Molecular Diagnostics

British Journal of Cancer (2009) 101, 149–159. doi:10.1038/sj.bjc.6605112 www.bjcancer.com
Published online 9 June 2009

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

P de Graeff1,4, A P G Crijns1,4, S de Jong2, M Boezen3, W J Post3, E G E de Vries2, A G J van der Zee1 and G H de Bock3

  1. 1Department of Gynaecologic Oncology, University Medical Centre Groningen, University of Groningen, Hanzeplein 1, Groningen 9713 GZ, The Netherlands
  2. 2Department of Medical Oncology, University Medical Centre Groningen, University of Groningen, Hanzeplein 1, Groningen 9713 GZ, The Netherlands
  3. 3Department of Epidemiology, University Medical Centre Groningen, University of Groningen, Hanzeplein 1, Groningen 9713 GZ, The Netherlands

Correspondence: Dr GH de Bock, E-mail: g.h.de.bock@epi.umcg.nl

4These authors contributed equally to the work

Received 27 January 2009; Revised 22 April 2009; Accepted 1 May 2009; Published online 9 June 2009.

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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.

Keywords:

p53, EGFR, HER-2/neu, ovarian cancer, meta-analysis