Xu Kai, Yang Shouhua, Zhao Yingchao
Department of Otolaryngology-Head and Neck Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, China.
Department of Obstetrics and Gynecology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, China.
Oncotarget. 2017 Jan 3;8(1):285-302. doi: 10.18632/oncotarget.12306.
There is no consensus on the syntheses concerning the impact of BRCA mutation on ovarian cancer survival. A systematic review and meta-analysis of observational studies was conducted that evaluated the impact of BRCA mutations on the survival outcomes of patients with ovarian cancer. The primary outcome measure was overall survival (OS) and secondary outcome was progression-free survival (PFS). We presented data with hazard ratios (HRs) and 95% confidence interval (CI) and pooled them using the random-effects models. From 2,624 unique records, 34 eligible studies including 18,396 patients were identified. BRCA1/2 mutations demonstrated both OS and PFS benefits in patients with ovarian cancer (OS: HR = 0.67, 95% CI, 0.57 to 0.78, I2 = 76.5%, P <0.001; PFS: HR = 0.62, 95% CI, 0.53 to 0.73, I2 = 18.1%, P = 0.261). For BRCA1 mutation carriers, the HRs for OS and PFS benefits were 0.73 (95% CI, 0.63 to 0.86) and 0.68 (95% CI, 0.52 to 0.89), respectively. For BRCA2 mutation carriers, the HRs for OS and PFS benefits were 0.57 (95% CI, 0.45 to 0.73) and 0.48 (95% CI, 0.30 to 0.75), respectively. The results of subgroup analyses for OS stratified by study quality, tumor stage, study design, sample size, number of research center, duration of follow-up, baseline characteristics adjusted and tumor histology were mostly constant across BRCA1/2, BRCA1 and BRCA2 mutation subtypes. In summary, for patients with ovarian cancer, BRCA mutations were associated with improved OS and PFS. Further large-scale prospective cohort studies should be conducted to test its benefits in specific patients.
关于BRCA突变对卵巢癌生存率的影响，目前尚无定论。我们进行了一项观察性研究的系统评价和荟萃分析，以评估BRCA突变对卵巢癌患者生存结局的影响。主要结局指标是总生存期（OS），次要结局是无进展生存期（PFS）。我们以风险比（HRs）和95%置信区间（CI）呈现数据，并使用随机效应模型进行汇总。从2624条独特记录中，确定了34项符合条件的研究，包括18396例患者。BRCA1/2突变在卵巢癌患者中显示出OS和PFS方面的获益（OS：HR = 0.67，95% CI，0.57至0.78，I2 = 76.5%，P <0.001；PFS：HR = 0.62，95% CI，0.53至0.73，I2 = 18.1%，P = 0.261）。对于BRCA1突变携带者，OS和PFS获益的HR分别为0.73（95% CI，0.63至0.86）和0.68（95% CI，0.52至0.89）。对于BRCA2突变携带者，OS和PFS获益的HR分别为0.57（95% CI，0.45至0.73）和0.48（95% CI，0.30至0.75）。根据研究质量、肿瘤分期、研究设计、样本量、研究中心数量、随访时间、调整后的基线特征和肿瘤组织学对OS进行亚组分析的结果，在BRCA1/2、BRCA1和BRCA2突变亚型中大多保持一致。总之，对于卵巢癌患者，BRCA突变与OS和PFS的改善相关。应开展进一步的大规模前瞻性队列研究，以检验其在特定患者中的获益情况。
