Abstract

BackgroundPublished studies have yielded inconsistent results on the relationship between p53 status and the progression of stage T1 non-muscle invasive bladder cancer (NMIBC). Therefore, we performed a meta-analysis to evaluate the prognostic value of p53 in T1 NMIBC.MethodsWe systematically searched for relevant literatures in MEDLINE, EMBASE, and Web of Science. Data were pooled together from individual studies, and meta-analysis was performed. Study quality was assessed using the Newcastle-Ottawa Scale. Pooled risk ratios (RRs) and 95 % CI were calculated to estimate the effect sizes. Moreover, subgroup analyses were carried out.ResultsA total of 12 studies comprising 712 patients were subjected to the final analysis. p53 overexpression was significantly associated with higher progression rate of T1 NMIBC (RR 2.32, 95 % CI 1.59–3.38). Moderate heterogeneity was observed across the studies (I2 = 39 %, P < 0.0001). In a subgroup analysis stratified by stage, p53 overexpression was a predictor of progression in T1 grade 3 NMIBC (RR 2.71, 95 % CI 1.31–5.64). In addition, in a subgroup analysis stratified by intravesical therapy, p53 overexpression was a predictor of progression in T1 NMIBC received Bacillus Calmette-Guérin intravesical therapy (RR 3.35, 95 % CI 1.89–5.93). Furthermore, after excluding the study that possibly contributed to the heterogeneity by the sensitivity analysis, the association p53 overexpression was significantly correlated with progression of T1 NMIBC (RR 2.74, 95 % CI 2.05–3.65) without evidence of heterogeneity (I2 = 0 %, P < 0.0001).ConclusionsThis meta-analysis suggested that p53 overexpression may be associated with progression of T1 NMIBC patients. Because of the heterogeneity and other limitations, further studies with rigid criteria and large populations are still warranted to confirm our findings.

Highlights

  • Published studies have yielded inconsistent results on the relationship between p53 status and the progression of stage T1 non-muscle invasive bladder cancer (NMIBC)

  • Of the 45 article that were in full-text format, 24 were excluded because of not including progression data; 9 were excluded since there were no specific result about p53 status in T1 NMIBC

  • Molecular markers are promising for accurately predicting the progression of T1 NMIBC patients. p53 plays an important role in the regulation of cell cycle and apoptosis

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Summary

Introduction

Published studies have yielded inconsistent results on the relationship between p53 status and the progression of stage T1 non-muscle invasive bladder cancer (NMIBC). Du et al World Journal of Surgical Oncology (2016) 14:137 Another approach has been to identify biomarkers to predict the probability of progression in T1 NMIBC [6]. The value of pretreatment p53 status on the progression of T1 NMIBC has been studied and discussed. Several studies reported that p53 overexpression is positively associated with progression of T1 NMIBC [12, 13]. Some studies failed to confirm the association between p53 overexpression and progression of T1 NMIBC [14, 15]

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