Prognostic value of microRNAs in head and neck cancers: a systematic review and meta-analysis protocol

BACKGROUND: Head and neck cancers form a significant share of all cancer incidences worldwide. Though treatment modalities exist, post-treatment recurrence and survival rates in recurrent patients continue to be high. MiRNAs offer an effective method of estimating the probability of recurrence and survival of HNC patients, thereby allowing for effective treatment and better survival rates. METHODS: The systematic review protocol was prepared according to the Preferred Reporting Items for Systematic Review and Meta-Analyses Protocols (PRISMA-P) 2015 statement. Relevant studies will be identified by a rigorous search of multiple bibliographical databases, including MEDLINE, Scopus, PubMed, Web of Science, Embase and Science Direct, without any language restrictions (up to June 2018). The primary screening will be performed by a review team via analysis of titles and abstracts of published articles. Final selection of articles will be achieved by two independent reviewers, based on predefined selection criteria. Data will be extracted from eligible studies using a pre-piloted data extraction form. Statistical analysis will be performed on the basis of available data, extracted from eligible studies. Meta-analysis will be performed, and a forest plot will be generated, to determine pooled hazard ratios (HR) and 95% confidence interval (CI) using CMA. A fixed or random-effects model of meta-analysis will be used depending upon the between-study heterogeneity; publication bias will be determined by the Egger’s bias indicator test. A narrative synthesis will be undertaken where statistical data is found to be insufficient. DISCUSSION: There is a lack of highly sensitive and specific biomarkers for estimating the HNC patients’ prognostic outcomes, particularly in post-treatment conditions. This systematic review will identify and validate specific miRNA as prognostic biomarkers by utilising a collection of previously published data on miRNA expression and survival. Highlighting these prognostic specific miRNAs will have major clinical implications by allowing for better overall treatment strategies and patient survival estimates, by offering clinicians a method of quantitatively analysing prognosis via miRNA expression. SYSTEMATIC REVIEW REGISTRATION: This review protocol was registered on PROSPERO and assigned the registration number CRD42017077411.