Prognostic value of FOXM1 in solid tumors: a systematic review and meta-analysis

// Lijun Li 1,* , Dang Wu 2,* , Qun Yu 3 , Lingdi Li 4 and Pin Wu 5 1 Department of Surgery, Hangzhou Xixi Hospital, Hangzhou, China 2 Department of Radiation Oncology, Second Affiliated Hospital, Zhejiang University School of Medicine, Zhejiang University, Hangzhou, China 3 Fourth Ward of Neurosurgery, Division of Nursing, Second Affiliated Hospital, Zhejiang University School of Medicine, Zhejiang University, Hangzhou, China 4 Department of Oncology, Hangzhou Cancer Hospital, Hangzhou, China 5 Department of Thoracic Surgery, Second Affiliated Hospital, Zhejiang University School of Medicine, Zhejiang University, Hangzhou, China * These authors contributed equally to this work Correspondence to: Lingdi Li, email: // Pin Wu, email: // Keywords : FOXM1, solid tumors, prognosis, overall survival, disease free survival Received : July 02, 2016 Accepted : February 20, 2017 Published : February 27, 2017 Abstract Accumulated studies have provided controversial evidences of the association between Forkhead Box M1 (FOXM1) expression and survival of human solid tumors. To address this inconsistency, we performed a meta-analysis with 23 studies identified from PubMed and Medline. We found elevated FOXM1-protein expression was significantly associated with worse 3-year overall survival (OS) (OR = 3.30, 95% CI = 2.56 to 4.25, P < 0.00001) 5-year OS (OR =3.35, 95% CI = 2.64 to 4.26, P < 0.00001) and 10-year OS (OR = 5.24, 95% CI = 2.61 to 10.52, P < 0.00001) of human solid tumors. Similar results were observed when disease free survival (DFS) were analyzed. Subgroup analysis showed that FOXM1 overexpression was associated with poor prognosis of colorectal cancer, gastric cancer, hepatic cancer, lung cancer and ovarian cancer. High expression level of FOXM1 was also associated with advanced tumor stage. In conclusion, elevated FOXM1 expression is associated with poor survival in most solid tumors. FOXM1 is a potential biomarker for prognosis prediction and a promising therapeutic target in human solid tumors.