Vincenzo Di Nunno1, Veronica Mollica1, Matteo Brunelli2, Lidia Gatto3, Riccardo Schiavina4, Michelangelo Fiorentino5, Matteo Santoni6, Rodolfo Montironi7, Anna Caliò2, Albino Eccher2, Michele Milella8, Guido Martignoni2,9, Eugenio Brunocilla4, Francesco Massari10. 1. Division of Oncology, S. Orsola-Malpighi Hospital, Via Albertoni n 15, 40138, Bologna, Italy. 2. Department of Pathology AOUI, University of Verona, Verona, Italy. 3. Oncology Unit, SG Moscati Hospital of Taranto, Taranto, Italy. 4. Department of Urology, University of Bologna, S. Orsola-Malpighi Hospital, Bologna, Italy. 5. Pathology Service, Addarii Institute of Oncology, S-Orsola-Malpighi Hospital, Bologna, Italy. 6. Oncology Unit, Macerata Hospital, via Santa Lucia 2, Macerata, Italy. 7. Section of Pathological Anatomy, Polytechnic University of the Marche Region, School of Medicine, United Hospitals, Ancona, Italy. 8. Section of Oncology, Department of Medicine, University of Verona School of Medicine, Verona, Italy. 9. Department of Pathology, Pederzoli Hospital, Peschiera del Garda, Italy. 10. Division of Oncology, S. Orsola-Malpighi Hospital, Via Albertoni n 15, 40138, Bologna, Italy. francesco.massari@aosp.bo.it.
Abstract
CONTEXT: 9p loss appears a reliable and promising marker able to differentiate specific categories of patients with renal cell carcinoma associated with a worse prognosis. OBJECTIVE: The aim was to systematically evaluate relative risk of death, cancer-specific survival (CSS) and disease-free survival (DFS) among patients harboring 9p loss. EVIDENCE SYNTHESIS: We found a total of 92 potentially relevant articles focused on the detection of 9p loss in patients with renal cell carcinoma and clinical outcomes of this population. Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines were employed to carry out this work. Fourteen studies resulted to be eligible for this analysis; 11 of these reported data on 5-year overall survival, six on CSS and four on DFS. An increased risk of death has been observed in patients harboring 9p loss (pooled relative risk of 3.965; 95% confidence interval [CI] 2.647-5.940, p < 0.001). Similarly, worse CSS (hazard ratio [HR] 6.776; 95% CI 3.824-12.009; p < 0.001) and DFS (HR 2.914; 95% CI 1.245-6.819; p = 0.014) have been observed in this population. Heterogeneity was significant in survival analysis, while no significant heterogeneity was observed in the CSS and DFS analyses. CONCLUSIONS: Patients harboring chromosome 9p loss have worse clinical outcomes in terms of overall survival, CSS and DFS.
CONTEXT: 9p loss appears a reliable and promising marker able to differentiate specific categories of patients with renal cell carcinoma associated with a worse prognosis. OBJECTIVE: The aim was to systematically evaluate relative risk of death, cancer-specific survival (CSS) and disease-free survival (DFS) among patients harboring 9p loss. EVIDENCE SYNTHESIS: We found a total of 92 potentially relevant articles focused on the detection of 9p loss in patients with renal cell carcinoma and clinical outcomes of this population. Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines were employed to carry out this work. Fourteen studies resulted to be eligible for this analysis; 11 of these reported data on 5-year overall survival, six on CSS and four on DFS. An increased risk of death has been observed in patients harboring 9p loss (pooled relative risk of 3.965; 95% confidence interval [CI] 2.647-5.940, p < 0.001). Similarly, worse CSS (hazard ratio [HR] 6.776; 95% CI 3.824-12.009; p < 0.001) and DFS (HR 2.914; 95% CI 1.245-6.819; p = 0.014) have been observed in this population. Heterogeneity was significant in survival analysis, while no significant heterogeneity was observed in the CSS and DFS analyses. CONCLUSIONS:Patients harboring chromosome 9p loss have worse clinical outcomes in terms of overall survival, CSS and DFS.
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