IADR Abstract Archives
The prognostic significance of cancer-associated fibroblasts in oral cancer: a systematic review of the literature and meta-analysis
Objectives: The association between cancer-associated fibroblasts (CAFs) in oral cancer (OC) and poor survival is based on small-size studies
We conducted a systematic review of the literature and meta-analysis in order to consolidate this association.
Methods: A systematic search of the English language literature for studies that immunohistochemically identified CAFs (alpha smooth muscle positivity) in relation to survival was done. Raw data was reconstructed from graphs of hazard ratio or Kaplan-Meier survival plots. Univariate analysis using Fishers' Exact Test with odds ratio was used to perdict 5-year mortality followed by multivariate analysis using cox regression. Significance was set at p<0.05.
Results: Nine studies (N=582 OC patients) met the inclusion criteria. OC patients with high CAF density had a relative risk of mortality that was 5.045 times higher compared to patients with low CAF density (p<0.001, 95% CI 3.45-7.38). In addition, multivariate analysis showed that being a male had a protective effect (ß=-4.44), so that the relative risk to die within 5 years from diagnosis in males was 10 times lower than in females (p=0.025, 95% CI 0.00-0.57).
Conclusions:
High CAF density significantly increased the risk to die from OC within 5 years but being a male had a protective effect compared to females. Further studies attempting to establish a cutoff point for CAFs density to be used by clinicians as a reliable prognostic tool in cases of OC, are required.
We conducted a systematic review of the literature and meta-analysis in order to consolidate this association.
Methods: A systematic search of the English language literature for studies that immunohistochemically identified CAFs (alpha smooth muscle positivity) in relation to survival was done. Raw data was reconstructed from graphs of hazard ratio or Kaplan-Meier survival plots. Univariate analysis using Fishers' Exact Test with odds ratio was used to perdict 5-year mortality followed by multivariate analysis using cox regression. Significance was set at p<0.05.
Results: Nine studies (N=582 OC patients) met the inclusion criteria. OC patients with high CAF density had a relative risk of mortality that was 5.045 times higher compared to patients with low CAF density (p<0.001, 95% CI 3.45-7.38). In addition, multivariate analysis showed that being a male had a protective effect (ß=-4.44), so that the relative risk to die within 5 years from diagnosis in males was 10 times lower than in females (p=0.025, 95% CI 0.00-0.57).
Conclusions:
High CAF density significantly increased the risk to die from OC within 5 years but being a male had a protective effect compared to females. Further studies attempting to establish a cutoff point for CAFs density to be used by clinicians as a reliable prognostic tool in cases of OC, are required.