title: Predictive value of excision repair cross-complementation group 1 expression for platinum-based chemotherapy and survival in gastric cancer: a meta-analysis.
abstract: OBJECTIVE
  The predictive value of excision repair cross-complementation group 1 (ERCC1) gene for survival and response to platinum-based chemotherapy in gastric cancer (GC) remains controversial. We performed a meta-analysis to clarify the precise estimation of the prognostic and predictive effect of ERCC1.
  
  
  METHODS
  A systematic literature search was conducted using PubMed, ScienceDirect, Wiley and American Society of Clinical Oncology (ASCO) before March 2014. Studies analyzing survival data and/or chemotherapy response in GC by ERCC1 status were identified. The principal outcome measures were hazard ratios (HRs) for survival and relative risks (RRs) for chemotherapy response. Pooled HRs and RRs were calculated using fixed- or random-effects models according to the heterogeneity.
  
  
  RESULTS
  Twenty-one studies involving 1,628 patients met our inclusion criteria. High ERCC1 expression was significantly associated with shorter overall survival (OS) and lower response to chemotherapy in advanced GC patients receiving palliative chemotherapy (HR 1.83; 95 % CI 1.45-2.31; P < 0.001; RR 0.49; 95 % CI 0.38-0.62; P < 0.001). There was no significant difference in survival between high and low ERCC1 expression in adjuvant setting (OS: HR 1.38; 95 % CI 0.77-2.45; P = 0.276; EFS 0.72; 95 % CI 0.38-1.33; P = 0.291). Some evidence of heterogeneity and possible publication bias were discovered in few meta-analyses.
  
  
  CONCLUSIONS
  High ERCC1 expression might be an adverse prognostic and a drug-resistance predictive factor for advanced GC patients. However, further studies with consistent ERCC1 assessment methodology are needed.
authors.affiliation: Hubei Key Laboratory of Tumor Biological Behaviors, Department of Radiation and Medical Oncology, Zhongnan Hospital of Wuhan University, 169 Donghu Road, Wuhan, 430071, China.
authors.forename: Anqi
authors.initials: A
authors.lastname: Yao
authors.forename: You
authors.initials: Y
authors.lastname: Wang
authors.forename: Xiaohong
authors.initials: X
authors.lastname: Peng
authors.forename: Rong
authors.initials: R
authors.lastname: Ye
authors.forename: Qiaoli
authors.initials: Q
authors.lastname: Wang
authors.forename: Yuexiao
authors.initials: Y
authors.lastname: Qi
authors.forename: Fuxiang
authors.initials: F
authors.lastname: Zhou
mesh_terms: D004268:DNA-Binding Proteins / Q000235:genetics*; D004720:Endonucleases / Q000235:genetics*; D006801:Humans; D007150:Immunohistochemistry; D010984:Platinum / Q000627:therapeutic use*; D011237:Predictive Value of Tests; D017594:Publication Bias; D060888:Real-Time Polymerase Chain Reaction; D013274:Stomach Neoplasms / Q000188:drug therapy / Q000235:genetics* / Q000401:mortality
chemical_list: D004268:DNA-Binding Proteins; D010984:Platinum; C071447:ERCC1 protein, human; D004720:Endonucleases