Clinicopathologic Significance of Gene Alteration in Clear-Cell Renal Cell Carcinoma: An Updated Meta-Analysis and Review.

The () gene is inactivated frequently in sporadic clear-cell renal cell carcinomas (ccRCCs) by genetic alteration (mutation, loss of heterozygosity, or promoter hypermethylation). However, the pathological or prognostic significance of gene alteration has not been well defined. We conducted this meta-analysis to evaluate the association between alteration and clinopathologic findings in ccRCCs. We performed a systematic computerized search of online databases, including PubMed, EMBASE, Web of Science, and Google Scholar (up to July 2018). From ten studies, 1,082 patients were included in the pooled analyses of odds ratios (ORs) with 95% confidence intervals (CIs) for pathological features (nuclear grade and disease stage) or hazard ratios (HRs) with 95% CIs for overall survival (OS). alteration was not significantly associated with nuclear grade (OR = 0.79, 95% CI: 0.59⁻1.06, = 0.12) or disease stage (OR = 1.07, 95% CI: 0.79⁻1.46, = 0.65). There was also no significant correlation between alteration and OS (HR = 0.75, 95% CI: 0.43⁻1.29, = 0.30). When we pooled HRs for OS according to the alteration types, the combined HRs were 0.72 (95% CI: 0.47⁻1.11, = 0.14) for mutations and 1.32 (95% CI: 0.70⁻2.47, = 0.39) for methylation. In conclusion, this meta-analysis indicates that gene alteration is not significantly associated with the pathological features and survival in patients with ccRCC.