Prognostic Value of Bcl‐ <scp>xL</scp> in Head and Neck Squamous Cell Carcinoma: A Systematic Review and Meta‐Analysis

BACKGROUND: Head and neck squamous cell carcinoma is a heterogeneous disease with poor survival outcomes. Bcl-xL regulates tumor cell survival and apoptosis and has been associated with metastasis and poor prognosis, although its overall role remains undeciphered. METHODS: We systematically evaluated the prognostic value of Bcl-xL in head and neck squamous cell carcinoma following PRISMA 2020 guidelines. We identified 2241 reports from seven databases, of which 20 original studies with overall good quality (REMARK) and low bias (QUIPS) were included. RESULTS: An association between Bcl-xL levels and survival was rarely observed. However, high Bcl-xL levels correlated with increased risk of lymph node metastasis in 40% of studies. A study on oral tongue cancer identified a significant correlation between high Bcl-xL levels and decreased survival and lymph node metastasis. CONCLUSIONS: Current evidence does not support Bcl-xL as a general prognostic marker in head and neck squamous cell carcinoma. Nevertheless, Bcl-xL may have prognostic relevance in oral tongue cancer if further studies confirm the original finding.