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Meta-Analysis
. 2021 Apr 17;21(1):424.
doi: 10.1186/s12885-021-08170-3.

The prognostic significance of survivin expression in patients with HNSCC: a systematic review and meta-analysis

Liu-Qing Zhou #  1 , Yao Hu #  2 , Hong-Jun Xiao  3
Affiliations
Meta-Analysis

The prognostic significance of survivin expression in patients with HNSCC: a systematic review and meta-analysis

Liu-Qing Zhou et al. BMC Cancer. .

Abstract

Background: Survivin has been recently identified as a promising novel therapeutic target and prognostic marker in different types of cancer. Here we conducted a comprehensive meta-analysis to better clarify they the precise prognostic and diagnostic value of survivin in head and neck squamous cell carcinoma (HNSCC).

Methods: Database of PubMed (Medline), Embase, and Web of Science were systematically searched for related published literature up to September 2020. Pooled hazards ratios (HR) and related 95% confidence intervals (CI) were used to estimate the association of survivin expression and survival outcomes in HNSCC patients.

Results: Twenty eight studies with 4891 patients were finally included in this meta-analysis, the pooled analysis indicated that the survivin expression was significantly correlated with poorer overall survival (OS) (HR, 2.02; 95% CI, 1.65-2.47, P < 0.001), and poorer disease-free survival (DFS)/ disease-specific survival (DSS) (HR = 2.03, 95%CI: 1.64-2.52, P < 0.001; HR = 1.92, 95%CI: 1.41-2.60, P < 0.001, receptively). Similar results were observed in subgroup analysis stratified by different cancer types, such as laryngeal squamous cell carcinoma (LSCC) (HR = 1.35, 95%CI: 1.05-1.74, P < 0.001), oral squamous cell carcinomas (OSCC) (HR = 2.45, 95%CI: 1.89-3.17, P < 0.001), nasopharyngeal carcinoma (NPC) (HR = 2.53, 95%CI: 1.76-3.62, P < 0.001) and HNSCC (HR = 1.52, 95%CI: 1.25-1.86, P < 0.001). Furthermore, ethnicity-stratified analysis indicated that survivin was significantly associated with poorer OS among both Asian and Non- Asian HNSCC patients (HR = 2.16, 95%CI: 1.76-2.66; HR = 1.56, 95%CI: 1.33-1.82, respectively).

Conclusions: Our results suggested that survivin is predictors of worse prognosis in HNSCC patients. Hence, survivin is a potential therapeutic target for HNSCC.

Keywords: Head and neck squamous cell carcinoma; Meta-analysis; Prognosis; Survivin.

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Conflict of interest statement

The author(s) declare(s) that they have no competing interests.

Figures

Fig. 1
Fig. 1
Flow diagram of the selection of relevant studies included in the meta-analysis
Fig. 2
Fig. 2
Forest plot indicating the association between survivin expression and OS in HNSCC
Fig. 3
Fig. 3
Forest plot examining the association between survivin expression and DFS/DSS in HNSCC
Fig. 4
Fig. 4
Forest plot of OS in association with survivin in different types of HNSCC
Fig. 5
Fig. 5
Forest plot of OS in association with survivin in different types of geographic populations
Fig. 6
Fig. 6
The sensitivity analyses were conducted to evaluate the effects of each single study on the overall effect
Fig. 7
Fig. 7
Publication bias and trim and fill analysis of the enrolled analysis. a The Begg’s funnel plots; b The Egger’s test. c Trim and fill analysis
See this image and copyright information in PMC

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