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Lymphadenectomy for primary ovarian cancer: a systematic review and meta-analysis / 부인종양
Journal of Gynecologic Oncology ; : e67-2020.
Artículo en Inglés | WPRIM | ID: wpr-899376
ABSTRACT
Objective@#To assess the effectiveness of lymphadenectomy at primary debulking surgery (PDS) on the survival of patients with epithelial ovarian cancer (EOC). @*Methods@#We searched PubMed, Ichushi, and the Cochrane Library. Randomized controlled trials (RCTs) and retrospective cohort studies comparing survival of women with EOC undergoing lymphadenectomy at PDS with that of women without lymphadenectomy were included. We performed a meta-analysis of overall survival (OS), progression-free survival (PFS), and adverse events. @*Results@#For advanced-stage EOC, 2 RCTs including 1,074 women and 7 cohort studies comprising 3,161 women were evaluated. Meta-analysis revealed that lymphadenectomy was associated with improved OS (hazard ratio [HR]=0.80; 95% confidence interval [CI]=0.70– 0.90). However, meta-analysis of 2 RCTs revealed no significant difference in OS between the lymphadenectomy and no-lymphadenectomy groups (OS HR=1.02; 95% CI=0.85–1.22).For early-stage EOC, 1 RCT comprising 268 women and 4 cohort studies comprising 14,228 women were evaluated. Meta-analysis showed that lymphadenectomy was associated with improved OS (HR=0.75; 95% CI=0.68–0.82). A RCT of early-stage EOC reported that lymphadenectomy was not associated with improved OS (HR=0.85; 95% CI=0.49–1.47).Surgery-related deaths were similar in both groups (risk ratio [RR]=1.00; 95% CI=0.99–1.01);however, blood transfusion was required less frequently in the no-lymphadenectomy group (RR=0.74; 95% CI=0.63–0.86). @*Conclusions@#Meta-analysis of RCTs and observational studies suggest that lymphadenectomy was associated with improved OS in advanced- and early-stage EOC.However, results from RCTs demonstrate that lymphadenectomy was not associated with improved OS in advanced- and early-stage EOC.
Texto completo: Disponible Índice: WPRIM (Pacífico Occidental) Tipo de estudio: Ensayo Clínico Controlado / Estudio observacional / Revisiones Sistemáticas Evaluadas Idioma: Inglés Revista: Journal of Gynecologic Oncology Año: 2020 Tipo del documento: Artículo

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Texto completo: Disponible Índice: WPRIM (Pacífico Occidental) Tipo de estudio: Ensayo Clínico Controlado / Estudio observacional / Revisiones Sistemáticas Evaluadas Idioma: Inglés Revista: Journal of Gynecologic Oncology Año: 2020 Tipo del documento: Artículo