Abstract
Recent studies have shown diagnostic and prognostic values of circulating tumor cells (CTCs) and disseminated tumor cells (DTCs) in various cancers, including ovarian cancer. We aimed to evaluate the association of CTCs and/or DTCs with the clinical outcomes of ovarian cancer. Clinical studies of CTCs/DTCs of ovarian cancer were included for systematic review and meta-analysis. A total of 236 studies were screened but only 16 qualified studies with 1623 subjects were included. Odds ratio (OR) showed CTCs/DTCs were not significantly associated with serous carcinoma (OR = 0.71 [0.49, 1.05]), lymph node metastasis (OR 1.14 [0.67, 1.93]), and residual disease (OR 1.45 [0.90, 2.34]); but significantly associated with advanced tumor staging (OR = 1.90 [1.02, 3.56]). The overall pooled hazard ratio (HR) of CTCs/DTCs on OS and PFS/DFS was 1.94 [1.56– 2.40] and 1.99 [1.59–2.50], respectively. Subgroup analyses revealed that CTCs were significantly associated OS (HR 1.97 [1.50-2.58]) and PFS/DFS (HR 2.52 [1.83-3.48]), while DTCs was significantly associated OS (HR 1.89 [1.33, 2.68]) and PFS/DFS (HR 1.60 [1.17, 2.19]). Meta-analysis showed strong relationship of CTCs/DTCs with advanced staging, treatment response and poor prognosis in patients with ovarian cancer.Electronic supplementary materialThe online version of this article (doi:10.1186/s13048-015-0168-9) contains supplementary material, which is available to authorized users.
Highlights
Ovarian cancer is the most frequent cause of death amongst gynecological cancers worldwide
Association of circulating tumor cells (CTCs)/disseminated tumor cells (DTCs) with clinopathological characteristics revealed that CTCs/DTCs significantly associated with advanced tumor stage and treatment response
It suggested that CTCs/DTCs could be used as an early predictive marker of tumor response in ovarian cancer patients undergo chemotherapy
Summary
Ovarian cancer is the most frequent cause of death amongst gynecological cancers worldwide. Majority of cases diagnosed in late stage of the disease and resulted in poor survival [1]. The five-year survival rate of patients with ovarian cancer is only around 30 % in Stage III or IV [2]. The reasons of delayed diagnosis are partly due to lack of sensitive signs and symptoms and effective screening methods [3]. Survival has been improved with the use of cyto-reduction surgery along with platinum- and/or taxane-based chemotherapy, nearly 80 % eventually relapse within 5 years [4]. Methods that help detection of ovarian cancer in early stage and monitoring of tumor progression have great potential to improve survival of the patients
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