Evidence map›Paper›PMID 21448172›Full record

SynthesisBritish journal of cancer2011

Meta-analysis of immunohistochemical prognostic markers in resected pancreatic cancer.

R A Smith, J Tang, C Tudur-Smith, J P Neoptolemos, P Ghaneh

Open access · hybridAbstract readMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in British journal of cancer, 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 55 papers, 8 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
55citing papers in PubMed, 8 pooled it
7.2field-weighted citation impact, top 2% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

55 citing papers in PubMed, 8 syntheses or guidelines pooled it, 105 citations in OpenAlex.

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  6. High circulating VEGF level predicts poor overall survival in lung cancer.Journal of cancer research and clinical oncology · 2013
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  7. A systematic review of vascular endothelial growth factor expression as a biomarker of prognosis in patients with osteosarcoma.Tumour biology : the journal of the International Society for Oncodevelopmental Biology and Medicine · 2013
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  11. Diagnostic and Prognostic Values of Bile Biomarkers for Malignant Biliary Stenosis.Liver international : official journal of the International Association for the Study of the Liver · 2026
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors at 2 institutions in 1 country.

R A SmithDivision of Surgery and Oncology, School of Cancer Studies, University of Liverpool, Royal Liverpool University Hospital, 5th Floor Duncan Building, Daulby Street, Liverpool L69 3GA, UK.
J Tang
C Tudur-Smith
J P Neoptolemos
P Ghaneh
University of Liverpool · GBRoyal Liverpool University Hospital · GB

Funding

Cancer Research UK 11883Cancer Research UK 8968Department of Health 08/29/02
6 · The paper itself

Abstract

backgroundThe potential prognostic value of several commonly investigated immunohistochemical markers in resected pancreatic cancer is variably reported. The objective of this study was to conduct a systematic review of literature evaluating p53, p16, smad4, bcl-2, bax, vascular endothelial growth factor (VEGF) and epidermal growth factor receptor (EGFR) expression as prognostic factors in resected pancreatic adenocarcinoma and to conduct a subsequent meta-analysis to quantify the overall prognostic effect.

methodsRelevant literature was identified using Medline, EMBASE and ISI Web of Science. The primary end point was overall survival assessed on univariate analysis. Only studies analysing resected pancreatic adenocarcinoma were eligible for inclusion and the summary log(e) hazard ratio (logHR) and variance were pooled using an inverse variance approach. Evidence of heterogeneity was evaluated using the χ(2) test for heterogeneity and its impact on the meta-analysis was assessed by the I(2) statisic. Hazard ratios greater than one reflect adverse survival associated with positive immunostaining.

resultsVascular endothelial growth factor emerged as the most potentially informative prognostic marker (11 eligible studies, n=767, HR=1.51 (95% confidence interval, CI=1.18-1.92)) with no evidence of any significant publication bias (Egger's test, P=0.269). Bcl-2 (5 eligible studies, n=314, HR=0.51 (95% CI=0.38-0.68)), bax (5 studies, n=274, HR=0.63 (95% CI=0.48-0.83)) and p16 (3 studies, n=229, HR=0.63 (95% CI=0.43-0.92)) also returned significant overall survival differences, but in smaller patient series due to a lack of evaluable literature. Neither p53 (17 studies, n=925, HR=1.22 (95% CI=0.96-1.56)), smad4 (5 studies, n=540, HR=0.88 (95% CI=0.61-1.27)) nor EGFR (4 studies, n=250, HR=1.35 (95% CI=0.80-2.27)) was found to represent significant prognostic factors when analysing the pooled patient data. There was evidence of significant heterogeneity in four of the seven study groups.

conclusionThese results support the case for immunohistochemical expression of VEGF representing a significant and reproducible marker of adverse prognosis in resected pancreatic cancer.

Indexed as

Adenocarcinomabcl-2-Associated X ProteinBiomarkers, TumorCyclin-Dependent Kinase Inhibitor p16ErbB ReceptorsHumansImmunohistochemistryNeoplasm ProteinsPancreatic NeoplasmsPredictive Value of TestsPrognosisProto-Oncogene Proteins c-bcl-2Smad4 ProteinTumor Suppressor Protein p53Vascular Endothelial Growth Factor ABAX protein, humanbcl-2-Associated X ProteinBiomarkers, TumorCDKN2A protein, humanCyclin-Dependent Kinase Inhibitor p16EGFR protein, humanErbB ReceptorsNeoplasm ProteinsProto-Oncogene Proteins c-bcl-2Smad4 ProteinSMAD4 protein, humanTumor Suppressor Protein p53Vascular Endothelial Growth Factor AVEGFA protein, human

Identifiers

PMID21448172
PMCPMC3101928
OpenAlexW2076151940

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.