Background: This meta-analysis evaluated the clinicopathologic and prognostic significance of RASSF1A  promoter methylation in renal cell carcinoma (RCC).
Materials and methods: The ORs or HRs and their 95% CIs were calculated. Trial sequential analysis was conducted.
Results: Twenty-two articles that included 1,421 patients with RCC and 724 controls were identified. RASSF1A  promoter methylation correlated with RCC in tissue, blood, and urine samples. On multivariate analysis, RASSF1A  promoter methylation was associated with tumor grade (grade 3–4 vs 1–2: OR=3.59), clinical stage (stage 3–4 vs 1–2: OR=2.15), T classification (pT2–4 vs pT1: OR=2.66), histologic subtypes (papillary vs clear cell: OR=2.91), and cancer-specific survival (HR=1.78), but it was not linked to age, gender, lymph node status, distant metastasis, or overall survival. The Cancer Genome Atlas data also showed that RASSF1A  methylation was significantly more likely to be seen in papillary vs clear-cell RCC (OR=23.19).
Conclusion: RASSF1A  promoter methylation may be associated with the development and progression of RCC, as well as poor cancer-specific survival. Methylation was more frequent in papillary vs clear-cell RCC. More studies are needed to confirm these findings in blood or urine samples.
Keywords: RAS association domain family protein 1A, methylation, survival, clinical features