Prognostic Value of SMAD4 in Pancreatic Cancer: A Meta-Analysis
Open accessAbstract
PURPOSE: The prognostic value of SMAD4 in pancreatic cancer has been evaluated in several studies. However, the conclusions remain controversial. Therefore, we aimed to evaluate the association between SMAD4 expression and the outcome of pancreatic cancer patients by performing a meta-analysis. METHODS: We systematically searched for relevant studies evaluating the relationship between SMAD4 expression and the outcome of pancreatic cancer patients until May 2015. A meta-analysis was performed using STATA 12.0, and pooled hazard ratios (HRs) with 95% confidence intervals (CIs) were used to estimate the strength of the association between SMAD4 expression and the prognosis of pancreatic cancer patients. RESULTS: The analysis included 1762 patients from 14 studies, with 1401 patients from 11 studies and 927 patients from 8 studies included in the univariate and multivariate analyses, respectively. Loss of SMAD4 expression was found to be significantly correlated with poor overall survival, with the combined HR (95% CI) of 1.20 (1.03-1.40). After adjusting for potential confounders using the Cox regression model, the pooled HR (95% CI) was 1.88 (1.31-2.70). In subgroup analysis, study region, number of patients, follow-up duration, and cutoff value were found to affect the significance of the association between loss of SMAD4 expression and poor prognosis. In addition, there was no evidence of publication bias, as suggested by Begg's and Egger's test. CONCLUSIONS: Loss of SMAD4 was associated with poor survival and was a negative prognostic indicator in patients with pancreatic cancer.
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An association between SMAD4 inactivation in resected PDAC and poor prognosis has been reported.
“While an association between SMAD4 inactivation in resected PDAC and poor prognosis has been reported, a separately reported meta-analysis did not show association between SMAD4 mutation and OS61,62.”
From Impact of KRAS mutations and co-mutations on clinical outcomes in pancreatic ductal adenocarcinoma (2024) · cites this paper as [61]
A separately reported meta-analysis did not show an association between SMAD4 mutation and OS.
“While an association between SMAD4 inactivation in resected PDAC and poor prognosis has been reported, a separately reported meta-analysis did not show association between SMAD4 mutation and OS61,62.”
From Impact of KRAS mutations and co-mutations on clinical outcomes in pancreatic ductal adenocarcinoma (2024) · cites this paper as [61]
Reported results about the prognostic value of SMAD4 have been inconsistent.
“SMAD4 is a tumor suppressor gene, and reported results about the prognostic value of SMAD4 have been inconsistent39,60–62.”
From Impact of KRAS mutations and co-mutations on clinical outcomes in pancreatic ductal adenocarcinoma (2024) · cites this paper as [61]
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- Authors
- Shugang, X., Hongfa, Y., Jianpeng, L., Xu, Z., Jingqi, F., Xiangxiang, L., & Wei, L.
- Affiliations
- Jilin University (CN)
- ORCID
- Xu, Zheng
- Venue
- Translational Oncology
- Publisher
- Elsevier BV
- Published
- 2016-02
- Volume
- 9
- Issue
- 1
- Pages
- 1-7
- ISSN
- 1936-5233 (ISSN-L)
- PMC
- PMC4800056
- OpenAlex
- W2289504874
- Cited by
- 72
- References
- 29
- Citations by year
- 2026: 3 · 2025: 4 · 2024: 5 · 2023: 5 · 2022: 8 · 2021: 17 · 2020: 3 · 2019: 10 · 2018: 7 · 2017: 6 · 2016: 4
- FWCI
- 0.91
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Translational Oncology (publishedVersion, cc-by-nc-nd)
- Europe PMC (PubMed Central) (publishedVersion, cc-by-nc-nd)
- PubMed Central (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- Jilin University
- Topics
- Health Sciences › Medicine › Oncology › Pancreatic and Hepatic Oncology Research
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › TGF-β signaling in diseases
- Health Sciences › Medicine › Surgery › Cholangiocarcinoma and Gallbladder Cancer Studies
- Keywords
- SMAD4, pancreatic cancer, prognostic factors, overall survival, tumor suppressor
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