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RASSF1A promoter methylation correlates development, progression, and poor cancer-specific survival of renal cell carcinoma: trial sequential analysis

Authors Zhuang Q, Chen Z, Shen J, Fan M, Xue D, Lu H, Xu R, He X

Received 8 August 2018

Accepted for publication 1 November 2018

Published 20 December 2018 Volume 2019:12 Pages 119—134


Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Amy Norman

Peer reviewer comments 3

Editor who approved publication: Dr Leo Jen-Liang Su

Qianfeng Zhuang,* Zhen Chen,* Jie Shen,* Min Fan, Dong Xue, Hao Lu, Renfang Xu, Xiaozhou He

Department of Urology, The Third Affiliated Hospital of Soochow University, Changzhou 213003, China

*These authors contributed equally to this work

Background: This meta-analysis evaluated the clinicopathologic and prognostic significance of RASSF1A promoter methylation in renal cell carcinoma (RCC).
Materials and methods: The ORs or HRs and their 95% CIs were calculated. Trial sequential analysis was conducted.
Results: Twenty-two articles that included 1,421 patients with RCC and 724 controls were identified. RASSF1A promoter methylation correlated with RCC in tissue, blood, and urine samples. On multivariate analysis, RASSF1A promoter methylation was associated with tumor grade (grade 3–4 vs 1–2: OR=3.59), clinical stage (stage 3–4 vs 1–2: OR=2.15), T classification (pT2–4 vs pT1: OR=2.66), histologic subtypes (papillary vs clear cell: OR=2.91), and cancer-specific survival (HR=1.78), but it was not linked to age, gender, lymph node status, distant metastasis, or overall survival. The Cancer Genome Atlas data also showed that RASSF1A methylation was significantly more likely to be seen in papillary vs clear-cell RCC (OR=23.19).
Conclusion: RASSF1A promoter methylation may be associated with the development and progression of RCC, as well as poor cancer-specific survival. Methylation was more frequent in papillary vs clear-cell RCC. More studies are needed to confirm these findings in blood or urine samples.

Keywords: RAS association domain family protein 1A, methylation, survival, clinical features

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