Survival impact of epidermal growth factor receptor overexpression in patients with non-small cell lung cancer: a meta-analysis
- 1Department of Chest Surgery, Atami Hospital, International University of Health and Welfare, 13-1 Higashikaigan-cho, Atami-shi, Shizuoka, 413-0012, Japan
- 2Center for Medical Informatics, International University of Health and Welfare, 2600-1 Kitananamaru, Ohtawara-shi, Tochigi, 324-8501, Japan
- Correspondence to:
Dr H Nakamura
Department of Chest Surgery, Atami Hospital, International University of Health and Welfare, 13-1 Higashikaigan-cho, Atami-shi, Shizuoka, 413-0012 Japan;
- Received 9 February 2005
- Accepted 8 June 2005
- Published Online First 11 November 2005
Background: It is thought that overexpression of epidermal growth factor receptor (EGFR) in non-small cell lung cancer (NSCLC) might compromise patient survival, presumably by promoting tumour growth by an autocrine mechanism. However, conflicting results have been reported from various laboratories, and the clinical importance of EGFR overexpression remains unsettled.
Methods: A meta-analysis of previous studies was performed to quantitatively review the effects of EGFR overexpression on survival in patients with NSCLC using a DerSimonian-Laird random effects model. Eighteen studies including 2972 patients were subjected to final analysis.
Results: Overall, positivity for EGFR overexpression differed between histological types: 39% in adenocarcinomas, 58% in squamous cell carcinomas, 38% in large cell carcinomas, and 32% in cancers in a miscellaneous category (p<0.0001). The combined hazard ratio (HR) was 1.14 (95% CI 0.97 to 1.34; p = 0.103), indicating that EGFR overexpression has no significant impact on survival. When only the 15 immunohistochemistry based studies were considered, the combined HR was 1.08 (95% CI 0.92 to 1.28; p = 0.356), again suggesting that EGFR overexpression has no impact on survival. Heterogeneity testing indicated that there was heterogeneity between studies but publication bias was absent, which suggests that the summary statistics obtained may approximate the actual average.
Conclusions: EGFR overexpression was not associated with poorer survival in patients with NSCLC. Specific mutations of the EGFR gene will need further study in terms of survival implications.
Published Online First 11 November 2005
This study was funded in part by grant no. 15591493 from the Ministry of Education, Science, Sports, and Culture of Japan.
Competing interests: none declared.