Prognostic role of epidermal growth factor receptor in head and neck cancer: A meta-analysis

Background and Objectives To evaluate the predicting value of the epidermal growth factor receptor (EGFR) for survival in patients with head and neck cancer (HNC). Methods Data were collected from studies comparing overall survival (OS) or progression-free survival (PFS) in patients with higher or lower EGFR levels. Studies were pooled and combined hazard ratios (HRs) of EGFR for survival were calculated. Results A total of 68 studies involving 6,781 patients were included for meta-analysis. Either EGFR protein expression or gene copy number had prognostic value in HNC patients. EGFR overexpression could predict worse outcome, with HRs of 1.65 (95% CI: 1.45, 1.86) for OS and 1.27 (95% CI: 1.17, 1.37) for PFS. Increased EGFR copy number was also associated with reduced survival, with HRs of 1.5 (95% CI: 1.15, 1.96) for OS and 1.35 (95% CI: 1.14, 1.61) for PFS. Furthermore, EGFR overexpression could predict poorer OS in both eastern and western countries. Particularly, EGFR was considered a strong predictor in laryngeal squamous cell cancer (HR > 2). Conclusion Elevated EGFR expression and gene copy number could predict poor survival in HNC patients. J. Surg. Oncol. 2013; 108:387-397.