Prognostic factors in Krukenberg tumor
Krukenberg tumor (KT) is a rare secondary ovarian tumor. Little is known about clinicopathologic factors affecting prognosis in KT.
To assess the prognostic value of clinicopathologic factors in KT through a systematic review and meta-analysis.
Electronic databases were searched from their inception to February 2019 for studies assessing the association of clinicopathologic factors with overall survival in KT. Pooled hazard ratio (HR) was calculated for each factor; a p value < 0.05 was considered significant.
Twenty-three studies with 1743 patients were included. A decreased overall survival was significantly associated with peritoneal involvement (HR 1.944; p = 0.003), ascites (HR 2.055; p = 0.034), synchronous presentation (HR 1.679; p = 0.034) and increased serum CEA levels (HR 1.380; p = 0.010), but not with age > 50 (HR 0.946; p = 0.743), menopausal status (HR 1.565; p = 0.204), gastric origin (HR 1.600; p = 0.201), size > 5 cm (HR 1.292; p = 0.119), size > 10 cm (HR 0.925; p = 0.714), bilateral ovarian involvement (HR 1.113; p = 0.347), non-peritoneal extaovarian metastases (HR 1.648; p = 0.237), liver metastases (HR 1.118, p = 0.555), predominant signet ring cell morphology (HR 1.322; p = 0.208) and levels of CA125 (HR 0.933; p = 0.828) and CA19.9 (HR 0.996; p = 0.992).
Peritoneal involvement, synchronous presentation, ascites and increased serum CEA levels appear as unfavorable prognostic factors in KT and might affect the patient management.
KeywordsCancer Metastasis Prognosis Management Oncology Hazard ratio Therapy
RL, MDL: study conception, electronic search, eligibility of the studies, inclusion criteria, risk of bias, data extraction and data analysis. AR, AT: study conception, disagreement resolution, manuscript preparation, data extraction and data analysis. GS, ADC: electronic search, eligibility of the studies, inclusion criteria, risk of bias, data extraction and data analysis. MM: methods supervision, manuscript preparation. MDA, LI: study design, methods supervision, manuscript preparation. FZ: study design, manuscript preparation, whole study supervision. FC: study design, methods supervision, whole study supervision.
No financial support was received for this study.
Compliance with ethical standards
Conflict of interest
The authors declare no conflict of interest.
Given the study design (systematic review and meta-analysis), Institutional Review Board approval was not requested, since no new patients’ data were handled.
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