Abstract
This study aimed to conduct a meta-analysis to investigate the association between human epidermal growth factor receptor 2 (HER-2/neu) expression and survival in patients with epithelial ovarian cancer (EOC). HER-2/neu is one of the most frequently studied molecular biological parameters in EOC, but its prognostic impact has not been fully assessed. PubMed and Embase were searched for studies that reported HER-2/neu expression and survival in patients with EOC. The primary outcome was overall survival (OS), and the secondary outcome was progression-free survival (PFS). Hazard ratios (HRs) with 95% confidence interval (CI) were determined using Mantel–Haenszel random-effects model. Publication bias was investigated using funnel plots and Egger’s test. A total of 56 studies (N=7212) were included in the analysis. The results showed that patients possessing HER-2/neu expression had significant disadvantages in OS (HR = 1.41; 95%CI, 1.31 to 1.51; P < 0.001) and PFS (HR = 1.38; 95% CI, 1.23–1.56; P < 0.001). The trim-and-fill method, Copas model, and subgroup analyses stratified by the study characteristics confirmed the robustness of the results. The present study findings provided further indication that HER-2/neu expression in patients with EOC has an adverse impact on OS and PFS.
Highlights
Epithelial ovarian cancer (EOC) is considered as the second most common malignancy in women
The results showed that patients possessing HER-2/neu expression had significant disadvantages in overall survival (OS) (HR = 1.41; 95%confidence interval (CI), 1.31 to 1.51; P < 0.001) and progression-free survival (PFS) (HR = 1.38; 95% CI, 1.23–1.56; P < 0.001)
The full text reading of the remaining studies resulted in the exclusion of 60 additional studies (9 studies shared an identical population; 34 studies had no relevant outcomes; 6 studies were with small sample size and 11 studies were letters, comments, or correspondence)
Summary
Epithelial ovarian cancer (EOC) is considered as the second most common malignancy in women. Established clinicopathological prognostic factors of EOC include World Health Organization (WHO) grade, residual tumor after primary surgery, age at diagnosis, performance status, histological characteristics, and tumor rupture during surgery These factors inadequately predicted the clinical outcomes of EOC [4]. A UK based trial compared the multimodality screening of ovarian cancer with ultrasound and CA-125 versus either ultrasound alone and/or no screening and concluded that the former was more effective in the detection of earlystage cancer [6]. Despite this evidence, the molecular mechanisms contributing to its aggressiveness are not fully understood.
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