Department of Public Health, School of Medicine, University of Naples Federico II, Naples, Italy.
Department of Advanced Biomedical Sciences, School of Medicine, University of Naples Federico II, Via Sergio Pansini, 5, 80131, Naples, Italy.
Arch Gynecol Obstet. 2019 Nov;300(5):1155-1165. doi: 10.1007/s00404-019-05301-x. Epub 2019 Sep 21.
Krukenberg tumor (KT) is a rare secondary ovarian tumor. Little is known about clinicopathologic factors affecting prognosis in KT.
To assess the prognostic value of clinicopathologic factors in KT through a systematic review and meta-analysis.
Electronic databases were searched from their inception to February 2019 for studies assessing the association of clinicopathologic factors with overall survival in KT. Pooled hazard ratio (HR) was calculated for each factor; a p value < 0.05 was considered significant.
Twenty-three studies with 1743 patients were included. A decreased overall survival was significantly associated with peritoneal involvement (HR 1.944; p = 0.003), ascites (HR 2.055; p = 0.034), synchronous presentation (HR 1.679; p = 0.034) and increased serum CEA levels (HR 1.380; p = 0.010), but not with age > 50 (HR 0.946; p = 0.743), menopausal status (HR 1.565; p = 0.204), gastric origin (HR 1.600; p = 0.201), size > 5 cm (HR 1.292; p = 0.119), size > 10 cm (HR 0.925; p = 0.714), bilateral ovarian involvement (HR 1.113; p = 0.347), non-peritoneal extaovarian metastases (HR 1.648; p = 0.237), liver metastases (HR 1.118, p = 0.555), predominant signet ring cell morphology (HR 1.322; p = 0.208) and levels of CA125 (HR 0.933; p = 0.828) and CA19.9 (HR 0.996; p = 0.992).
Peritoneal involvement, synchronous presentation, ascites and increased serum CEA levels appear as unfavorable prognostic factors in KT and might affect the patient management.
克鲁肯贝格瘤（KT）是一种罕见的卵巢继发性肿瘤。目前对于影响 KT 患者预后的临床病理因素知之甚少。
通过系统评价和荟萃分析评估 KT 患者临床病理因素的预后价值。
从数据库建立起至 2019 年 2 月，检索评估 KT 患者临床病理因素与总生存率相关性的研究。对每个因素进行汇总风险比（HR）计算；p 值＜0.05 被认为具有统计学意义。
纳入 23 项研究，共 1743 例患者。结果显示，腹膜受累（HR 1.944；p=0.003）、腹水（HR 2.055；p=0.034）、同步表现（HR 1.679；p=0.034）和血清 CEA 水平升高（HR 1.380；p=0.010）与较差的总生存率显著相关，而年龄＞50 岁（HR 0.946；p=0.743）、绝经状态（HR 1.565；p=0.204）、胃来源（HR 1.600；p=0.201）、肿瘤大小＞5cm（HR 1.292；p=0.119）、肿瘤大小＞10cm（HR 0.925；p=0.714）、双侧卵巢受累（HR 1.113；p=0.347）、非腹膜外卵巢转移（HR 1.648；p=0.237）、肝转移（HR 1.118，p=0.555）、主要印戒细胞形态（HR 1.322；p=0.208）和 CA125（HR 0.933；p=0.828）和 CA19.9（HR 0.996；p=0.992）水平与较差的总生存率无关。
腹膜受累、同步表现、腹水和血清 CEA 水平升高似乎是 KT 的不良预后因素，可能影响患者的管理。
