Significance of HER2 expression in patients with upper tract urothelial carcinoma: A meta-analysis

Abstract

Objective: Several studies have explored the prognostic values of HER2 expression in upper tract urothelial carcinoma (UTUC), however, the results obtained are not consistent. We aimed to calculate the clinical significance of HER2 expression on the outcome of UTUC patients using a meta-analysis. Materials and methods: Using published evidence, we performed a meta-analysis to examine the clinical values of HER2 expression in patients with UTUC. Thirty-five articles from 679 articles related to the epidermal growth factor receptor family expression assessment in UTUC patients were reviewed and seven papers were found to be fit for analyses. The estimates included the odds ratio (OR), distribution related to stage and grade, hazard ratios (HRs), and 95% confidence intervals (CIs) from survival analyses of intravesical recurrence, progression, and overall survival (OS). Results: The pooled results showed that HER2 expression is significantly associated with higher stage, but not with tumor grade in patients with UTUC (OR, 2.05; 95% CI, 1.15–3.68; p = 0.016 and OR, 4.73; 95% CI, 0.80–27.8; p = 0.086, respectively). In addition, the pooled survival analyses demonstrated that HER2 expression yielded a worse recurrence-free survival in UTUC patients (HR, 4.32; 95% CI, 2.17–8.60; p < 0.0001). However, there is lack of statistical significance in terms of progression-free survival and OS (HR, 2.08; 95% CI, 0.46–9.32; p = 0.339 and HR, 1.06; 95% CI, 0.48–2.37; p = 0.879, respectively). Conclusion: Existing studies on UTUC are heterogeneous and limited. Our analysis suggests that HER2 expression plays an important role in cancer recurrence in the urinary bladder after the primary treatment of UTUC.

Keywords

• epidermal growth factor receptor
• survival
• systemic review
• urothelial neoplasm