title: Relationship between cathepsin-D content and disease-free survival in node-negative breast cancer patients: a meta-analysis.
abstract: Several reports have evaluated the correlation between cathepsin-D and overall survival or disease-free survival in node-negative breast cancer patients. Because conflicting data have so far been reported, a meta-analysis was conducted to clarify this problem. Eleven studies were included in our meta-analysis (total of 2690 patients). A specific meta-analytical methodology for censored data was used, and disease-free survival was the primary end point. Patients with low cathepsin-D levels had a significantly better disease-free survival than patients with high cathepsin-D values (meta-analytical odds ratio from 0.59 to 0.60 over the interval from 1 to 7 years). A secondary meta-analysis conducted exclusively on the data from eight studies based on cytosol assay gave substantially similar results. One limitation of our study is that the cut-off values to define high and low cathepsin-D concentrations were not identical in the various studies included in our meta-analysis (range from 20 to 78 pmol mg(-1) protein), thus introducing a possible bias in the statistical analysis of the data. However, a simulation based on the well-accepted method of the so-called publication bias showed that more than 100 null studies would be required to lead our results to a statistical level of non-significance. Considering the results of our meta-analysis, we conclude that the data presently available confirm a statistically significant association between high cathepsin-D values and poor disease-free survival in node-negative breast cancer patients.
authors.affiliation: Department of Gynaecology and Obstetrics, Catholic University, Rome, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Ferrandina
authors.forename: G
authors.initials: G
authors.lastname: Scambia
authors.forename: F
authors.initials: F
authors.lastname: Bardelli
authors.forename: P
authors.initials: P
authors.lastname: Benedetti Panici
authors.forename: S
authors.initials: S
authors.lastname: Mancuso
authors.forename: A
authors.initials: A
authors.lastname: Messori
mesh_terms: D001943:Breast Neoplasms / Q000201:enzymology / Q000628:therapy*; D002402:Cathepsin D / Q000032:analysis*; D003600:Cytosol / Q000201:enzymology; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008207:Lymphatic Metastasis; D016017:Odds Ratio
chemical_list: D002402:Cathepsin D