Prognostic role of hormone receptors in ovarian cancer: A systematic review and meta-analysis

Objective: The aim of this study was to summarize the global predicting role of hormone receptors for survival in ovarian cancer. Methods: Eligible studies were identified and assessed for quality through multiple search strategies. Data were collected from studies comparing overall or progression-free/diseasefree/ relapse-free survival in patients with elevated levels of estrogen receptor (ER), progesterone receptor (PR), or human epidermal growth factor receptor 2 (HER2) with those in patients with lower levels. Studies were pooled, and combined hazards ratios (HRs) of ER, PR, and HER2 for survival were calculated, respectively. Results: A total of 35 studies were included for meta-analysis (23 for ER, 19 for PR, and 8 for HER2). For overall survival, the pooledHRof PR reached 0.88 [95% confidence interval (CI), 0.82-0.95], which means that elevated PR level could significantly indicate better survival. In contrast, elevated levels of HER2 could predict worse outcome with anHR of 1.41 (95% CI, 1.05-1.89). Increased level of ER was not significantly prognostic (HR, 0.94; 95% CI, 0.87-1.01). For progression-free survival/disease-free survival/recurrence-free survival, elevated PR level also had predictive value for better outcome with a pooled HR of PR of 0.80 (95% CI, 0.67-0.95). Oppositely, elevated HER2 level could predict poorer outcome with an HR of 1.55 (95% CI, 1.11-2.16). Estrogen receptor failed to predict outcome with an HR of 0.90 (95% CI, 0.78-1.03). Conclusions: In patients with ovarian cancer, elevated level of PR predicted favorable survival, and elevated level of HER2 was associated with worse survival.