{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T04:58:37Z","timestamp":1790657917481,"version":"4.1.0"},"reference-count":34,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T00:00:00Z","timestamp":1790640000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Oncol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>At present, the prognostic value of serum uric acid (SUA) in Nasopharyngeal carcinoma (NPC) remains controversial, and relevant clinical evidence lacks systematic and comprehensive verification. This the first-ever meta-analysis comprehensively synthesized evidence across various regimens to systematically evaluate the association between serum uric acid (SUA) levels and survival outcomes in NPC patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This meta-analysis was strictly performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Eligible clinical studies focusing on the prognostic role of SUA in NPC were systematically retrieved from domestic and international electronic databases. All retrieved literatures were screened strictly based on predefined inclusion and exclusion criteria. The methodological quality of enrolled studies was assessed using the Newcastle-Ottawa Scale (NOS). Literature screening, data extraction, and quality evaluation were independently conducted by two investigators, and any discrepancies were resolved by consensus or consultation with a third senior researcher. Key prognostic data including hazard ratios (HR) with 95% confidence intervals (CI) for Overall Survival (OS), Progression-Free Survival(PFS), and Distant Metastasis-Free Survival (DMFS) were extracted and pooled for quantitative analysis to evaluate the prognostic significance of SUA in NPC.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The pooled results demonstrated that elevated SUA was significantly correlated with OS in NPC patients, with a combined HR of 0.245 (95% CI: 0.092\u20130.398). In contrast, no statistically significant associations were observed between SUA levels and PFS or DMFS. The pooled HR for PFS was 0.557 (95% CI: 0.070\u20131.044), and the pooled HR for DMFS was 0.715 (95% CI: 0.023\u20131.407). The 95% CI of both PFS and DMFS crossed the invalid value of 1, indicating no significant statistical difference.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>SUA level is an independent prognostic factor for OS in patients with NPC, and higher levels of uric acid may improve the overall survival of patients. No significant correlation was identified between SUA levels and PFS or DMFS in NPC patients. SUA may serve as a novel, convenient, and non-invasive biomarker for prognostic evaluation of NPC, may provide a reference for prognostic risk stratification and individualized management. Further large-sample, high-quality prospective cohort studies are warranted to validate the present findings.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Systematic review registration<\/jats:title>\n                    <jats:p>\n                      <jats:ext-link>https:\/\/www.crd.york.ac.uk\/PROSPERO\/view\/CRD420261483250<\/jats:ext-link>\n                      , identifier CRD420261483250.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fonc.2026.1922633","type":"journal-article","created":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T04:36:58Z","timestamp":1790656618000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["The association between serum uric acid and prognosis of nasopharyngeal carcinoma: a comprehensive meta-analysis of observational studies"],"prefix":"10.3389","volume":"16","author":[{"given":"Xin","family":"Wang","sequence":"first","affiliation":[{"name":"Medical Record Statistics Office, The First Affiliated Hospital of Shantou University Medical College","place":["Shantou, Guangdong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shukai","family":"Zheng","sequence":"additional","affiliation":[{"name":"Department of Medical Management, The Second Affiliated Hospital of Shantou University Medical College","place":["Shantou, Guangdong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Taifeng","family":"Du","sequence":"additional","affiliation":[{"name":"Department of Medical Management, The Second Affiliated Hospital of Shantou University Medical College","place":["Shantou, Guangdong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,9,29]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1007\/s10555-024-10176-9","article-title":"Epidemiology of nasopharyngeal carcinoma: current insights and future outlook","volume":"43","author":"Su","year":"2024","journal-title":"Cancer Metastasis Rev"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21834","article-title":"Global cancer statistics 2022: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries","volume":"74","author":"Bray","year":"2024","journal-title":"CA: A Cancer J For Clin"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1016\/s1470-2045(16)30410-7","article-title":"Induction chemotherapy plus concurrent chemoradiotherapy versus concurrent chemoradiotherapy alone in locoregionally advanced nasopharyngeal carcinoma: a phase 3, multicentre, randomised controlled trial","volume":"17","author":"Sun","year":"2016","journal-title":"Lancet Oncol"},{"key":"B4","doi-asserted-by":"publisher","first-page":"136","DOI":"10.3892\/etm.2021.11059","article-title":"Nasopharyngeal carcinoma: a new synthesis of literature data (review)","volume":"23","author":"Jicman Stan","year":"2022","journal-title":"Exp Ther Med"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.j2376","article-title":"Serum uric acid levels and multiple health outcomes: umbrella review of evidence from observational studies, randomised controlled trials, and Mendelian randomisation studies","volume":"357","author":"Li","year":"2017","journal-title":"BMJ (Clinical Res Ed)"},{"key":"B6","doi-asserted-by":"publisher","first-page":"9221","DOI":"10.3390\/ijms22179221","article-title":"Molecular biological and clinical understanding of the pathophysiology and treatments of hyperuricemia and its association with metabolic syndrome, cardiovascular diseases and chronic kidney disease","volume":"22","author":"Yanai","year":"2021","journal-title":"Int J Mol Sci"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.1186\/ar3199","article-title":"Epidemiology of gout","volume":"40","author":"Roddy","year":"2014","journal-title":"Rheumatic Dis Clinics North America"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjms.2023.11.013","article-title":"Effect of serum uric acid and gout on the incidence of colorectal cancer: a meta-analysis","volume":"367","author":"Liu","year":"2024","journal-title":"Am J Med Sci"},{"key":"B9","doi-asserted-by":"publisher","first-page":"366","DOI":"10.1016\/j.chom.2024.02.001","article-title":"Alistipes indistinctus-derived hippuric acid promotes intestinal urate excretion to alleviate hyperuricemia","volume":"32","author":"Xu","year":"2024","journal-title":"Cell Host Microbe"},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.1002\/art.40807","article-title":"Contemporary prevalence of gout and hyperuricemia in the United States and decadal trends: the National Health and Nutrition Examination Survey, 2007-2016","volume":"71","author":"Chen-Xu","year":"2019","journal-title":"Arthritis Rheumatol (Hoboken NJ)"},{"key":"B11","article-title":"Roles of hyperuricemia in metabolic syndrome and cardiac-kidney-vascular system diseases","volume":"10","author":"Wang","year":"2018","journal-title":"Am J Trans Res"},{"key":"B12","doi-asserted-by":"publisher","DOI":"10.1002\/cam4.3214","article-title":"Serum uric acid levels and risk of kidney cancer incidence and mortality: a prospective cohort study","volume":"9","author":"Dai","year":"2020","journal-title":"Cancer Med"},{"key":"B13","doi-asserted-by":"publisher","DOI":"10.3389\/fonc.2024.1354235","article-title":"Serum uric acid and prostate cancer: findings from the NHANES (2007-2020)","volume":"14","author":"Yan","year":"2024","journal-title":"Front Oncol"},{"key":"B14","doi-asserted-by":"publisher","DOI":"10.1097\/md.0000000000040591","article-title":"Exploring the link between serum uric acid and colorectal cancer: insights from genetic evidence and observational data","volume":"103","author":"Chen","year":"2024","journal-title":"Medicine"},{"key":"B15","doi-asserted-by":"publisher","DOI":"10.1007\/s10552-014-0408-0","article-title":"Serum uric acid levels and cancer mortality risk among males in a large general population-based cohort study","volume":"25","author":"Taghizadeh","year":"2014","journal-title":"Cancer Causes Control CCC"},{"key":"B16","doi-asserted-by":"publisher","DOI":"10.1136\/thoraxjnl-2014-205271","article-title":"Serum uric acid and the risk of respiratory disease: a population-based cohort study","volume":"69","author":"Horsfall","year":"2014","journal-title":"Thorax"},{"key":"B17","doi-asserted-by":"publisher","DOI":"10.3736\/jcim20090918","article-title":"Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement","volume":"339","author":"Moher","year":"2009","journal-title":"BMJ (Clinical Res Ed)"},{"key":"B18","article-title":"Meta-analysis series part 4: quality assessment tools for observational studies","volume":"4","author":"Zeng","year":"2012","journal-title":"Chin J Evid Based Cardiovasc Med"},{"key":"B19","doi-asserted-by":"publisher","DOI":"10.1007\/s10654-010-9491-z","article-title":"Critical evaluation of the Newcastle-Ottawa scale for the assessment of the quality of nonrandomized studies in meta-analyses","volume":"25","author":"Stang","year":"2010","journal-title":"Eur J Epidemiol"},{"key":"B20","doi-asserted-by":"publisher","DOI":"10.1191\/026921699666884611","article-title":"Quantifying heterogeneity in a meta-analysis","volume":"21","author":"Higgins","year":"2002","journal-title":"Stat Med"},{"key":"B21","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.315.7109.629","article-title":"Bias in meta-analysis detected by a simple, graphical test","volume":"315","author":"Egger","year":"1997","journal-title":"BMJ (Clinical Res Ed)"},{"key":"B22","doi-asserted-by":"publisher","DOI":"10.1186\/1748-717x-8-121","article-title":"Plasma uric acid and tumor volume are highly predictive of outcome in nasopharyngeal carcinoma patients receiving intensity modulated radiotherapy","volume":"8","author":"Lin","year":"2013","journal-title":"Radiat Oncol (London England)"},{"key":"B23","doi-asserted-by":"publisher","DOI":"10.1002\/hed.24631","article-title":"Use of pretreatment serum uric acid level to predict metastasis in locally advanced nasopharyngeal carcinoma","volume":"39","author":"Du","year":"2017","journal-title":"Head Neck"},{"key":"B24","doi-asserted-by":"publisher","first-page":"15","DOI":"10.3892\/mco.2026.2924","article-title":"Prognostic value of serum uric acid levels following radiotherapy and chemotherapy in nasopharyngeal carcinoma","volume":"24","author":"He","year":"2026","journal-title":"Mol Clin Oncol"},{"key":"B25","doi-asserted-by":"publisher","first-page":"519","DOI":"10.1186\/s12885-021-08285-7","article-title":"Prognostic value of serum uric acid and tumor response to induction chemotherapy in locally advanced nasopharyngeal carcinoma","volume":"21","author":"Xu","year":"2021","journal-title":"BMC Cancer"},{"key":"B26","doi-asserted-by":"publisher","DOI":"10.1073\/pnas.78.11.6858","article-title":"Uric acid provides an antioxidant defense in humans against oxidant- and radical-caused aging and cancer: a hypothesis","volume":"78","author":"Ames","year":"1981","journal-title":"PNAS"},{"key":"B27","doi-asserted-by":"publisher","DOI":"10.2174\/138161205774913255","article-title":"Uric acid and oxidative stress","volume":"11","author":"Glantzounis","year":"2005","journal-title":"Curr Pharm Des"},{"key":"B28","doi-asserted-by":"publisher","first-page":"1","DOI":"10.5049\/ebp.2014.12.1.1","article-title":"Uric acid puzzle: dual role as anti-oxidantand pro-oxidant","volume":"12","author":"Kang","year":"2014","journal-title":"Electrolyte Blood Pressure E BP"},{"key":"B29","doi-asserted-by":"publisher","DOI":"10.1016\/j.redox.2018.101070","article-title":"Metabolic syndrome and cancer risk: the role of xanthine oxidoreductase","volume":"21","author":"Battelli","year":"2019","journal-title":"Redox Biol"},{"key":"B30","doi-asserted-by":"publisher","DOI":"10.1155\/2015\/764250","article-title":"Serum uric acid increases risk of cancer incidence and mortality: a systematic review and meta-analysis","volume":"2015","author":"Yan","year":"2015","journal-title":"Mediators Inflammation"},{"key":"B31","doi-asserted-by":"publisher","DOI":"10.1038\/onc.2014.119","article-title":"The uric acid transporter SLC2A9 is a direct target gene of the tumor suppressor p53 contributing to antioxidant defense","volume":"34","author":"Itahana","year":"2015","journal-title":"Oncogene"},{"key":"B32","doi-asserted-by":"publisher","DOI":"10.1097\/00005344-200109000-00005","article-title":"Systemic uric acid administration increases serum antioxidant capacity in healthy volunteers","volume":"38","author":"Waring","year":"2001","journal-title":"J Cardiovasc Pharmacol"},{"key":"B33","doi-asserted-by":"publisher","first-page":"705","DOI":"10.1186\/s13104-017-2990-1","article-title":"Prognostic factors of nasopharyngeal carcinoma patients in a tertiary referral hospital: a retrospective cohort study","volume":"10","author":"Siti-Azrin","year":"2017","journal-title":"BMC Res Notes"},{"key":"B34","doi-asserted-by":"publisher","first-page":"e807-8","DOI":"10.1016\/j.ijrobp.2024.07.1773","article-title":"Exploring the role of serum uric acid as a potential biomarker in nasopharyngeal carcinoma: a retrospective study post-adjuvant chemotherapy","volume":"120","author":"Zeng","year":"2024","journal-title":"Int J Radiat Oncol Biol Phys"}],"container-title":["Frontiers in Oncology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fonc.2026.1922633\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T04:37:12Z","timestamp":1790656632000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fonc.2026.1922633\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,29]]},"references-count":34,"alternative-id":["10.3389\/fonc.2026.1922633"],"URL":"https:\/\/doi.org\/10.3389\/fonc.2026.1922633","relation":{},"ISSN":["2234-943X"],"issn-type":[{"value":"2234-943X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,29]]},"article-number":"1922633"}}