Abstract：
OBJECTIVE: Circulating tumor DNA (ctDNA) is emerging as a potential prognostic biomarker in multiple tumor types. However, despite the many studies available on small series of patients with ovarian cancer, a recent systematic review and meta-analysis is lacking. The objective of this study was to determine the association of ctDNA with progression-free-survival and overall survival in patients with epithelial ovarian cancer.
METHODS: An electronic search was conducted using PubMed (MEDLINE), Embase, CENTRAL (Cochrane Library), and CINAHL-Complete from January 2000 to September 15, 2023. To be included in the analysis the studies had to meet the following pre-specified inclusion criteria: (1) evaluable ctDNA; (2) progression-free-survival and overall survival reported as hazard ratio (HR); and (3) the patient population had epithelial ovarian cancer at the time of ctDNA detection. We evaluated the association of ctDNA with progression-free survival and overall survival. Secondary outcomes focused on sub-group analysis of genomic alterations and international Federation of Gynecology and Obstetrics (FIGO) stage.
RESULTS: A total of 26 studies reporting on 1696 patients with epithelial ovarian cancer were included. The overall concordance rate between plasma-based and tissue-based analyses was approximately 62%. We found that a high level of ctDNA in epithelial ovarian cancer was associated with worse progression-free survival (HR 5.31, 95% CI 2.14 to 13.17, p<0.001) and overall survival (HR 2.98, 95% CI 1.86 to 4.76, p<0.0001). The sub-group analysis showed a greater than threefold increase in the risk of relapse in patients with positive HOXA9 meth-ctDNA (HR 3.84, 95% CI 1.57 to 9.41, p=0.003).
CONCLUSIONS: ctDNA was significantly associated with worse progression-free survival and overall survival in patients with epithelial ovarian cancer. Further prospective studies are needed.
UNASSIGNED: CRD42023469390.
METHODS: An electronic search was conducted using PubMed (MEDLINE), Embase, CENTRAL (Cochrane Library), and CINAHL-Complete from January 2000 to September 15, 2023. To be included in the analysis the studies had to meet the following pre-specified inclusion criteria: (1) evaluable ctDNA; (2) progression-free-survival and overall survival reported as hazard ratio (HR); and (3) the patient population had epithelial ovarian cancer at the time of ctDNA detection. We evaluated the association of ctDNA with progression-free survival and overall survival. Secondary outcomes focused on sub-group analysis of genomic alterations and international Federation of Gynecology and Obstetrics (FIGO) stage.
RESULTS: A total of 26 studies reporting on 1696 patients with epithelial ovarian cancer were included. The overall concordance rate between plasma-based and tissue-based analyses was approximately 62%. We found that a high level of ctDNA in epithelial ovarian cancer was associated with worse progression-free survival (HR 5.31, 95% CI 2.14 to 13.17, p<0.001) and overall survival (HR 2.98, 95% CI 1.86 to 4.76, p<0.0001). The sub-group analysis showed a greater than threefold increase in the risk of relapse in patients with positive HOXA9 meth-ctDNA (HR 3.84, 95% CI 1.57 to 9.41, p=0.003).
CONCLUSIONS: ctDNA was significantly associated with worse progression-free survival and overall survival in patients with epithelial ovarian cancer. Further prospective studies are needed.
UNASSIGNED: CRD42023469390.
摘要：
目的：循环肿瘤DNA（ctDNA）正在成为多种肿瘤类型的潜在预后生物标志物。然而,尽管有许多关于小系列卵巢癌患者的研究，缺乏最近的系统评价和荟萃分析.这项研究的目的是确定ctDNA与上皮性卵巢癌患者的无进展生存期和总生存期的关系。
方法：使用PubMed（MEDLINE）进行电子搜索，Embase,CENTRAL(CochraneLibrary),andCINAHL-从2000年1月至2023年9月15日完成。要纳入分析，研究必须满足以下预先指定的纳入标准：（1）可评估的ctDNA；（2）无进展生存期和总生存期报告为风险比（HR）；（3）患者群体在ctDNA检测时患有上皮性卵巢癌。我们评估了ctDNA与无进展生存期和总生存期的相关性。次要结果集中在基因组改变的亚组分析和国际妇产科联合会（FIGO）阶段。
结果：共有26项研究报告了1696例上皮性卵巢癌患者。基于血浆的分析和基于组织的分析之间的总体一致率为大约62%。我们发现，上皮性卵巢癌中高水平的ctDNA与无进展生存期（HR5.31，95％CI2.14至13.17，p<0.001）和总生存期（HR2.98，95％CI1.86至4.76，p<0.0001）有关。亚组分析显示，HOXA9甲基-ctDNA阳性患者的复发风险增加了三倍以上（HR3.84，95％CI1.57至9.41，p=0.003）。
结论：ctDNA与上皮性卵巢癌患者无进展生存期和总生存期较差显著相关。需要进一步的前瞻性研究。
■CRD42023469390。
方法：使用PubMed（MEDLINE）进行电子搜索，Embase,CENTRAL(CochraneLibrary),andCINAHL-从2000年1月至2023年9月15日完成。要纳入分析，研究必须满足以下预先指定的纳入标准：（1）可评估的ctDNA；（2）无进展生存期和总生存期报告为风险比（HR）；（3）患者群体在ctDNA检测时患有上皮性卵巢癌。我们评估了ctDNA与无进展生存期和总生存期的相关性。次要结果集中在基因组改变的亚组分析和国际妇产科联合会（FIGO）阶段。
结果：共有26项研究报告了1696例上皮性卵巢癌患者。基于血浆的分析和基于组织的分析之间的总体一致率为大约62%。我们发现，上皮性卵巢癌中高水平的ctDNA与无进展生存期（HR5.31，95％CI2.14至13.17，p<0.001）和总生存期（HR2.98，95％CI1.86至4.76，p<0.0001）有关。亚组分析显示，HOXA9甲基-ctDNA阳性患者的复发风险增加了三倍以上（HR3.84，95％CI1.57至9.41，p=0.003）。
结论：ctDNA与上皮性卵巢癌患者无进展生存期和总生存期较差显著相关。需要进一步的前瞻性研究。
■CRD42023469390。
