current guidelines recommend neoadjuvant therapy for patients with stage II or III rectal cancer. The addition of platinum derivatives to fluoropyrimidine-based chemoradiotherapy has been frequently investigated, but their role in this setting remains controversial. Methods PubMed, Cochrane Library, and Web of Science were systematically searched for randomized trials comparing chemoradiotherapy with or without platinum agents in stage II or III rectal cancer. Main outcome parameters were overall and disease-free survival, additional outcomes included pathological complete response, isolated local recurrence, distant recurrence, toxicity, and perioperative morbidity. Time-to-event data were pooled as hazard ratios (HRs) by the inverse variance method and binary outcomes as odds ratios (ORs) by the Peto method with their respective 95% confidence interval (CI). All statistical tests were two-sided. Results Ten randomized controlled trials with data on 5599 patients were included in the meta-analysis. Platinum derivatives did not statistically significantly improve overall survival (HR = 0.93, 95% CI = 0.82 to 1.05, P = .23), disease-free survival (HR = 0.91, 95% CI = 0.83 to 1.01, P = .07), or local recurrence (OR = 0.83, 95% CI = 0.66 to 1.05, P = .12). However, it led to a statistically significant increase of pathological complete response (OR = 1.31, 95% CI = 1.10 to 1.55, P = .002) and a statistically significant reduction of distant recurrence (OR = 0.78, 95% CI = 0.66 to 0.92, P = .004). Benefits were accompanied by higher rates of grade 3 or 4 toxicities. Conclusions Intensified neoadjuvant chemoradiotherapy with the addition of platinum derivatives cannot be recommended routinely because it did not improve overall or disease-free survival and was associated with increased toxicity. It needs to be elucidated whether the benefits in distant recurrence and pathological complete response may be advantageous for selected high-risk patients.

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Is Overexpression of Ki-67 a Prognostic Biomarker of Upper Tract Urinary Carcinoma? A Retrospective Cohort Study and Meta-Analysis

Cellular Physiology and Biochemistry ◽

10.1159/000453211 ◽

2016 ◽

Vol 40 (6) ◽

pp. 1613-1625 ◽

Cited By ~ 4

Author(s):

Bo Fan ◽

Hongshuo Zhang ◽

Huidan Jin ◽

Yu Gai ◽

Honglong Wang ◽

...

Keyword(s):

Disease Progression ◽

Meta Analysis ◽

Disease Free Survival ◽

Poor Survival ◽

Cancer Specific Survival ◽

Ki 67 ◽

Free Survival ◽

Upper Tract ◽

Muscle Invasive ◽

Disease Free

Background: Upper tract urinary carcinoma (UTUC) is a relatively uncommon but aggressive disease. The Ki-67 antigen is a classic marker of cellular proliferation, but there is still controversy regarding the significance and importance of Ki-67 in tumor progression. Methods: In this study, we first detected Ki-67 expression in UTUC patients by immunohistochemistry (IHC). Subsequently, we quantitatively combined the results with those from the published literature in a meta-analysis after searching several databases. Results: IHC results demonstrated that patients with muscle-invasive tumors (T2-T4) had higher Ki-67 expression than those with non-muscle-invasive tumors (Tis-T1), suggesting that high Ki-67 expression may be associated with the aggressive form of UTUC. Kaplan-Meier curves showed that patients with high Ki-67 expression had significantly poorer cancer-specific survival (CSS) and disease-free survival (DFS). Furthermore, multivariate analysis suggested that Ki-67 expression was an independent prognostic factor for CSS (hazard ratio, HR=3.196) and DFS (HR=3.517) in UTUC patients. Then, a meta-analysis of the published literature investigating Ki-67 expression and its effects on UTUC prognosis was conducted. After searching the PubMed, Medline, Embase, Cochrane Library and Scopus databases, 12 articles met the eligibility criteria for this analysis. The eligible studies included a total of 1740 patients with a mean number of 82 patients per study (range, 38-475). The combined results showed that increased Ki-67 levels were associated with poor survival and disease progression, with a pooled HR estimate of 2.081 and 2.791, respectively. In subgroup analysis, the pooled HR was statistically significant for cancer-specific survival (HR=2.276), metastasis-free survival (HR=3.008) and disease-free survival (HR=6.336). Conclusions: In conclusion, high Ki-67 expression was associated with poor survival in patients with UTUC, as well as a high risk of disease progression, although these findings need to be interpreted with caution. Large-scale, adequately designed, prospective trials are needed to further confirm the value of Ki-67 in prognosis of UTUC patients.

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Prognostic Role of C-Reactive Protein in Breast Cancer: A Systematic Review and Meta-Analysis

The International Journal of Biological Markers ◽

10.5301/jbm.2011.8872 ◽

2011 ◽

Vol 26 (4) ◽

pp. 209-215 ◽

Cited By ~ 53

Author(s):

Yijie Han ◽

Feng Mao ◽

Ying Wu ◽

Xiaonan Fu ◽

Wei Zhang ◽

...

Keyword(s):

Breast Cancer ◽

Meta Analysis ◽

Disease Free Survival ◽

C Reactive Protein ◽

Cancer Specific Survival ◽

Free Survival ◽

Reactive Protein ◽

Hazard Ratios ◽

Disease Free

Background Recent studies have shown that C-reactive protein (CRP) may be associated with breast cancer. The purpose of this study is to summarize the predictive role of CRP for survival in breast cancer as shown in all available studies worldwide. Methods Related studies were identified and evaluated for quality through multiple search strategies. Data were collected from studies comparing overall, cancer-specific, and disease-free survival (OS, CSS, and DFS) in patients with elevated CRP levels and those having lower levels. Studies were pooled, and combined hazard ratios (HRs) of CRP for survival were calculated. Results A total of 10 studies (n=4,502) were included for this meta-analysis (9 for OS, 3 for CSS, and 3 for DFS). For overall and disease-free survival, the pooled HRs of CRP were significant at 1.62 (95% confidence interval [95% CI], 1.20-2.18) and 1.81 (95% CI, 1.44-2.26), respectively. For cancer-specific survival, the pooled HR in higher CRP expression in breast cancer was 2.08 (95% CI, 1.48-2.94), which could strongly predict poorer survival in breast cancer. Conclusions CRP has a critical prognostic value in patients with breast cancer as an inflammation biomarker.

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Prognostic values of tumoral MMP2 and MMP9 overexpression in breast cancer: a systematic review and meta-analysis

BMC Cancer ◽

10.1186/s12885-021-07860-2 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Hanfang Jiang ◽

Huiping Li

Keyword(s):

Breast Cancer ◽

Tumor Cells ◽

Web Of Science ◽

Histological Grade ◽

Meta Analysis ◽

Clinical Stage ◽

Disease Free Survival ◽

Free Survival ◽

Mmp9 Expression ◽

Disease Free

Abstract Background Breast cancer (BC) is a leading cause of cancer-related death in females worldwide. Previous studies have demonstrated that matrix metalloproteinases (MMPs) play key roles in metastasis and are associated with survival in various cancers. The prognostic values of MMP2 and MMP9 expression in BC have been investigated, but the results remain controversial. Thus, we performed the present meta-analysis to investigate the associations between MMP2/9 expressions in tumor cells with clinicopathologic features and survival outcome in BC patients. Methods Eligible studies were searched in PubMed, Web of Science, EMBASE, CNKI and Wanfang databases. The associations of MMP2/9 overexpression in tumor cells with overall survival (OS), disease-free survival (DFS) and recurrence-free survival (RFS) were assessed by hazard ratio (HR) and 95% confidence interval (CI). The associations of MMP2/9 overexpression with clinicopathological features were investigated by calculating odds ratio (OR) and 95% CI. Subgroup analysis, sensitivity analysis, meta-regression, and analysis for publication bias were performed. Results A total of 41 studies comprising 6517 patients with primary BC were finally included. MMP2 overexpression was associated with an unfavorable OS (HR = 1.60, 95% CI 1.33 –1.94, P < 0.001) while MMP9 overexpression predicted a shorter OS (HR = 1.52, 95% CI 1.30 –1.77, P < 0.001). MMP2 overexpression conferred a higher risk to distant metastasis (OR = 2.69, 95% CI 1.35–5.39, P = 0.005) and MMP9 overexpression correlated with lymph node metastasis (OR = 2.90, 95% CI 1.86 – 4.53, P < 0.001). Moreover, MMP2 and MMP9 overexpression were both associated with higher clinical stage and histological grade in BC patients. MMP9 overexpression was more frequent in patients with larger tumor sizes. Conclusions Tumoral MMP2 and MMP9 are promising markers for predicting the prognosis in patients with BC.

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Prognostic Efficacy of Tumor-Stroma Ratio in Women With Breast Cancer: A Meta-Analysis of Cohort Studies

Frontiers in Oncology ◽

10.3389/fonc.2021.731409 ◽

2021 ◽

Vol 11 ◽

Author(s):

Pengli Jiang ◽

Yulong Chen ◽

Bin Liu

Keyword(s):

Breast Cancer ◽

Cohort Studies ◽

Meta Analysis ◽

Disease Free Survival ◽

Tumor Stroma ◽

Current Evidence ◽

Cancer Specific Survival ◽

Free Survival ◽

Prognostic Predictor

BackgroundTumor-stroma ratio (TSR) has been suggested as an emerging prognostic predictor in women with breast cancer. However, previous studies evaluating the association between TSR and survival in women with breast cancer showed inconsistent results. We performed a meta-analysis to systematically evaluate the possible prognostic role of TSR in breast cancer.MethodsRelevant cohort studies were obtained via search of PubMed, Embase, and Web of Science databases. A random-effects model, which incorporated the potential heterogeneity, was used to pool the results.ResultsTwelve cohort studies with 6175 patients were included. Nine of the 12 studies used 50% as the cutoff to divide the patients into those with stroma-rich (low TSR) and stroma-poor (high TSR) tumors. Pooled results showed that compared women with stroma-poor tumor, those with stroma-rich tumor were associated with worse survival outcomes (disease-free survival [DFS]: hazard ratio [HR] = 1.56, 95% confidence interval [CI]: 1.32 to 1.85, P < 0.001; overall survival [OS]: HR = 1.67, 95% CI: 1.46 to 1.91, P < 0.001; and cancer-specific survival [CSS]: HR = 1.75, 95% CI: 1.40 to 2.20, P < 0.001). Analysis limited to women with triple-negative breast cancer (TNBC) showed consistent results (DFS: HR: 2.07, 95% CI: 1.59 to 2.71, P < 0.001; OS: HR: 2.04, 95% CI: 1.52 to 2.73, P < 0.001; and CSS: HR: 2.40, 95% CI: 1.52 to 3.78, P < 0.001).ConclusionsCurrent evidence from retrospective studies supports that tumor TSR is a prognostic predictor or poor survival in women with breast cancer.

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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.

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

10.21203/rs.3.rs-38181/v1 ◽

2020 ◽

Author(s):

Zhao Yang Wang ◽

Yuanzhu Jiang ◽

Wen Xiao ◽

Xianbiao Xue ◽

Xiangwei Zhang ◽

...

Keyword(s):

Overall Survival ◽

Meta Analysis ◽

Prognostic Significance ◽

Disease Free Survival ◽

Disease Specific Survival ◽

Cancer Specific Survival ◽

Free Survival ◽

Tumor Length ◽

Disease Free ◽

Disease Specific

Abstract Background: In clinical work, it is increasingly finding that even for patients with the same TNM stage of esophageal cancer (EC), the prognosis of different patients is still very different. Tumor length has been analyzed as a possible independent prognostic factor in many studies, but no unanimous conclusion has been reached. Therefore, this review is expected to use meta-analysis to evaluate the association between tumor length and prognostic significance in EC patients.Methods: A systematic search for relevant articles was performed in the PubMed, Web of Science, and Embase. Hazard ratio and 95% conﬁdence intervals (CIs) will be used as effective measures to estimate the correlation between tumor length and prognostic significance including overall survival, disease-free survival, progression-free survival, disease-specific survival, and cancer-speciﬁc survival. We will use the software STATA 15.0 to perform the meta-analysis to calculate the data synthesis. Results: Finally, 41 articles with 28, 973 patients were included in our study. Comprehensive statistical results showed that long tumor is 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 tumor and poor OS. Sensitivity analysis and publication bias evaluation confirmed the reliability and stability of these results. Similar results can be obtained in analyses of progress-free survival (PFS), disease-specific survival (DSS), and cancer-specific survival (CSS). Conclusion: The results of this meta-analysis showed that the long tumor was related to the poor OS, DFS, PFS, DSS and CSS in EC patients. It was suggested that 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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