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Meta-Analysis
. 2016 Jun;95(23):e3661.
doi: 10.1097/MD.0000000000003661.

HER-2 expression in biopsy and surgical specimen on prognosis of osteosarcoma: A systematic review and meta-analysis of 16 studies

Qingyu Zhang  1 , Fanxiao Liu, Bomin Wang, Zhenfeng Li, Dongsheng Zhou, Qiang Yang, Jinlei Dong, Jianmin Li
Affiliations
Meta-Analysis

HER-2 expression in biopsy and surgical specimen on prognosis of osteosarcoma: A systematic review and meta-analysis of 16 studies

Qingyu Zhang et al. Medicine (Baltimore). 2016 Jun.

Erratum in

  • Erratum: Medicine, Volume 95, Issue 23: Erratum.
    [No authors listed] [No authors listed] Medicine (Baltimore). 2016 Jul 18;95(28):e0916. doi: 10.1097/01.md.0000489580.04709.16. eCollection 2016 Jul. Medicine (Baltimore). 2016. PMID: 31265603 Free PMC article.

Abstract

Numerous original clinical studies have attempted to investigate the prognostic value of HER-2 overexpression in osteosarcoma, but the results of these studies are not consistent. This meta-analysis and systematic review was performed to further assess the correlation between HER-2 expression and prognosis in patients with osteosarcoma. A detailed search of relevant publications was conducted using 7 electronic databases: PubMed, Embase, the Cochrane library, the Wanfang database, the China National Knowledge Internet (CNKI) database, the Chinese VIP database, and the Chinese Biological Medical (CBM) Database for publications through August 1, 2015, using the following keywords (HER-2 OR ErbB-2 OR C-erbB-2 OR neu) AND (osteosarcoma OR osteogenic tumor). The bibliographies of potentially relevant articles and identified articles were then searched by hand. Eligible studies were those that enrolled participants with osteosarcoma and provided survival outcome in HER-2 positive and negative groups. The hazard ratio (HR) and 95% confidence interval (CI) for each individual study was calculated and pooled to obtain integrated estimates, using random effects modeling. Sixteen studies involving 934 participants with osteosarcoma met our inclusion criteria. HER-2 overexpression was documented in 42.2% of patients with osteosarcoma. Compared with patients without HER-2 overexpression, those overexpressing HER-2 had decreased overall survival (HR = 2.03, 95% CI: 1.36-3.03, P < 0.001). Statistical associations between HER-2 overexpression and unfavorable overall survival (OS) were observed for both biopsy and surgical removal specimens (HR = 2.07, 95%CI: 1.16-3.72, P = 0.014; and HR = 2.02, 95%CI: 1.10-3.71, P = 0.024). Results for disease-free survival (DFS) were similar. Overexpression of HER-2 is significantly associated with poor outcome for patients with osteosarcoma and should be assessed at diagnosis and after surgery as a prognostic factor. However, larger-scale multicenter clinical studies are needed to further support these findings.

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Conflict of interest statement

The authors have no conflicts of interest to disclose.

Figures

Figure 1
Figure 1
Selection process for eligible studies included in the meta-analysis.
Figure 2
Figure 2
Forest plot of the association between HER-2 overexpression and overall survival in osteosarcoma.
Figure 3
Figure 3
Forest plot of the subgroup analysis of OS: (A) biopsy samples and (B) surgical removal samples.
Figure 4
Figure 4
Forest plot of the association between HER-2 overexpression and overall survival in patients with localized disease at presentation.
Figure 5
Figure 5
Forest plot of the association between HER-2 overexpression and disease-free survival in osteosarcoma.
Figure 6
Figure 6
Annotation: forest plot of sensitivity analyses—(A) association between HER-2 overexpression and overall survival in osteosarcoma and (B) association between HER-2 overexpression and disease-free survival in osteosarcoma.
Figure 7
Figure 7
Annotation: funnel plots of publication bias—(A) publication bias for overall survival, P = 0.292 (Egger's) and (B) publication bias for disease-free survival, P = 0.218 (Egger's).
See this image and copyright information in PMC

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