Objective To systematically review the clinicopathological and prognostic value of circulating tumor cells (CTCs) in peripheral blood (PB) in head and neck cancer patients by meta-analysis.

Methods We electronically searched PubMed, EmBase, Cochrane Library, CBM, CNKI and Wanfang database for collecting the studies about the clinicopathological and prognostic relevance of CTCs in PB in head and neck cancer patients (from inception to March 2018).Two researchers screened the literatures according to the inclusion and exclusion criteria, and further extracted the data and evaluated the quality.Stata 12.0 software was used for this analysis.

Results A total of 18 studies (English:17; Chinese:1) involving 779 patients with head and neck cancer were eligible for the final analyses.The pooled results showed CTCs-positive in PB was significantly associated with poorer overall survival (OS) (P=0.006), disease-free survival (DFS) (P < 0.001) and progression-free survival (PFS) (P=0.008).And, the risk of recurrence in CTCs-positive patients was significantly higher than that in CTCs-negative patients (P=0.022).Furthermore, CTCs-positive in PB showed a significantly positive correlation with T stage (P=0.028), N stage (P=0.016) and TNM stage (P=0.024) of head and neck cancer, rather than age, gender or tumor histological grade.

Conclusion  CTCs detected from PB has significantly prognostic value for the patients with head and neck cancer, and CTCs-positive indicates poor prognosis.