In:
Journal of Cellular Biochemistry, Wiley, Vol. 120, No. 9 ( 2019-09), p. 14486-14498
Abstract:
Ovarian metastasis from gastric cancer (Krukenberg tumor [KT]) has no consensus treatment and the role of surgical treatment is still controversial. Identifying prognostic factors for KT could help guide the management of this tumor. We used a meta‐analysis to evaluate the prognostic value of metastasectomy and other factors in patients with KT to develop a treatment plan. We searched literature in PubMed, Cochrane library and EMBASE. We analyzed hazard ratios (HR) and 95% confidence intervals (CI) with respect to overall survival (OS). The meta‐analysis included 12 cohort studies with 1,031 patients associated with longer OS following metastasectomy (HR = 0.41; 95% CI = 0.32–0.53; P 〈 0.001), R0 resection (HR = 0.37; 95% CI = 0.26–0.53; P 〈 0.001), metachronous ovarian metastasis (HR = 0.74; 95% CI = 0.58–0.93; P = 0.012), size of KT ( 〈 5 cm) (HR = 0.74; 95% CI = 0.58–0.95; P = 0.019), ECOG PS (Eastern Cooperative Oncology Group performance status) 0 to 1 (HR = 0.48; 95% CI = 0.29–0.80; P = 0.004), tumor confined to ovary (HR = 0.40; 95% CI = 0.16–0.99; P = 0.047), and tumor confined to pelvic cavity (HR = 0.36; 95% CI = 0.14–0.92; P = 0.033). Shorter OS was associated with peritoneal carcinomatosis (HR = 2.00; 95% CI = 1.25–3.21; P = 0.004), ascites (HR = 1.66; 95% CI = 1.19–2.31; P = 0.003) and positive CEA (HR = 1.41; 95% CI = 1.10–1.82; P = 0.007). Gastrectomy led to a slight improvement in OS, but without statistical significance (HR = 0.69; 95% CI = 0.47–1.02; P = 0.061). No significant difference in OS was observed in patients with signet‐ring cells (HR = 1.17; 95% CI = 0.91–1.51; P = 0.226), bilateral ovarian metastasis (HR = 0.87; 95% CI = 0.70–1.08; P = 0.212), age ≥ 50 years (HR = 0.93; 95% CI = 0.71–1.22; P = 0.619), positive CA19‐9 (HR = 1.01; 95% CI = 0.75–1.35; P = 0.960), and positive CA‐125 (HR = 0.98; 95% CI = 0.73–1.33; P = 0.915). Various factors affect OS in patients with KT.
Type of Medium:
Online Resource
ISSN:
0730-2312
,
1097-4644
Language:
English
Publisher:
Wiley
Publication Date:
2019
detail.hit.zdb_id:
1479976-5
SSG:
12
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