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Annals of Oncology Advance Access published online on September 15, 2006
Annals of Oncology, doi:10.1093/annonc/mdl287
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© 2006 European Society for Medical Oncology
Received April 3, 2006
Revised June 30, 2006
Accepted July 3, 2006

original article

Thyroid transcription factor 1--a new prognostic factor in lung cancer: a meta-analysis

T. Berghmans 1 *, M. Paesmans 2, C. Mascaux 1, B. Martin 1, A.-P. Meert 1, A. Haller 3, J.-J. Lafitte 4, and J.-P. Sculier 1

1 Department of Intensive Care and Thoracic Oncology, Institut Jules Bordet, Centre des Tumeurs de l'Université Libre de Bruxelles, Belgium
2 Data Centre, Institut Jules Bordet, Centre des Tumeurs de l'Université Libre de Bruxelles, Belgium
3 Department of Pathology, Institut Jules Bordet, Centre des Tumeurs de l'Université Libre de Bruxelles, Belgium
4 Chest Department, Centre Hospitalier Universitaire Calmette, Lille, France

* To whom correspondence should be addressed.
T. Berghmans, E-mail: thierry.berghmans{at}bordet.be


  Abstract

Background: The aim of this study was to determine the prognostic role for survival of thyroid transcription factor 1 (TTF-1) in lung cancer.

Methods: Studies evaluating survival and TTF-1 in lung cancer patients, published until August 2005, were assessed with a methodological scoring system. The required data for estimation of individual hazard ratios (HRs) for survival were extracted from the publications and a combined HR was calculated.

Results: We identified 10 eligible papers, all dealing with non-small-cell lung cancer (NSCLC). Eight were meta-analysed (evaluable studies). Seven studies included patients with local and/or locoregional diseases and three dealt only with adenocarcinoma. Median methodological quality score was 65.9% (range = 31.8%-70.5%). TTF-1 positivity was associated with statistically significant reduced or improved survival in one and four studies, respectively. Combined HR for the eight evaluable studies was 0.64 [95% confidence interval (CI) = 0.41-1.00]. In the subgroup of adenocarcinoma, the combined HR was 0.53 (95% CI = 0.29-0.95).

Conclusion: TTF-1 is a good prognostic factor for survival in NSCLC. Its effect appears also significant when the analysis is restricted to patients with adenocarcinoma. This study supports the fact that TTF-1 could be included in further prospective trials studying prognostic factors in NSCLC.

Keywords: lung cancer; meta-analysis; prognostic factor; survival; systematic review; thyroid transcription factor 1.
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