Junaid Anwar, Ahmed Abdelhakeem, Muhammad Shariq Khan, Hafiz Muhammad Arslan, Juwairiya Shuroog, Zouina Sarfraz, Ali Saeed, Anwaar Saeed
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In this study, we systematically analyzed survival outcomes among gastric cancer patients with ovarian metastases who underwent standard chemotherapy, surgical resection of ovarian metastases, or combined chemotherapy and surgery.</p><p><strong>Methods: </strong>We conducted a systematic review and meta-analysis of randomized controlled trials and observational studies retrieved from MEDLINE (PubMed), Embase, and the Cochrane Library until January 25, 2024, applying the Boolean logic. Participants included individuals with pathologically and radiologically confirmed ovarian metastasis or clinically symptomatic cases with imaging evidence. Statistical analyses were performed using R (v.4.3.2., Vienna). The study was registered with PROSPERO (ID-CRD42023488373).</p><p><strong>Results: </strong>A total of 1502 patients from 17 retrospective studies were pooled for analysis of overall survival (OS) outcomes. The OS in the standard chemotherapy cohort, as determined by the random effects model, was 6.708 months (95% CI 3.867 to 9.548; P<0.0001), with non-significant heterogeneity (I<sup>2</sup> = 5.5%). In the surgical resection cohort, OS was 12.786 months (95% CI 6.9 to 18.671; P<0.0001), with low heterogeneity (I<sup>2</sup> = 0%). In the combined chemotherapy and surgical resection cohort, OS was 16.228 months (95% CI 12.254 to 20.202), with insignificant heterogeneity (I<sup>2</sup> = 0%).</p><p><strong>Conclusion: </strong>This meta-analysis offers key insights into survival outcomes associated with different therapeutic modalities in gastric cancer with Krukenberg metastases. It provides valuable evidence for clinical decision-making and future research directions. While the combined approach of chemotherapy and surgery demonstrates the highest effect size for OS, careful consideration of patient-centric approaches is essential in the oncological care landscape.</p>","PeriodicalId":15895,"journal":{"name":"Journal of Gastrointestinal Cancer","volume":null,"pages":null},"PeriodicalIF":1.6000,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Survival Outcomes in Stage IV Gastric Cancer Patients with Krukenberg Tumors: A Systematic Review and Meta Analysis.\",\"authors\":\"Junaid Anwar, Ahmed Abdelhakeem, Muhammad Shariq Khan, Hafiz Muhammad Arslan, Juwairiya Shuroog, Zouina Sarfraz, Ali Saeed, Anwaar Saeed\",\"doi\":\"10.1007/s12029-024-01068-w\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Stage IV gastric cancer patients with Krukenberg tumors typically exhibit poor survival outcomes, often less than 2 years. 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引用次数: 0
摘要
背景：患有克鲁肯贝格肿瘤的 IV 期胃癌患者通常生存率较低，通常不足 2 年。对这一肿瘤亚群的管理仍未标准化，卵巢切除术对生存的影响仍不确定。在这项研究中，我们系统分析了有卵巢转移的胃癌患者接受标准化疗、卵巢转移灶手术切除或联合化疗和手术的生存结果：我们采用布尔逻辑对截至 2024 年 1 月 25 日从 MEDLINE (PubMed)、Embase 和 Cochrane 图书馆检索到的随机对照试验和观察性研究进行了系统回顾和荟萃分析。研究对象包括经病理学和放射学证实的卵巢转移瘤患者或有影像学证据的临床症状病例。统计分析使用 R (v.4.3.2., Vienna) 进行。该研究已在 PROSPERO（ID-CRD42023488373）注册：共汇总了17项回顾性研究中的1502名患者，对总生存期（OS）结果进行了分析。根据随机效应模型确定，标准化疗队列的OS为6.708个月（95% CI为3.867至9.548；P2=5.5%）。手术切除队列的 OS 为 12.786 个月（95% CI 6.9 至 18.671；P2 = 0%）。在化疗和手术切除联合队列中，OS 为 16.228 个月（95% CI 12.254 至 20.202），异质性不显著（I2 = 0%）：这项荟萃分析提供了与克鲁肯贝格转移灶胃癌不同治疗模式相关的生存结果的重要见解。它为临床决策和未来研究方向提供了有价值的证据。虽然化疗和手术的联合方法对OS的影响最大，但在肿瘤治疗过程中，仔细考虑以患者为中心的方法至关重要。
Survival Outcomes in Stage IV Gastric Cancer Patients with Krukenberg Tumors: A Systematic Review and Meta Analysis.
Background: Stage IV gastric cancer patients with Krukenberg tumors typically exhibit poor survival outcomes, often less than 2 years. The management of this tumor subgroup remains non-standardized, and the impact of oophorectomy on survival remains uncertain. In this study, we systematically analyzed survival outcomes among gastric cancer patients with ovarian metastases who underwent standard chemotherapy, surgical resection of ovarian metastases, or combined chemotherapy and surgery.
Methods: We conducted a systematic review and meta-analysis of randomized controlled trials and observational studies retrieved from MEDLINE (PubMed), Embase, and the Cochrane Library until January 25, 2024, applying the Boolean logic. Participants included individuals with pathologically and radiologically confirmed ovarian metastasis or clinically symptomatic cases with imaging evidence. Statistical analyses were performed using R (v.4.3.2., Vienna). The study was registered with PROSPERO (ID-CRD42023488373).
Results: A total of 1502 patients from 17 retrospective studies were pooled for analysis of overall survival (OS) outcomes. The OS in the standard chemotherapy cohort, as determined by the random effects model, was 6.708 months (95% CI 3.867 to 9.548; P<0.0001), with non-significant heterogeneity (I2 = 5.5%). In the surgical resection cohort, OS was 12.786 months (95% CI 6.9 to 18.671; P<0.0001), with low heterogeneity (I2 = 0%). In the combined chemotherapy and surgical resection cohort, OS was 16.228 months (95% CI 12.254 to 20.202), with insignificant heterogeneity (I2 = 0%).
Conclusion: This meta-analysis offers key insights into survival outcomes associated with different therapeutic modalities in gastric cancer with Krukenberg metastases. It provides valuable evidence for clinical decision-making and future research directions. While the combined approach of chemotherapy and surgery demonstrates the highest effect size for OS, careful consideration of patient-centric approaches is essential in the oncological care landscape.
期刊介绍：
The Journal of Gastrointestinal Cancer is a multidisciplinary medium for the publication of novel research pertaining to cancers arising from the gastrointestinal tract.The journal is dedicated to the most rapid publication possible.The journal publishes papers in all relevant fields, emphasizing those studies that are helpful in understanding and treating cancers affecting the esophagus, stomach, liver, gallbladder and biliary tree, pancreas, small bowel, large bowel, rectum, and anus. In addition, the Journal of Gastrointestinal Cancer publishes basic and translational scientific information from studies providing insight into the etiology and progression of cancers affecting these organs. New insights are provided from diverse areas of research such as studies exploring pre-neoplastic states, risk factors, epidemiology, genetics, preclinical therapeutics, surgery, radiation therapy, novel medical therapeutics, clinical trials, and outcome studies.In addition to reports of original clinical and experimental studies, the journal also publishes: case reports, state-of-the-art reviews on topics of immediate interest or importance; invited articles analyzing particular areas of pancreatic research and knowledge; perspectives in which critical evaluation and conflicting opinions about current topics may be expressed; meeting highlights that summarize important points presented at recent meetings; abstracts of symposia and conferences; book reviews; hypotheses; Letters to the Editors; and other items of special interest, including:Complex Cases in GI Oncology: This is a new initiative to provide a forum to review and discuss the history and management of complex and involved gastrointestinal oncology cases. The format will be similar to a teaching case conference where a case vignette is presented and is followed by a series of questions and discussion points. A brief reference list supporting the points made in discussion would be expected.
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