Abstract
Several studies have assessed the clinicopathological and prognostic value of cyclooxygenase-2 (COX-2) expression in patients with head and neck cancer (HNC), but their results remain controversial. To address this issue, a meta-analysis was carried out. A total of 29 studies involving 2430 patients were subjected to final analysis. Our results indicated that COX-2 expression was not statistically associated with advanced tumor stage (OR, 1.23; 95% CI, 0.98–1.55) but correlated with high risk of lymph node metastasis (OR, 1.28; 95% CI, 1.03–1.60) and advanced TNM stage (OR, 1.33; 95% CI, 1.06–1.66). Moreover, COX-2 expression had significant effect on poor OS (HR, 1.93; 95% CI, 1.29–2.90), RFS (HR, 2.02; 95% CI, 1.00–4.08) and DFS (HR, 5.14; 95% CI, 2.84–9.31). The results of subgroup analyses revealed that COX-2 expression was related with high possibility of lymph node metastasis in oral cancer (OR, 1.49; 95% CI, 1.01–2.20) and advanced TNM stage in oral cancer (OR, 1.58; 95% CI, 1.05–2.37) and no site-specific HNC (OR, 1.64; 95% CI, 1.02–2.62). However, subgroup analyses only showed a tendency without statistically significant association between COX-2 expression and survival. Significant heterogeneity was not found when analyzing clinicopathological data, but it appeared when considering survival data. No publication bias was detected in this study. This meta-analysis suggested that COX-2 expression could act as a prognostic factor for patients with HNC.
Highlights
Head and neck cancer (HNC) comprise a series of tumors arising in the lip, oral cavity, pharynx and larynx
Our results indicated that COX-2 expression was not statistically associated with advanced tumor stage (OR, 1.23; 95% confidence intervals (CI), 0.98–1.55) but correlated with high risk of lymph node metastasis (OR, 1.28; 95% CI, 1.03–1.60) and advanced TNM stage (OR, 1.33; 95% CI, 1.06–1.66)
The results of subgroup analyses revealed that COX-2 expression was related with high possibility of lymph node metastasis in oral cancer (OR, 1.49; 95% CI, 1.01–2.20) and advanced TNM stage in oral cancer (OR, 1.58; 95% CI, 1.05–2.37) and no site-specific head and neck cancer (HNC) (OR, 1.64; 95% CI, 1.02–2.62)
Summary
Head and neck cancer (HNC) comprise a series of tumors arising in the lip, oral cavity, pharynx and larynx. Several studies suggested that none of the TNM systems used or proposed could account for even 30% of the variation observed in the survival rates of HNC [4,5,6]. Inflammation-induced COX-2 www.impactjournals.com/oncotarget has been reported to participate in the development and survival of cancers [9,10,11]. COX-2 might be a potential prognostic factor to predict the survival in patients with cancers. Numerous studies have examined the relationship between COX-2 expression and survival in patients with HNC [22,23,24,25,26,27]. We performed a meta-analysis to evaluate the clinicopathological and prognostic role of COX-2 expression in patients with HNC
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
