Prognostic value of p53 alterations in human osteosarcoma: a meta analysis.
Tumor suppressor gene p53 functions as the guardian of the human genome and mutations in p53 contribute to cancer development. However, studies that investigated the potential of p53 as a prognostic marker in osteosarcoma patients have yielded inconclusive results. Based on recommendation of the Cochrane Collaboration, this meta-analysis was conducted using data from the 17 published studies to evaluate the association of p53 alterations with clinical outcome of osteosarcoma patients. Different databases, including MEDLINE, PsycINFO, Scopus, EMBASE, and the Cochrane Central Register of Controlled Trials (CENTRAL) were searched. Prognostic value of p53 alterations was determined by risk ratio (RR). The data showed that p53-positive immunostaining tended to associate with decreased 2-year survival rates (RR, 1.94; 95% CI, 1.43 to 2.64; p < 0.0001, I(2) = 10%). However, the prediction value of RR was smaller with p53 expression than with p53 mutations. Moreover, patients who received neoadjuvant chemotherapy and surgery tended to have a stronger association between p53-positive staining and 2-year mortality compared to the patients treated with surgery only. However, p53-positive staining was not associated with 3-year (RR, 1.64; 95% CI, 0.84 to 3.20; P = 0.15; I(2) = 56%) and 5-year survival (RR, 1.25; 95% CI, 0.78 to 2.01; P = 0.36; I(2) = 70%). The data from the current study suggest that p53-positive osteosarcoma only predicted a decreased short-term survival rate, but not 3- or 5-year survival.
Department of Orthopedic Surgery, Shanxi Provincial Corps Hospital of The Chinese People's Armed Police Force 36 Shifan Street, Taiyuan 030006, Shanxi, China ; Department of Anatomy, Histology and Embryology & K.K. Leung Brain Research Centre, Preclinical School of Medicine, Fourth Military Medical University Xi'an 710032, PR China.
Dong
D
Yao
Department of Anatomy, Histology and Embryology & K.K. Leung Brain Research Centre, Preclinical School of Medicine, Fourth Military Medical University Xi'an 710032, PR China.
Guo-Hong
GH
Cai
Department of Anatomy, Histology and Embryology & K.K. Leung Brain Research Centre, Preclinical School of Medicine, Fourth Military Medical University Xi'an 710032, PR China.
Jing
J
Chen
Department of Vascular and Endocrine Surgery, Xijing Hospital, Fourth Military Medical University Xi'an 710032, PR China.
Rui
R
Ling
Department of Anatomy, Histology and Embryology & K.K. Leung Brain Research Centre, Preclinical School of Medicine, Fourth Military Medical University Xi'an 710032, PR China.
Sheng-Xi
SX
Wu
Department of Vascular and Endocrine Surgery, Xijing Hospital, Fourth Military Medical University Xi'an 710032, PR China.
Yong-Ping
YP
Li
D014408:Biomarkers, Tumor / Q000032:analysis* / Q000235:genetics; D001859:Bone Neoplasms / Q000737:chemistry* / Q000235:genetics / Q000401:mortality / Q000473:pathology / Q000628:therapy; D017024:Chemotherapy, Adjuvant; D016009:Chi-Square Distribution; D006801:Humans; D016017:Odds Ratio; D012516:Osteosarcoma / Q000737:chemistry* / Q000235:genetics / Q000401:mortality / Q000473:pathology / Q000628:therapy; D011237:Predictive Value of Tests; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome; D016159:Tumor Suppressor Protein p53 / Q000032:analysis* / Q000235:genetics
D014408:Biomarkers, Tumor; C495901:TP53 protein, human; D016159:Tumor Suppressor Protein p53
meta-analysis; osteosarcoma; p53; survival