Thymidylate Synthase Expression And Prognosis In Colorectal Cancer

BACKGROUND:Although many studies have investigated in the prognostic effect of thymidylate synthase (TS) for colorectal cancer, still no consensus is reached. The aim of this MA is to derive a more precise estimate of the prognostic significance of TS expression in localized cancers which were treated by both curative resection and adjuvant chemotherapy.MATERIALS AND METHOD:Seventeen eligible studies reporting survival in2893patients stratified by TS expression were pooled using a fixed-or random-effects model. The main outcome measure was hazard ratio (HR).RESULTS:The overall HR for OS was1.01(95%CI0.74-1.39, p=0.947), with an I2of64.4%. The total HR for DFS was1.36(95%CI0.97-1.89, p=0.072), with an I2of75.8%. Besides, in the protein tested subgroup, the total HR for DFS was1.72(95%CI1.02-2.89, p=0.042), with an I2of81.3%.CONCLUSION:In the adjuvant setting, TS expression seems to predict poorer DFS, but this is not the case for OS. Therefore, we believe that it is inappropriate to regard TS expression as a prognostic factor for stage II and stage III CRCs accepting adjuvant chemotherapy.