Abstract
PurposeTo conduct a meta-analysis to evaluate the prognostic role of E-cadherin expression in bone and soft tissue sarcomas.MethodsThe PubMed, EMBASE, and Web of Science databases were searched using terms related to E-cadherin, sarcoma, and prognosis for all articles published in English before March 2014. Pooled effect was calculated from the available data to evaluate the association between negative E-cadherin expression and 5-year overall survival and tumor clinicopathological features in sarcoma patients. Pooled odds ratios (OR) and risk ratios (RR) with 95% confidence intervals (CI) were calculated using a fixed-effects model.ResultEight studies met the selection criteria and reported on 812 subjects. A total of 496 subjects showed positive E-cadherin expression (59.9%). Negative E-cadherin expression in bone and soft tissue sarcomas was correlated with lower 5-year overall survival (OR = 3.831; 95% CI: 2.246–6.534), and was associated with higher clinical stage (RR = 1.446; 95% CI: 1.030–2.028) and with male sex (RR = 0.678; 95% CI: 0.493–0.933).ConclusionIn the E-cadherin negative group, 5-year overall survival was significantly worse than in the E-cadherin positive group. However, further studies are required to confirm these results.
Highlights
Sarcomas are a heterogeneous group of mesenchymal neoplasms that can be grouped into two general categories: soft tissue sarcoma (STS) and primary bone sarcoma (PBS) [1]
In order to be included in this meta-analysis, studies needed to meet specific criteria: (a) sarcoma patients included in the studies were confirmed histopathologically; (b) the association of E-cadherin expression with sarcoma was evaluated; (c) Kaplan–Meier survival analysis or 5-year overall survival was performed or clinicopathological features were evaluated; and (d) full text articles were written in English
A total of 28 articles were determined to be irrelevant and 4 articles were identified as review articles or case reports on E-cadherin expression in sarcoma
Summary
Sarcomas are a heterogeneous group of mesenchymal neoplasms that can be grouped into two general categories: soft tissue sarcoma (STS) and primary bone sarcoma (PBS) [1]. There are more than 100 distinct subtypes of sarcomas; STSs include liposarcoma, leiomyosarcoma, synovial sarcoma, rhabdomyosarcoma, and angiosarcoma; PBSs include osteosarcoma, Ewing’s sarcoma, chondrosarcoma, and giant cell tumor. Despite recent advances in treatment, sarcoma prognosis varies greatly between subtypes. Traditional therapeutic modalities are used in the treatment of most sarcoma subtypes, which, in many cases, are resistant to adjuvant therapies [3]. E-cadherin ( known as cadherin 1) is a cell-cell adhesion molecule that regulates histogenesis and stabilization and differentiation of the epithelium [4]. Down-regulation of E-cadherin expression results in the breaking of cell-cell contacts and the cells become mesenchymal cells [5]. Cell may transition from an epithelial to a mesenchymal like form (epithelial-to-mesenchymal transition) [6]
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