Efficacy and safety of neoadjuvant chemotherapy versus primary debulking surgery in patients with ovarian cancer: a meta-analysis / 부인종양
Journal of Gynecologic Oncology
;
: e12-2020.
Article
in English
| WPRIM
| ID: wpr-834477
ABSTRACT
OBJECTIVE@#Neoadjuvant chemotherapy (NACT) for the treatment of epithelial ovarian cancer (EOC) has remained controversial. This meta-analysis was performed to systematically assess the efficacy and safety of NACT versus primary debulking surgery (PDS) in patients with EOC.@*METHODS@#PubMed, Embase, ClinicalTrials.gov, and Cochrane Library were queried to assess the therapeutic value of NACT versus PDS in EOC. Electronic databases were queried by using the keywords “ovarian cancereoplasmsâ€, “primary debulking surgeryâ€, and “neoadjuvant chemotherapyâ€.@*RESULTS@#The available trials were pooled, and hazard ratios (HRs), relative risk ratios (RRs) and associated 95% confidence intervals (95% CIs) were determined. Sixteen trials involving 57,450 participants with EOC (NACT, 9,475; PDS, 47,975) were evaluated. We found that NACT resulted in markedly decreased overall survival than PDS in patients with EOC (HR=1.30; 95% CI=1.13–1.49; heterogeneity p<0.001, ²=82.7%). Furthermore, our results demonstrated that the NACT group displayed increased completeness of debulking removal (RR=1.69, 95% CI=1.32–2.17; heterogeneity p<0.001, ²=81.9%), and reduced risk of postsurgical death (RR=0.18, 95% CI=0.06–0.51; heterogeneity p=0.698, ²=0%) and major infection (RR=0.29, 95% CI=0.17–0.51; heterogeneity p=0.777, ²=0%) compared with patients administered PDS.@*CONCLUSIONS@#This meta-analysis indicated that NACT results in increased completeness of debulking removal, and reduced risk of postsurgical death and major infection compared with PDS, while PDS is associated with improved survival in comparison with NACT in EOC patients.TRIAL REGISTRATION PROSPERO Identifier CRD42019120625
Full text:
Available
Index:
WPRIM (Western Pacific)
Type of study:
Etiology study
/
Systematic reviews
Language:
English
Journal:
Journal of Gynecologic Oncology
Year:
2020
Type:
Article
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