Article
The prognostic value of TP53 mutations in oesophageal adenocarcinoma: a systematic review and meta-analysis
Gut
(2016)
Abstract
Objective: To clarify the prognostic role of tumour
protein 53 (TP53) mutations in patients with
oesophageal adenocarcinoma (OAC) as there is a need
for biomarkers that assist in guiding management for
patients with OAC.
Design: A systematic review was conducted using
MEDLINE, Embase, PubMed and Current Contents
Connect to identify studies published between January
1990 and February 2015 of oesophageal cancer
populations (with OAC diagnoses >50% of cases) that
measured tumoural TP53 status and reported hazard
ratios (HR), or adequate data for estimation of HR for
survival for TP53-defined subgroups. Risk of bias for HR
estimates was assessed using prespecified criteria for the
appraisal of relevant domains as defined by the
Cochrane Prognosis Methods Group including adherence
to Grading of Recommendations, Assessment,
Development and Evaluation and REporting
recommendations for tumor MARKer prognostic studies
guidelines, as well as assay method used (direct TP53
mutation assessment vs immunohistochemistry) and
adjustment for standard prognostic factors. A pooled HR
and 95% CI were calculated using a random-effects
model.
Results: Sixteen eligible studies (11 with OAC only and
5 mixed histology cohorts) including 888 patients were
identified. TP53 mutations were associated with reduced
survival (HR 1.48, 95% CI 1.16 to 1.90, I2=33%). A
greater prognostic effect was observed in a sensitivity
analysis of those studies that reported survival for OAConly
cohorts and were assessed at low risk of bias (HR
2.11, 95% CI 1.35 to 3.31, I2=0%).
Conclusions: Patients with OAC and TP53 gene
mutations have reduced overall survival compared with
patients without these mutations, and this effect is
independent of tumour stage.
Disciplines
Publication Date
2016
DOI
10.1136/gutjnl-2015-310888
Citation Information
Fisher, O., Lord, S., Falkenback, D., Clemons, N., Eslick, G., and Lord, R. (2016). The prognostic value of TP53 mutations in oesophageal adenocarcinoma: a systematic review and meta-analysis. Gut, Online first. DOI: 10.1136/gutjnl-2015-310888