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

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. MEDLINE and Embase (January 1990 to November 2011) was searched for translational studies that correlated HER2 expression with survival in operable oesophageal cancer. 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. HER2 overexpression and gene amplification in operable oesophageal cancer was an indicator of poor prognosis.