Prognostic value of epidermal growth factor receptor mutations in resected non-small cell lung cancer: a systematic review with meta-analysis

Zhixuan Zhang, Ting Wang, Jun Zhang, Xiaohong Cai, Changchuan Pan, Yu Long, Jing Chen, Chengya Zhou, Xude Yin, Zhixuan Zhang, Ting Wang, Jun Zhang, Xiaohong Cai, Changchuan Pan, Yu Long, Jing Chen, Chengya Zhou, Xude Yin

Abstract

Background: The prognostic value of epidermal growth factor receptor (EGFR) mutations in resected non-small cell lung cancer (NSCLC) remains controversial. We performed a systematic review with meta-analysis to assess its role.

Methods: Studies were identified via an electronic search on PubMed, Embase and Cochrane Library databases. Pooled hazard ratio (HR) for disease-free survival (DFS) and overall survival (OS) were calculated for meta-analysis.

Results: There were 16 evaluated studies (n = 3337) in the meta-analysis. The combined HR evaluating EGFR mutations on disease free survival was 0.96 (95% CI [0.79-1.16] P = 0.65). The combined HR evaluating EGFR mutations on overall survival was 0.86 (95% CI [0.72-1.04] P = 0.12). The subgroup analysis based on univariate and multivariate analyses in DFS and OS showed no statistically significant difference. There was also no statistically significant difference in DFS and OS of stage I NSCLC patients.

Conclusion: The systematic review with meta-analysis showed that EGFR mutations were not a prognostic factor in patients with surgically resected non-small cell lung cancer. Well designed prospective study is needed to confirm the result.

Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Figure 1. PRISMA Flow chart of the…
Figure 1. PRISMA Flow chart of the search result of the meta-analysis.
Figure 2. Sensitivity analysis for combined HRs…
Figure 2. Sensitivity analysis for combined HRs evaluating EGFR mutations on disease free survival.
Figure 3. Fixed-effect model forest plot of…
Figure 3. Fixed-effect model forest plot of HR of DFS in statistical analysis method subgroup analysis according to EGFR mutation status.
Solid diamond indicates the pooled HR of DFS, square indicates hazard ratio value of each study.
Figure 4. Fixed-effect model forest plot of…
Figure 4. Fixed-effect model forest plot of HR of DFS in pathologic stage subgroup analysis according to EGFR mutation status.
Solid diamond indicates the pooled HR of DFS, square indicates hazard ratio value of each study.
Figure 5. Funnel plot for publication bias…
Figure 5. Funnel plot for publication bias test DFS.
The two oblique lines indicate the pseudo 95% CI.
Figure 6. Sensitivity analysis for combined HRs…
Figure 6. Sensitivity analysis for combined HRs evaluating EGFR mutations on overall survival.
Figure 7. Fixed-effect model forest plot of…
Figure 7. Fixed-effect model forest plot of HR of OS in statistical analysis method subgroup analysis according to EGFR mutation status.
Solid diamond indicates the pooled HR of OS, Square indicates hazard ratio value of each study.
Figure 8. Random-effect model forest plot of…
Figure 8. Random-effect model forest plot of HR of OS in pathologic stage subgroup analysis according to EGFR mutation status.
Solid diamond indicates the pooled HR of OS, Square indicates hazard ratio value of each study.
Figure 9. Funnel plot for publication bias…
Figure 9. Funnel plot for publication bias test OS.
The two oblique lines indicate the pseudo 95% CI.

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