Prognostic Significance of Survivin Expression in Patients with Ovarian Carcinoma: A Meta-Analysis.

ABSTRACT

BACKGROUND: Survivin belongs to the protein family of inhibitors of apoptosis (IAP) and is a regulator of the cell cycle and apoptosis. The aim of this study was to assess the clinical and prognostic significance of expression survivin in patients with ovarian cancer. METHODS: We systematically searched for articles in PubMed, the American Chemical Society (Publications), Medline, the Royal Society of Chemistry, Scopus and the Web of Science. Patient clinical data, overall survival (OS), disease-free survival (DFS), and survivin expression were extracted from individual studies. We performed statistical analysis using the STATA 16 package. Eighteen publications containing data from 2233 patients with ovarian cancer were included in this meta-analysis. RESULTS: We found an adverse effect of survivin expression on OS (risk ratio (HR) 1.60; 95% confidence interval (CI) 1.33-1.93, p = 0.00) but this was not observed on DFS (HR 1.06; 95% CI 0.55-2.05, p = 0.87). The analysis of clinicopathological parameters showed that survivin expression was associated with the histological grades (G1-2 vs. G3) (odds ratio (OR) = 0.53, 95% CI 0.34-0.83, p = 0.01) and International Federation Gynecology and Obstetrics (FIGO) stage (I-II vs. III-IV) (OR = 0.22, 95% CI 0.09-0.55, p = 0.00), but it was not significantly correlated with the histological subtype (OR = 1.14, 95% CI 0.83-1.58, p = 0.42). CONCLUSIONS: Our meta-analysis suggests that survivin expression may be a marker of poor prognosis in ovarian cancer. Survivin expression was associated with parameters of greater aggressiveness of ovarian cancer. Prospective studies are needed to confirm our results indicating that survivin expression can be used as an ovarian cancer biomarker.