The prognostic value of TP53 mutations in oesophageal adenocarcinoma: a systematic review and meta-analysis

Area of Science:

• Oncology
• Genetics
• Molecular Biology

Background:

• Oesophageal adenocarcinoma (OAC) requires reliable prognostic biomarkers to guide patient management.
• Tumour protein 53 (TP53) mutations are frequently observed in various cancers, but their specific prognostic role in OAC needs clarification.

Purpose of the Study:

• To systematically evaluate the prognostic significance of TP53 mutations in patients diagnosed with OAC.
• To determine if TP53 mutation status can predict survival outcomes in OAC.

Main Methods:

• A systematic review of studies published between 1990 and 2015 was performed using multiple databases (MEDLINE, Embase, PubMed, Current Contents Connect).
• Studies included populations with at least 50% OAC diagnoses, reporting TP53 status and survival data (hazard ratios).
• Risk of bias was assessed, and a pooled hazard ratio was calculated using a random-effects model.

Main Results:

• Sixteen studies comprising 888 patients were analyzed.
• TP53 mutations were significantly associated with reduced overall survival in OAC patients (HR 1.48, 95% CI 1.16-1.90).
• A stronger negative prognostic effect was observed in a sensitivity analysis of high-quality, OAC-only studies (HR 2.11, 95% CI 1.35-3.31).

Conclusions:

• TP53 gene mutations are associated with diminished overall survival in oesophageal adenocarcinoma.
• The prognostic impact of TP53 mutations on survival is independent of the tumour stage in OAC patients.
• TP53 mutation status represents a valuable prognostic biomarker for OAC.