The association between serum uric acid and prognosis of nasopharyngeal carcinoma: a comprehensive meta-analysis of observational studies

Background 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. Methods 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. Results The pooled results demonstrated that elevated SUA was significantly correlated with OS in NPC patients, with a combined HR of 0.245 (95% CI: 0.092–0.398). 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: 0.070–1.044), and the pooled HR for DMFS was 0.715 (95% CI: 0.023–1.407). The 95% CI of both PFS and DMFS crossed the invalid value of 1, indicating no significant statistical difference. Conclusion 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. Systematic review registration https://www.crd.york.ac.uk/PROSPERO/view/CRD420261483250 , identifier CRD420261483250.