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1 Dept of Internal Medicine, 3 Data Centre, and 4 Service of Pathology, Jules Bordet Institute, Brussels, Belgium. 2 Service of Pneumology and Thoracic Medicine, CHU Calmette, Lille, France
CORRESPONDENCE: A-P. Meert, Institut Jules Bordet, 1, rue Héger Bordet, 1000-Bruxelles, Belgium. Fax: 32 25343756. E-mail: ap.meert@bordet.be
Keywords: epidermal growth factor receptor, lung cancer, systematic review
Received: November 19, 2001
Accepted June 18, 2002
This study was supported by an FNRS-Télévie grant (7.4512.98), Belgium. A-P. Meert is an FNRS research fellow.
The prognostic value of epidermal growth factor receptor (EGF-R) for survival of patients with lung cancer remains controversial. The authors performed a systematic review of the literature in order to clarify its impact.
Published studies were identified using an electronic search in order to aggregate the available survival results, after a methodological assessment using a scale specifically designed by the European Lung Cancer Working Party (ELCWP). To be eligible, a study had to have dealt with EGF-R assessment in lung cancer patients on the primary site and to have analysed survival according to EGF-R expression.
Among the 16 eligible studies, 14 assessed any nonsmall-cell lung cancer (NSCLC) subtype, one adenocarcinoma only and one squamous-cell carcinoma only. The overall median quality score was 56.3%, with no significant difference either between studies assessable or not assessable for meta-analysis or between studies with significant and nonsignificant results. One individual trial reported a survival benefit for patients with EGF-R expression, three a survival disadvantage and 12 no statistically significant difference. Eleven studies (2,185 patients) provided sufficient data to allow a meta-analysis of the survival results. EGF-R expression positivity was determined according to the cut-off as determined by the authors. The meta-analysis showed that EGF-R expression was not a statistically significant prognostic factor for survival in NSCLC. In the subgroup of studies using immunohistochemistry, statistical tests reached a significant level against EGF-R.
Epidermal growth factor receptor might be a poor prognostic factor for survival in nonsmall-cell lung cancer. The amplitude of the impact is small, however, and may be subject to publication bias.
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