Laboratory of Experimental Surgery and Surgical Research N.S Christeas.
1st Department of Obstetrics and Gynecology, Alexandra Hospital, National and Kapodistrian University of Athens, Athens, Greece.
Am J Clin Oncol. 2019 Sep;42(9):725-731. doi: 10.1097/COC.0000000000000570.
The impact of anemia on cancer survival has been previously mentioned in various oncological fields. To date, however, it remains unknown whether prechemotherapy hemoglobin (Hgb) levels are predictive of ovarian cancer survival (OC). The purpose of the present systematic review is to accumulate evidence in this field.
We used the Medline, Scopus, Clinicaltrials.gov, EMBASE, Cochrane Central Register of Controlled Trials CENTRAL, and Google Scholar databases in our primary search. The date of our last search was set for July 30, 2018. Statistical meta-analysis was performed with the RevMan 5.3 software.
Overall, 11 articles were included that recruited 1816 women with OC. Five articles that involved 856 OC patients were included in the meta-analysis. Compared with patients with anemia, patients with Hgb levels >12 g/dL had increased odds of overall survival (odds ratio, 1.72; 95% confidence interval: 1.41, 2.10). Similarly, the progression-free survival of patients was significantly affected, although the available data could not be accumulated in a meta-analysis because of the heterogeneity in outcome reporting measures.
Current evidence suggests that prechemotherapy Hgb levels below the threshold of 12 g/dL can potentially predict worse overall survival of OC patients. Future research is required in the field to elucidate whether several independent variables such as the stage and histology of disease and rates of optimal debulking affect the clinical significance of this association.
贫血对癌症生存的影响在不同的肿瘤学领域都曾被提及。然而，迄今为止，化疗前血红蛋白（Hgb）水平是否能预测卵巢癌（OC）的生存情况仍不得而知。本系统评价的目的是为该领域积累证据。
我们在初次检索中使用了 Medline、Scopus、Clinicaltrials.gov、EMBASE、Cochrane 中央对照试验注册中心 CENTRAL 和 Google Scholar 数据库。最后一次检索日期定为 2018 年 7 月 30 日。使用 RevMan 5.3 软件进行统计荟萃分析。
共纳入了 11 项研究，共纳入了 1816 名 OC 患者。Meta 分析纳入了 5 项涉及 856 名 OC 患者的研究。与贫血患者相比，Hgb 水平>12 g/dL 的患者总体生存的优势比（OR）为 1.72（95%置信区间：1.41，2.10）。同样，尽管由于结局报告措施的异质性，无法对可用数据进行荟萃分析，但患者的无进展生存也受到了显著影响。
目前的证据表明，化疗前 Hgb 水平低于 12 g/dL 的阈值可能预示着 OC 患者的总体生存更差。需要在该领域进行进一步的研究，以阐明是否有几个独立的变量，如疾病的分期和组织学以及最佳减瘤率，会影响这一关联的临床意义。
