Sarcopenia and ovarian cancer survival: a systematic review and meta‐analysis

ObjectiveThe potential therapeutic effects of metformin on several cancers were reported. However, the evidence of the effects of metformin on ovarian cancer is still limited and inconclusive. This systematic review and meta-analysis study aims to summarize the existing evidence of the therapeutic effects of metformin on ovarian cancer.MethodsWe performed systematic searches using electronic databases including PubMed and EMBASE until December 2012. Key words included “metformin” AND (“ovarian cancer” OR “ovary tumor”). All human studies assessing the effects of metformin on ovarian cancer were eligible for inclusion. All articles were reviewed independently by 2 authors with a standardized approach for the purpose of study, study design, patient characteristics, exposure, and outcomes. The data were pooled using a random-effects model.ResultsOf 190 studies retrieved, only 3 observational studies and 1 report of 2 randomized controlled trials were included. Among those studies, 2 reported the effects of metformin on survival outcomes of ovarian cancer, whereas the other 2 reported the effects of metformin on ovarian cancer prevention. The findings of studies reporting the effects on survival outcomes indicated that metformin may prolong overall, disease-specific, and progression-free survival in ovarian cancer patients. The results of studies reporting the effects of metformin on ovarian cancer prevention were meta-analyzed. It indicated that metformin tended to decrease occurrence of ovarian cancer among diabetic patients with the pooled odds ratio of 0.57 (95% confidence interval, 0.16–1.99).ConclusionsOur findings showed the potential therapeutic effects of metformin on survival outcomes of ovarian cancer and ovarian cancer prevention. However, most of the evidence was observational studies. There is a call for further well-conducted controlled clinical trials to confirm the effects of metformin on ovarian cancer survival and ovarian cancer prevention.

Download Full-text

Perioperative blood transfusion and ovarian cancer survival rates: A meta-analysis based on univariate, multivariate and propensity score matched data

European Journal of Obstetrics & Gynecology and Reproductive Biology ◽

10.1016/j.ejogrb.2020.06.013 ◽

2020 ◽

Vol 252 ◽

pp. 137-143

Author(s):

Vasilios Pergialiotis ◽

Nikolaos Thomakos ◽

Maximos Frountzas ◽

Dimitrios Haidopoulos ◽

Dimitrios Loutradis ◽

...

Keyword(s):

Ovarian Cancer ◽

Blood Transfusion ◽

Propensity Score ◽

Cancer Survival ◽

Meta Analysis ◽

Survival Rates ◽

Ovarian Cancer Survival ◽

Matched Data ◽

Perioperative Blood Transfusion

Download Full-text

Gene expression meta-analysis identifies chromosomal regions involved in ovarian cancer survival

Genes Chromosomes and Cancer ◽

10.1002/gcc.20676 ◽

2009 ◽

Vol 48 (8) ◽

pp. 711-724 ◽

Cited By ~ 9

Author(s):

Mads Thomassen ◽

Kirsten M. Jochumsen ◽

Ole Mogensen ◽

Qihua Tan ◽

Torben A. Kruse

Keyword(s):

Gene Expression ◽

Ovarian Cancer ◽

Cancer Survival ◽

Meta Analysis ◽

Ovarian Cancer Survival

Download Full-text

The influence of reproductive and hormonal factors on ovarian cancer survival

International Journal of Gynecological Cancer ◽

10.1111/j.1525-1438.2007.01031.x ◽

2008 ◽

Vol 18 (3) ◽

pp. 407-413 ◽

Cited By ~ 20

Author(s):

C. M. Nagle ◽

C. J. Bain ◽

A. C. Green ◽

P. M. Webb

Keyword(s):

Systematic Review ◽

Ovarian Cancer ◽

Cancer Survival ◽

Cox Regression ◽

Population Based ◽

Hazard Ratios ◽

History Of ◽

Hormonal Exposures ◽

Ovarian Cancer Survival ◽

Invasive Epithelial Ovarian Cancer

Reproductive and hormonal exposures are known to influence ovarian carcinogenesis, but little is known about the effect of these factors on survival. We have studied survival according to hormonal and reproductive history in a population-based cohort of 676 Australian women aged 18–79, newly diagnosed with invasive epithelial ovarian cancer in the early 1990s. In order to place our findings in context, we have also undertaken a systematic review of the pertinent literature. Detailed information about each woman's reproductive and contraceptive history was obtained from pregnancy and contraceptive calendars at the time of diagnosis. Cox regression was used to obtain multivariate adjusted hazard ratios (HR) and 95% confidence intervals (CI). A total of 419 (62%) of the 676 women died during the follow-up (giving a 5-year survival proportion of 44%). Apart from better survival for women who had ever breastfed (multivariate HR 0.74, 95% CI 0.55–0.98), we found no association between survival from invasive ovarian cancer and a range of hormonal and gynecological factors including parity, use of oral contraceptives, and histories of tubal sterilization or hysterectomy. Systematic review of the literature generally supported the lack of influence of these factors on survival from ovarian cancer. We conclude that, except for a possible survival advantage among women with a history of breastfeeding, reproductive and hormonal exposures prior to diagnosis do not influence survival from invasive ovarian cancer, in contrast to their substantial effects on etiology of this disease

Download Full-text

No Effect of Metformin on Ovarian Cancer Survival: A Systematic Review and Meta-Analysis of Cohort Studies

Current Pharmaceutical Design ◽

10.2174/1381612825666190716113126 ◽

2019 ◽

Vol 25 (23) ◽

pp. 2595-2601

Author(s):

Yongbo Wang ◽

Xiaoxue Liu ◽

Pengfei Yan ◽

Yongyi Bi ◽

Yu Liu ◽

...

Keyword(s):

Ovarian Cancer ◽

Cohort Studies ◽

Cancer Patients ◽

Cancer Survival ◽

Meta Analysis ◽

Disease Free Survival ◽

Preliminary Evidence ◽

Hazard Ratios ◽

Retrospective Cohort Studies ◽

Ovarian Cancer Survival

Background: A number of observational studies examined the association between metformin therapy and ovarian cancer survival outcomes, but the results are inconsistent. Objective: The study aimed to investigate the effect of metformin on survival for ovarian cancer patients. Methods: PubMed, Embase and Web of Science databases were searched for relevant studies from the inception to June 11, 2019. The strength of the relationship was assessed using summary of hazard ratios (HRs) with corresponding 95% confidence intervals (CI). Statistical analyses were carried out using the random-effects model. Results: Totally, 6 retrospective cohort studies involving 2,638 ovarian cancer patients were included. Metformin was not associated with improved overall survival (HR=0.78, 95% CI 0.54-1.12, P=0.175, I2= 61.6%) and disease- free survival (HR=0.49, 95% CI 0.20-1.17, P=0.106, I2=82.1%) in ovarian cancer patients compared to nonmetformin users. Conclusion: The current study provides preliminary evidence that metformin may not be associated with a survival benefit for ovarian cancer patients. More studies with rigorous designs are needed.

Download Full-text

Systematic review of adjuvant therapy for early stage (epithelial) ovarian cancer

International Journal of Gynecological Cancer ◽

10.1136/ijgc-00009577-200307000-00001 ◽

2003 ◽

Vol 13 (4) ◽

pp. 395-404 ◽

Cited By ~ 7

Author(s):

B. Winter-Roach ◽

L. Hooper ◽

H. Kitchener

Keyword(s):

Systematic Review ◽

Ovarian Cancer ◽

Adjuvant Chemotherapy ◽

Adjuvant Therapy ◽

Early Stage ◽

Meta Analysis ◽

Disease Free Survival ◽

Significant Difference ◽

Well Differentiated ◽

Platinum Chemotherapy

A systematic review and meta analysis has been undertaken in order to evaluate the effectiveness of adjuvant therapy following surgery for early ovarian cancer. Trials reported since 1990 have been of a higher quality enabling a meta analysis of adjuvant chemotherapy vs adjuvant radiotherapy and a meta analysis of adjuvant chemotherapy vs observation. There was no significant difference between radiotherapy and chemotherapy, though these comprised studies which demonstrated considerable heterogeneity. Chemotherapy did confer significant benefit over observation in terms of both overall and disease free survival. Except for women in whom adequate surgical staging has revealed well differentiated disease confined to one or both ovaries with intact capsule, platinum chemotherapy should be offered to reduce risk of recurrence.

Download Full-text

Vaginal hysterectomy with or without bilateral salpingo-oophorectomy may be an alternative treatment for endometrial cancer patients with medical co-morbidities precluding standard surgical procedures: a systematic review

International Journal of Gynecological Cancer ◽

10.1136/ijgc-2018-000015 ◽

2019 ◽

Vol 29 (2) ◽

pp. 299-304 ◽

Cited By ~ 1

Author(s):

Arnold-Jan Kruse ◽

Henk G ter Brugge ◽

Harm H de Haan ◽

Hugo W Van Eyndhoven ◽

Hans W Nijman

Keyword(s):

Ovarian Cancer ◽

Endometrial Cancer ◽

Vaginal Hysterectomy ◽

Cancer Survival ◽

Survival Rates ◽

Survival Outcomes ◽

Ovarian Malignancy ◽

Post Menopausal ◽

Ovarian Cancer Survival ◽

Overall Survival Rates

ObjectiveVaginal hysterectomy with bilateral salpingo-oophorectomy may be an alternative strategy for patients with low-risk endometrial cancer and medical co-morbidities precluding laparoscopic or abdominal procedures. The current study evaluates the prevalence of co-existent ovarian malignancy in patients with endometrial cancer and the influence of bilateral salpingo-oophorectomy on survival outcomes in these patients.MethodsMedline and EMBASE were searched for studies published between January 1, 2000 and November 20, 2017 that investigated (1) the prevalence of co-existing ovarian malignancy (either metastases or primary synchronous ovarian cancer in women with endometrial cancer, and (2) the influence of bilateral salpingo-oophorectomy on recurrence and/or survival rates.ResultsOf the pre-menopausal and post-menopausal patients (n=6059), 373 were identified with metastases and 106 were identified with primary synchronous ovarian cancer. Of the post-menopausal patients (n=6016), 362 were identified with metastases and 44 were identified with primary synchronous ovarian cancer. Survival outcomes did not differ for pre-menopausal patients with endometrial cancer with and without bilateral salpingo-oophorectomy (5-year overall survival rates were 89–94.5% and 86–97.8%, respectively).ConclusionBilateral salpingo-oophorectomy during vaginal hysterectomy seems to have a limited impact on disease outcome in patients with endometrial cancer. These results support the view that vaginal hysterectomy alone or with bilateral salpingo-oophorectomy may be an option for patients with endometrial cancer who are not ideal surgical candidates.

Download Full-text