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      Modest effect of p53, EGFR and HER-2/neu on prognosis in epithelial ovarian cancer: a meta-analysis

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          Abstract

          Background:

          P53, EGFR and HER-2/neu are the most frequently studied molecular biological parameters in epithelial ovarian cancer, but their prognostic impact is still unequivocal. We performed a meta-analysis to more precisely estimate their prognostic significance.

          Methods:

          Published studies that investigated the association between p53, EGFR and HER-2/neu status and survival were identified. Meta-analysis was performed using a DerSimonian–Laird model. Publication bias was investigated using funnel plots and sources of heterogeneity were identified using meta-regression analysis.

          Results:

          A total of 62 studies were included for p53, 15 for EGFR and 20 for HER-2/neu. P53, EGFR and HER-2/neu status had a modest effect on overall survival (pooled HR 1.47, 95% CI 1.33–1.61 for p53; HR 1.65, 95% CI 1.25–2.19 for EGFR and HR 1.67, 95% CI 1.34–2.08 for HER-2/neu). Meta-regression analysis for p53 showed that FIGO stage distribution influenced study outcome. For EGFR and HER-2/neu, considerable publication bias was present.

          Conclusions:

          Although p53, EGFR and HER-2/neu status modestly influences survival, these markers are, by themselves, unlikely to be useful as prognostic markers in clinical practice. Our study highlights the need for well-defined, prospective clinical trials and more complete reporting of results of prognostic factor studies.

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          Most cited references107

          • Record: found
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          Extracting summary statistics to perform meta-analyses of the published literature for survival endpoints.

          M Parmar, V. Torri, L. Stewart (1998)
          Meta-analyses aim to provide a full and comprehensive summary of related studies which have addressed a similar question. When the studies involve time to event (survival-type) data the most appropriate statistics to use are the log hazard ratio and its variance. However, these are not always explicitly presented for each study. In this paper a number of methods of extracting estimates of these statistics in a variety of situations are presented. Use of these methods should improve the efficiency and reliability of meta-analyses of the published literature with survival-type endpoints.
          Article 0 comments Cited 834 times – based on 0 reviews     Review now
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            REporting recommendations for tumour MARKer prognostic studies (REMARK)

            L M McShane, D Altman, W Sauerbrei … (2005)
            Despite years of research and hundreds of reports on tumour markers in oncology, the number of markers that have emerged as clinically useful is pitifully small. Often initially reported studies of a marker show great promise, but subsequent studies on the same or related markers yield inconsistent conclusions or stand in direct contradiction to the promising results. It is imperative that we attempt to understand the reasons that multiple studies of the same marker lead to differing conclusions. A variety of methodological problems have been cited to explain these discrepancies. Unfortunately, many tumour marker studies have not been reported in a rigorous fashion, and published articles often lack sufficient information to allow adequate assessment of the quality of the study or the generalisability of the study results. The development of guidelines for the reporting of tumour marker studies was a major recommendation of the US National Cancer Institute and the European Organisation for Research and Treatment of Cancer (NCI-EORTC) First International Meeting on Cancer Diagnostics in 2000. Similar to the successful CONSORT initiative for randomised trials and the STARD statement for diagnostic studies, we suggest guidelines to provide relevant information about the study design, preplanned hypotheses, patient and specimen characteristics, assay methods, and statistical analysis methods. In addition, the guidelines suggest helpful presentations of data and important elements to include in discussions. The goal of these guidelines is to encourage transparent and complete reporting so that the relevant information will be available to others to help them to judge the usefulness of the data and understand the context in which the conclusions apply.
            Article 0 comments Cited 546 times – based on 0 reviews     Review now
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              Improving the quality of reports of meta-analyses of randomised controlled trials: the QUOROM statement. Quality of Reporting of Meta-analyses.

              D Moher, D J Cook, S. Eastwood … (1999)
              The Quality of Reporting of Meta-analyses (QUOROM) conference was convened to address standards for improving the quality of reporting of meta-analyses of clinical randomised controlled trials (RCTs). The QUOROM group consisted of 30 clinical epidemiologists, clinicians, statisticians, editors, and researchers. In conference, the group was asked to identify items they thought should be included in a checklist of standards. Whenever possible, checklist items were guided by research evidence suggesting that failure to adhere to the item proposed could lead to biased results. A modified Delphi technique was used in assessing candidate items. The conference resulted in the QUOROM statement, a checklist, and a flow diagram. The checklist describes our preferred way to present the abstract, introduction, methods, results, and discussion sections of a report of a meta-analysis. It is organised into 21 headings and subheadings regarding searches, selection, validity assessment, data abstraction, study characteristics, and quantitative data synthesis, and in the results with "trial flow", study characteristics, and quantitative data synthesis; research documentation was identified for eight of the 18 items. The flow diagram provides information about both the numbers of RCTs identified, included, and excluded and the reasons for exclusion of trials. We hope this report will generate further thought about ways to improve the quality of reports of meta-analyses of RCTs and that interested readers, reviewers, researchers, and editors will use the QUOROM statement and generate ideas for its improvement.
              Article 0 comments Cited 422 times – based on 0 reviews     Review now
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                Author and article information

                Journal
                Journal ID (nlm-ta): Br J Cancer
                Title: British Journal of Cancer
                Publisher: Nature Publishing Group
                ISSN (Print): 0007-0920
                ISSN (Electronic): 1532-1827
                Publication date (Electronic): 09 June 2009
                Publication date Collection: 30 June 2009
                Publication date (Print): 07 July 2009
                Volume: 101
                Issue: 1
                Pages: 149-159
                Affiliations
                [1 ]Department of Gynaecologic Oncology, University Medical Centre Groningen, University of Groningen Hanzeplein 1, Groningen 9713 GZ, The Netherlands
                [2 ]Department of Medical Oncology, University Medical Centre Groningen, University of Groningen Hanzeplein 1, Groningen 9713 GZ, The Netherlands
                [3 ]Department of Epidemiology, University Medical Centre Groningen, University of Groningen Hanzeplein 1, Groningen 9713 GZ, The Netherlands
                Author notes
                [* ]Author for correspondence: g.h.de.bock@ 123456epi.umcg.nl
                [4]

                These authors contributed equally to the work

                Article
                Publisher Item ID: 6605112
                DOI: 10.1038/sj.bjc.6605112
                PMC ID: 2713689
                PubMed ID: 19513073
                SO-VID: cfc7d5da-2c73-440f-bb96-02ce225c22ee
                Copyright © Copyright 2009, Cancer Research UK
                History
                Date received : 27 January 2009
                Date revision received : 22 April 2009
                Date accepted : 01 May 2009
                Categories
                Subject: Molecular Diagnostics

                ScienceOpen disciplines: Oncology & Radiotherapy
                Keywords: her-2/neu,p53,egfr,ovarian cancer,meta-analysis
                Data availability:
                ScienceOpen disciplines: Oncology & Radiotherapy
                Keywords: her-2/neu, p53, egfr, ovarian cancer, meta-analysis

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