Abstract
Background: Many studies have attempted to correlate p53 abnormality including p53 gene mutation and p53 protein over expression with prognosis or therapeutic response in adjuvant chemotherapy but have yielded controversial results. To investigate whether p53 aberrations have different impacts on survival and outcomes of adjuvant chemotherapy among cancer patients, we conducted a meta-analysis. Methods: We performed comprehensive search before September 18, 2022. Hazard Ratio (HR) with 95% Confidence Interval (CI) was effective measure, and Stata 16.0 was applied for data analysis. Results: A total of 14 articles were enrolled in this meta-analysis. p53 protein over expression detected by immunohistochemistry was a risk factor of 5-year Overall Survival (OS) among cancer patients after Radical Surgery (RS). Furthermore, p53 protein over expressed patients displayed inferior response to adjuvant chemotherapy with unfavorable 5-year Disease Free Survival (DFS) (HR = 1.61, 95% CI: 1.12 ~ 2.32, P = 0.011). p53 gene mutation was a negative indicator of OS in adjuvant chemotherapy (HR = 1.41, 95% CI: 1.19 ~ 1.69, P< 0.001). Furthermore, we performed subgroup analysis according to year of publication, the number of patients, detection method of abnormal p53 and tumor types, consistent result was observed. Conclusion: p53 protein over expression appears to serve as a predictive and prognostic biomarker in adjuvant chemotherapy setting. p53 gene mutation is a potential predictor and could identify high-risk patients who obtain limited overall benefit from adjuvant chemotherapy and support clinical decision-making.
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