Abstract
Clinical trials have provided conflicting results regarding whether epidermal growth factor receptor (EGFR) overexpression predicts poor survival in cervical cancer patients. In this study, we perform a meta-analysis of the association between EGFR expression and survival in cervical cancer patients. We searched clinical studies in the Medline, PubMed, Embase, and Web of Science databases. A total of 22 studies with 2,505 patients were included, and pooled hazard ratios (HRs) with 95% confidence intervals (CIs) were calculated for each study. Heterogeneity was assessed using Higgins I2 to select a Mantel-Haenszel fixed effects model (I2 ≤50%) or a DerSimonian-Laird random effects model (I2 ≥50%). High EGFR levels predicted poor overall survival (OS) (HR: 1.40, 95% CI: 1.10–1.78) and disease-free survival (DFS) (HR: 1.84, 95% CI: 1.51–2.24). Stratified analyses showed that EGFR overexpression was significantly related to poor DFS in patients treated with chemoradiation or surgery. Moreover, the pooled odds ratios (ORs) revealed associations between EGFR expression and clinicopathological features, such as lymph node metastasis (OR: 1.72, 95% CI: 1.23–2.40) and tumor size ≥4 cm (OR: 1.64, 95% CI: 1.20–2.23). This meta-analysis demonstrates that EGFR overexpression is closely associated with reduced survival in patients with cervical cancer. These results may facilitate the individualized management of clinical decisions for anti-EGFR therapies in cervical cancer patients.
Highlights
Cervical cancer is the third most frequently diagnosed malignancy and represents the fourth leading cause of cancer-related death in females worldwide [1]
The following criteria for study eligibility were set before articles were collected: (1) Epidermal growth factor receptor (EGFR) was evaluated in primary cervical cancer tissues using immunohistochemistry (IHC) or by quantifying EGFR protein levels; (2) a hazard ratio (HR) and its confidence interval (CI) from a survival analysis were reported; (3) the median follow up time exceeded 2 years; (4) the investigated endpoints were overall survival (OS) and disease-free survival (DFS); and (5) when a single study was reported on multiple occasions, the latest or most informative article was selected
Based on the inclusion criteria listed in a previous sections, 32 papers were eligible for further assessment
Summary
Cervical cancer is the third most frequently diagnosed malignancy and represents the fourth leading cause of cancer-related death in females worldwide [1]. Prognostic Role of EGFR in Cervical Cancer in a 5-year survival rate of only 66% [3]. Tremendous efforts are still needed to improve the overall survival rate in patients with advanced-stage cervical cancer. EGFR inhibitors have demonstrated efficacy in some clinical trials involving patients with colon, lung, head, and neck cancers [5,6,7]. Several small-scale clinical trials of EGFR inhibitors have been completed in cervical cancer patients, but the effects of these drugs are not yet well established [8,9,10,11,12]. Numerous clinical trials have demonstrated that only a subset of patients respond to EGFR inhibitors. A practical predictor of a response to these drugs has not been identified for cervical cancer
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
