title: Prognostic Value of Circulating Tumor Cells in Ovarian Cancer: A Meta-Analysis.
abstract: BACKGROUND
  The prognostic value of circulating tumor cells (CTCs) in ovarian cancer has been investigated in previous studies, but the results are controversial. Therefore we performed a meta-analysis to systematically review these data and evaluate the value of CTCs in ovarian cancer.
  
  
  METHODS
  A literary search for relevant studies was performed on Embase, Medline and Web of Science databases. Then pooled hazard ratios (HRs) for survival with 95% confidence intervals (CIs), subgroup analyses, sensitivity analyses, meta-regression analyses and publication bias were conducted.
  
  
  RESULTS
  This meta-analysis is based on 11 publications and comprises a total of 1129 patients. The prognostic value of the CTC status was significant in overall survival (OS) (HR, 1.61;95% CI,1.22-2.13) and progression-free survival (PFS)/disease-free survival (DFS) (HR, 1.44; 95%CI, 1.18-1.75). Furthermore, subgroup analysis revealed that the value of CTC status in OS was significant in "RT-PCR" subgroup (HR, 2.02; 95% CI, 1.34-3.03), whereas it was not significant in "CellSearch" subgroup (HR, 1.15; 95% CI 0.45-2.92) and "other ICC" subgroup (HR, 1.09; 95% CI 0.62-1.90). The presence of CTC was also associated with an increased CA-125 (OR, 4.07; 95%CI, 1.87-8.85).
  
  
  CONCLUSIONS
  Our study demonstrates that CTC status is associated with OS and PFS/DFS in ovarian cancer.
authors.affiliation: Department of Clinical Laboratory, Xin Hua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200092, China.
authors.forename: Yunlan
authors.initials: Y
authors.lastname: Zhou
authors.affiliation: Department of Clinical Laboratory, Xin Hua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200092, China.
authors.forename: Bingxian
authors.initials: B
authors.lastname: Bian
authors.affiliation: Department of Clinical Laboratory, Xin Hua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200092, China.
authors.forename: Xiangliang
authors.initials: X
authors.lastname: Yuan
authors.affiliation: Department of Clinical Laboratory, Xin Hua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200092, China.
authors.forename: Guohua
authors.initials: G
authors.lastname: Xie
authors.affiliation: Department of Clinical Laboratory, Xin Hua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200092, China.
authors.forename: Yanhui
authors.initials: Y
authors.lastname: Ma
authors.affiliation: Department of Clinical Laboratory, Xin Hua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200092, China.
authors.forename: Lisong
authors.initials: L
authors.lastname: Shen
mesh_terms: D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D009360:Neoplastic Cells, Circulating / Q000473:pathology*; D010051:Ovarian Neoplasms / Q000097:blood* / Q000473:pathology*; D011379:Prognosis; D016016:Proportional Hazards Models