Yugang Liu, Zhaowei Teng, Ying Wang, Pengfei Gao, Junli Chen
(Department of Orthopedics, Affiliated Hospital of Hebei University of Engineering, Handan, Hebei, China (mainland))
Med Sci Monit 2015; 21:2877-2885
Osteosarcoma is the most common primary bone malignancy and has poor prognosis. Survivin has been identified as an independent prognostic factor for a majority of cancers. In the present study, we evaluated the effect of survivin expression on the clinical outcome of osteosarcoma patients.
MATERIAL AND METHODS: Online electronic databases were searched for related articles published between 2000 and 2015. Odds ratio (OR) and risk ratio (RR) with their 95% confidence intervals (CI) were employed to calculate the significance.
RESULTS: Overall, a total of 20 relevant studies were selected, including 1030 patients. No significant heterogeneity was observed among included studies (P>0.01, I2<50%). Survivin was expressed in 68.6% of all cases. Our results show that survivin expression increased the 5-year overall survival (RR=0.48, 95% CI=0.32–0.71, P=0.0002) and rate of postoperative recurrence (RR=1.80, 95% CI=1.09–2.97, P=0.02). It was associated with the grade of osteosarcoma (Enneking clinical stage, IIb–III vs. I–IIa: OR=5.26, 95% CI=3.76–7.34, P<0.00001; Price’s grade, III vs. I+II: OR=2.04, 95% CI=1.16–3.61, P=0.01), metastasis, and soft tissue invasion of osteosarcoma (OR=6.25, 95% CI=3.74–10.45, P<0.00001; OR=6.15, 95% CI=3.74–10.11, P<0.00001). No relationship was found between survivin expression and sex, age, or tumor size in patients with osteosarcoma.
CONCLUSIONS: Our results suggest that survivin can function as a new diagnostic biomarker for osteosarcoma and be used as a reference index to determine pathology classification of osteosarcoma, providing new targets for gene therapy of osteosarcoma.
Keywords: Adult, Adolescent, Age Factors, Aged, Bone Neoplasms - metabolism, Child, Data Interpretation, Statistical, Female, Gene Expression Profiling, Gene Expression Regulation, Neoplastic, Humans, Inhibitor of Apoptosis Proteins - metabolism, Male, Middle Aged, Neoplasm Metastasis, Neoplasm Recurrence, Local, Odds Ratio, Osteosarcoma - metabolism, Postoperative Period, Prognosis, Reference Values, Sex Factors, Treatment Outcome, young adult