You are here

Article Text

Article menu
Download PDFPDF
Original research
Five-year survival decreases over time in patients with BRCA-mutated ovarian cancer: a systemic review and meta-analysis
  1. Chen Nahshon1,
  2. Ofra Barnett-Griness2,
  3. Yakir Segev1,
  4. Meirav Schmidt1,
  5. Ludmila Ostrovsky1 and
  6. Ofer Lavie1
  1. 1 Department of Gynecological Oncology, Carmel Medical Center, Haifa, Israel
  2. 2 Department of Community Medicine and Epidemiology, Carmel Medical Center, Haifa, Israel
  1. Correspondence to Chen Nahshon, Department of Gynecological Oncology, Carmel Medical Center, Haifa 3436212, Israel; csarshalom{at}gmail.com

Abstract

Introduction Short-term survival rates of patients with BRCA-mutated ovarian cancer have been previously shown to be longer than those of non-carriers. We aimed to study the long-term survival rates of these patients and investigate whether the 5-year advantage decreases over time.

Methods A systematic review of the literature was conducted according to the Preferred Reporting Items for Systematic reviews and Meta-Analyzes (PRISMA) statement. The study protocol can be assessed at PROSPERO International prospective register of systematic reviews (http://www.crd.york.ac.uk/PROSPERO, registration number CRD42019137455). We considered for inclusion studies providing Kaplan–Meier survival curves up to and including 10 years, comparing patients with ovarian cancer with and without BRCA mutations. Our main outcome was the conditional probability of surviving an additional 5 years.

Results A total of 13 references comprising 4565 patients was analyzed, of which 1131 BRCA1/2-mutated carriers and 3434 non-carriers were included. The expected higher 5-year survival rate in BRCA-mutated patients was observed (risk difference (RD)=14.9%, p=0.0002, risk ratio (RR)=1.36, p=0.001). Ten-year survival rates were comparatively less improved in BRCA-mutated patients (RD=8.6%, p=0.042, RR=1.25, p=0.12). After already surviving 5 years, no advantage in probability of further surviving 5 additional years was observed for the BRCA-mutated group (RD=2.9%, p=0.71, RR=0.97, p=0.78).

Conclusion Our results provide insight into long-term survival rates and prognosis in patients with BRCA-mutated ovarian cancer which suggest that, despite the improved 5-year prognosis, the conditional probability of surviving an additional 5 years does not show the same advantage. The relatively low long-term advantage highlights the significance of epithelial ovarian cancer recurrence prevention. In the era of poly adenosine ribose inhibitors, future studies should explore the adequate follow-up and the benefit of a longer maintenance treatment phase, aiming to prolong the long-term survival of BRCA-mutated patients.

  • ovarian cancer

Data availability statement

All data relevant to the study are included in the article or uploaded as supplementary information. All data relevant to the study are included in the article or uploaded as supplementary information Study protocol can be assessed at PROSPERO International prospective register of systematic reviews (http://www.crd.york.ac.uk/PROSPERO, registration number CRD42019137455).

https://doi.org/10.1136/ijgc-2020-001392

Statistics from Altmetric.com

    Request Permissions

    If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

    Data availability statement

    All data relevant to the study are included in the article or uploaded as supplementary information. All data relevant to the study are included in the article or uploaded as supplementary information Study protocol can be assessed at PROSPERO International prospective register of systematic reviews (http://www.crd.york.ac.uk/PROSPERO, registration number CRD42019137455).

    View Full Text

    Footnotes

    • Contributors CN: data collection, statistical analysis, writing original draft, methodology, investigation. OB-G: formal analysis, writing- review and editing, methodology, investigation, software. YS: data collection, validation, review. MS: validation, review. LO: validation, review. OL: conceptualization, writing- review and editing, methodology, investigation, supervision.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.