Family History and Survival of Patients with Gastric Cancer: A Meta-Analysis

Background: Previous studies have generated conflicting evidence regarding associations between familyhistory and survival after gastric cancer surgery. In this study, we investigated this question using a meta-analysis.Materials and
Methods: To identify relevant studies, PubMed and Embase databases were searched up to June2013. Two reviewers independently assessed search results and data extraction of included studies. Hazard ratios(HRs) and 95% confidence intervals (CIs) for overall survival (OS) were calculated based on fixed- or randomeffectsmodels. Homogeneity of effects across studies was assessed using x2 test statistics and quantified by I2.
Results: A total of five studies were selected according to the inclusion criteria. The total number of patientsincluded was 2,030, which ranged from 145 to 598 per study. There was no significant difference in OS by familyhistory of cancer (HR=0.83, 95%CIs=0.50-1.38), but subgroup analysis of patients with a first-degree familyhistory of cancer (HR=0.74, 95%CIs=0.60-0.93) and gastric cancer family history (HR=0.56, 95%CIs=0.41-0.76)tended to show better OS in these patients.
Conclusions: This meta-analysis suggests that a first-degree familyhistory of cancer or gastric cancer family history is associated with better survival of gastric cancer patientsafter surgery, after a systematic review of five previous studies. These results can be applied by clinicians whencounselling patients regarding their risk of death from gastric cancer. Further study is needed to investigate theunderlying mechanism between family history and survival in gastric cancer patients.