Systematic Review and Meta-analysis of the Influence of HER2 Expression and Amplification in Operable Oesophageal Cancer

Introduction: The prognostic significance of human epidermal growth factor 2 (HER2) overexpression in patients diagnosed with oesophageal cancer is controversial. We performed a systematic review and meta-analysis to determine the influence of HER2 overexpression and amplification on outcomes in operable oesophageal cancer. Methods: MEDLINE and Embase (January 1990 to November 2011) was searched for translational studies that correlated HER2 expression with survival in operable oesophageal cancer. Results: Fourteen studies involving 1,464 patients who had undergone potentially curative oesophagectomy for oesophageal cancer [322 (22 %) HER2-positive] were included. Five-year mortality was significantly higher in HER2-positive patients [odds ratio (OR) 1. 43, 95 % confidence interval (CI) 1. 04 to 1. 95, p = 0. 03]. Analysis related to histological cell type demonstrated significantly higher 5-year mortality in HER2-positive squamous cell carcinoma [OR 2. 88, 95 % CI 1. 34 to 6. 17, p = 0. 006] and adenocarcinoma [OR 1. 91, 95 % CI 1. 15 to 3. 17, p = 0. 01] on sensitivity analysis of higher-quality studies. Conclusion: HER2 overexpression and gene amplification in operable oesophageal cancer was an indicator of poor prognosis.