Prognostic value of IGF-1R expression in bone and soft tissue sarcomas: a meta-analysis

Figures & data

Table 1 Newcastle–Ottawa quality assessment scale

Scale item	Description	Score
Selection	1. Representativeness of the exposed cohort	4
	a. Truly representative of the average sarcoma patients in the community*
	b. Somewhat representative of the average sarcoma patients in the community*
	c. Selected group of users
	d. No description of the derivation of the cohort
	2. Selection of the nonexposed cohort
	a. Drawn from the same community as the exposed cohort*
	b. Drawn from a different source
	c. No description of the derivation of the nonexposed cohort
	3. Ascertainment of exposure (proof of sarcoma and IGF-1R measured by IHC)
	a. Secure record (such as surgical records)*
	b. Structured interview*
	c. Written self-report
	d. No description
	4. Demonstration that outcome of interest was not present at start of study
	a. Yes*
	b. No
Comparability	Comparability of cohorts on the basis of the design or analysis	1
	a. Study controls for IGF-1R expression*
	b. Study controls for other factors (age, sex, treatment, etc)*
Outcome	1. Assessment of outcome (death)	3
	a. Independent blind assessment*
	b. Record linkage*
	c. Self-report
	d. No description
	2. Was follow up long enough for outcomes to occur?
	a. Yes (5 years)*
	b. No
	3. Adequacy of follow up of cohorts
	a. Complete follow up – all subjects accounted for*
	b. Subjects lost to follow up unlikely to introduce bias – small number lost (25%) or description provided of those lost*
	c. Follow-up rate <75% and no description of those lost
	d. No statement

Note:

* Indicates significance.

Abbreviation: IHC, immunohistochemistry.

Figure 1 Flowchart of included studies.

Table 2 Characteristics of the seven studies included in the meta-analysis

Study (author, year)	Patient source	Numberof patients	Tumor type	Analysis method	Outcome	HR estimation	NOS score
van de Luijtgaarden et al^Citation12 2013*	The Netherlands	44	Osteosarcoma	IHC	OVS	0.76 (0.16–3.61)a,b	7
Wang et al^Citation11 2012	People’s Republic of China	84	Osteosarcoma	IHC	OVS	2.30 (1.66–3.20)	8
Scotlandi et al^Citation15 2011	Italy	290	Ewing sarcoma	IHC	OVS	0.77 (0.63–0.93)a	8
van de Luijtgaarden et al^Citation16 2013**	The Netherlands	36	Ewing sarcoma	IHC	OVS	1.89 (0.61–5.86)a,b	7
van Gaal et al^Citation19 2013	The Netherlands	54	Rhabdomyosarcoma	IHC	OVS	18.02 (2.52–128.86)a	6
Palmerini et al^Citation17 2015	Italy	88	Synovial sarcoma	IHC	OVS	2.50 (1.11–5.63)a	8
Cheng et al^Citation18 2009	Canada	31	Liposarcoma	IHC	OVS	7.44 (1.59–34.81)	8

Notes:

a Data extracted from given information.

b Original data obtained from the author.

* Osteosarcoma.

** Ewing’s sarcoma.

Abbreviations: HR, hazard ratio; IHC, immunohistochemistry; NOS, Newcastle–Ottawa Scale; OVS, overall survival.

Figure 2 Meta-analysis of impact of IGF-1R expression on overall survival of patients with sarcomas.

Notes: Results are presented as individual and pooled HR and 95% CI. *Ewing’s sarcoma. **Osteosarcoma.
Abbreviations: CI, confidence interval; HR, hazard ratio; SE, standard error.

Table 3 Meta-analysis of overall and subgroup analysis for IGF-1R expression and OVS in BSTSs

Categories	Studies	Patients	HR (95% CI)	Model	Heterogeneity
					χ^2	I^2%	P-value	z	P-value
OVS	7	627	2.15 (1.06–4.38)	Random	51.39	88	<0.001	2.11	0.03
Tumor type
Osteosarcoma	2	128	2.20 (1.59–3.03)	Fixed	1.86	46	0.17	4.80	<0.001
Ewing sarcoma	2	326	1.01 (0.45–2.27)	Random	2.38	58	0.12	0.01	0.99
Geography
Western	6	543	2.22 (0.90–5.48)	Random	26.51	81	<0.001	1.73	0.08
Eastern	1	84	2.30 (1.66–3.20)	Random	–	–	–	–	–
Sample size
Smaller size (n<50)	3	111	2.18 (0.67–7.07)	Random	4.25	53	0.12	1.30	0.20
Larger size (n≥50)	4	516	2.15 (0.88–5.28)	Random	44.35	93	<0.001	1.68	0.09

Abbreviations: BSTS, bone and soft tissue sarcoma; CI, confidence interval; HR, hazard ratio; OVS, overall survival; –, no data.

Figure 3 Funnel plot for the evaluation of potential publication bias in the impact of IGF-1R expression on overall survival of patients with sarcomas.

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