Akademik Veri Yönetim Sistemi
BMC CANCER, cilt.25, sa.1, ss.1-12, 2025 (SCI-Expanded, Scopus)
It's a well-established fact that Fusobacterium nucleatum has been implicated in the pathogenesis and prognosis of several malignancies, but its role in head and neck cancers remains unclear. This systematic review and meta-analysis aimed to synthesize the evidence on the prognostic impact of Fusobacterium abundance in head and neck squamous cell carcinoma (HNSCC).
A comprehensive literature search of PubMed/MEDLINE, Web of Science, Scopus, and Embase was performed from inception to January 1, 2000, to October 15, 2025. Studies evaluating the association between Fusobacterium and oncological outcomes in HNSCC were included. Hazard ratios (HRs) with 95% confidence intervals (CIs) for overall survival (OS) and disease-specific survival (DSS) were pooled using random and fixed-effects models. Methodological quality was assessed with the Newcastle–Ottawa Scale (NOS), and reporting adhered to the PRISMA 2020 guidelines. The study protocol was prospectively registered in INPLASY (Registration ID: INPLASY2025110054).
A total of six studies met the inclusion criteria, and five studies were included in the quantitative synthesis. The pooled analysis demonstrated a significant association between high Fusobacterium abundance and improved OS (random-effects model: HR = 0.60; 95% CI: 0.38–0.95, p = 0.03; I² = 37.6%; fixed-effects model: HR = 0.61; 95% CI: 0.43–0.87, p = 0.01; I² = 40.2%) and DSS (random-effects model: HR = 0.34; 95% CI: 0.19–0.61, p < 0.001; I² = 41.6%,; fixed-effects model: HR = 0.37; 95% CI: 0.24–0.56, p < 0.001; I² = 40.1%) in patients with HNSCC. Heterogeneity was low-to-moderate, and no significant small study effect was detected based on funnel plot inspection.
This meta-analysis suggests that Fusobacterium nucleatum abundance is significantly associated with better OS and DSS in patients with head and neck cancers. Fusobacterium nucleatum may be a potentially useful prognostic biomarker; however, this interpretation should be made with caution due to the limited evidence base, small number of studies, and residual heterogeneity. Taken together, further validation in large-scale, prospective studies is required and critical.