P16INK4a overexpression and survival in osteosarcoma patients: a meta analysis

Osteosarcoma is one of the most common primary bone malignancies. Although there is a significant improvement of survival on osteosarcoma patients in the past decades, treatment of osteosarcoma is still unsatisfactory for the development of pulmonary metastasis. The potential prognostic value of p16^INK4a in osteosarcoma has been investigated, however, the results from different studies were somewhat controversial. To elucidate whether p16^INK4a is indeed a prognostic factor of osteosarcoma, we conducted a meta-analysis of the published literatures to provide a comprehensive evaluation of the significance of p16^INK4a expression in patients with osteosarcoma. Eight studies with a total of 354 patients with osteosarcoma were examined. The pooled odds ratio (OR) with corresponding 95% confidence interval (95% CI) was calculated to evaluate the effect of p16^INK4a expression on overall survival. Meta-analysis showed that patients with high p16^INK4a expression were significantly associated with favourable overall survival when compared to their counterparts with low or undetectable p16^INK4a expression (OR = 0.270, 95% CI 0.162-0.451, P < 0.001). Sensitivity analysis suggested the pooled OR was stable and not significantly changed when a single study was removed. In conclusion, the results from this meta-analysis highlight that p16^INK4a is an effective biomarker of survival in patients with osteosarcoma.