Liu YX, Chen ZH, Dou GJ, Lu JJ, Zhou Y. Prognostic significance of Fusobacterium nucleatum in colorectal cancer using reconstructed survival data. World J Gastrointest Oncol 2026; 18(10): 121850 [DOI: 10.4251/wjgo.121850]
Corresponding Author of This Article
Yuan Zhou, MD, Associate Professor, Department of Gastrointestinal Surgery, The Affiliated Hospital of Jiaxing University and The First Hospital of Jiaxing, No. 1882 Zhonghuan South Road, Jiaxing, Zhejiang Province 314000, China. zhouyuan0422@zjxu.edu.cn
Research Domain of This Article
Oncology
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research-article
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Liu YX, Chen ZH, Dou GJ, Lu JJ, Zhou Y. Prognostic significance of Fusobacterium nucleatum in colorectal cancer using reconstructed survival data. World J Gastrointest Oncol 2026; 18(10): 121850 [DOI: 10.4251/wjgo.121850]
Yi-Xiao Liu, Department of Stomatology, The Affiliated Hospital of Jiaxing University and The First Hospital of Jiaxing, Jiaxing, Zhejiang Province 314000, China
Zhi-Heng Chen, Guang-Jian Dou, Jia-Jun Lu, Yuan Zhou, Department of Gastrointestinal Surgery, The Affiliated Hospital of Jiaxing University and The First Hospital of Jiaxing, Jiaxing, Zhejiang Province 314000, China
Co-first authors: Yi-Xiao Liu and Zhi-Heng Chen.
Author contributions: Liu YX and Chen ZH wrote the first draft of the manuscript; Dou GJ, Lu JJ, and Zhou Y performed material preparation, data collection, and analysis; Zhou Y contributed to the study conception and design; Liu YX, Chen ZH, Dou GJ, Lu JJ, and Zhou Y commented on previous versions of the manuscript; and all authors read and approved the final manuscript. Liu YX and Chen ZH contributed equally to this work and are co-first authors.
AI contribution statement: No generative artificial intelligence tools were used in the preparation of this manuscript. The authors conducted all aspects of the study, including its conception, data analysis, interpretation, and writing, and take full responsibility for its content.
Supported by the National Clinical Key Specialty Construction Project - Oncology, No. 2023-GJZK-001; and Jiaxing City and Provinces to Build Medical Key Disciplines -Oncology, No. 2023-SSGJ-001.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
Corresponding author: Yuan Zhou, MD, Associate Professor, Department of Gastrointestinal Surgery, The Affiliated Hospital of Jiaxing University and The First Hospital of Jiaxing, No. 1882 Zhonghuan South Road, Jiaxing, Zhejiang Province 314000, China. zhouyuan0422@zjxu.edu.cn
Received: April 3, 2026 Revised: June 13, 2026 Accepted: August 18, 2026 Published online: October 15, 2026 Processing time: 168 Days and 13.2 Hours
Abstract
BACKGROUND
Fusobacterium nucleatum has been implicated in colorectal cancer (CRC) progression, recurrence, immune evasion, and treatment resistance. However, clinical studies evaluating its prognostic significance have reported inconsistent findings.
AIM
To determine the prognostic significance of tissue F. nucleatum abundance in CRC.
METHODS
We searched PubMed, Scopus, Web of Science, and the Cochrane Library through August 10, 2025. Eligible observational studies evaluated tissue F. nucleatum abundance in CRC and reported survival outcomes. Individual patient data were reconstructed from Kaplan–Meier curves. Cox proportional hazards models, random-effects meta-analysis, flexible parametric survival models, and restricted mean survival time analyses were performed.
RESULTS
Twelve cohort studies involving 4358 patients were included. Using the high/positive F. nucleatum expression group as the reference, the low/negative expression group had a significantly lower risk of disease-free survival (DFS) events, corresponding to worse DFS among patients with high/positive expression (hazard ratio = 0.45, 95% confidence interval: 0.37–0.56). A similar association was observed for cancer-specific survival (hazard ratio = 0.34, 95%CI: 0.26–0.44). No significant association was observed for overall survival (hazard ratio = 0.99, 95% confidence interval: 0.82–1.20). Restricted mean survival time differences were 21.8 months for DFS and 38.4 months for cancer-specific survival.
CONCLUSION
High tissue F. nucleatum abundance is associated with poorer DFS and cancer-specific survival, but not overall survival, in CRC.
Core Tip: This meta-analysis evaluated the prognostic significance of tissue Fusobacterium nucleatum abundance in colorectal cancer using reconstructed individual patient data from Kaplan–Meier curves. High/positive F. nucleatum expression was associated with poorer disease-free survival and cancer-specific survival, whereas no significant association was observed for overall survival. These findings suggest that F. nucleatum may be more closely associated with recurrence and cancer-specific mortality than with all-cause mortality, although further validation is required.
