Survival rate, recurrence rate, and complications of routine appendectomy for patients with borderline and malignant mucinous ovarian tumor: A systematic review and meta-analysis / Philippine Journal of Obstetrics and Gynecology

ABSTRACT

Objective@#The objective of the study is to determine the survival rate, recurrence rate, and complication rate among patients diagnosed with borderline and malignant mucinous ovarian tumor (MOT) who underwent complete surgical staging with appendectomy.@*Methodology@#Eligibility criteria – A search of published literature was conducted in the electronic databases of MEDLINE (PubMed), Cochrane, and Google Scholar through 2000–2022, using a search strategy based on the PIO framework. Information of sources – The citations were identified with the use of a combination of the following text words “mucinous ovarian tumors,” “MOT,” “appendectomy,” and “pseudomyxoma peritonei.” All retrospective studies with histopathologic diagnosis of borderline or malignant MOTs with patients who underwent appendectomy during primary surgery, including encompassing data on survival rate, recurrence rate, and/or incidence of complications (postoperative infections, appendectomy site leakage, hemorrhage, abscess, peritonitis, bowel perforation, and intestinal obstruction) that matched the terms set by the researchers were retrieved. Risk of bias – For the methodological quality of the individual clinical trials, the Jadad scale was used, which is based on the three following subscales randomization (2, 1, or 0), blinding (2, 1, or 0), and dropouts/withdrawals (1 or 0). Guidelines for Cochrane collaboration were used to assess the risk bias. Synthesis of results – Review Manager version 5.3 (RevMan 5.4.1) was used by the researcher to perform the systematic review and meta-analysis of included studies.@*Results@#There were eight retrospective studies included in this study. The random interval for survival rate is 64.9%–99.7% with a P < 0.1. The prediction interval for recurrence rate is 0%–100% with 95% confidence interval. The odds of complications occurring are <0.69–2.99 times with 95% confidence interval, with mean effect size is 0.083, and with a 95% confidence interval is 0.027–0.23.@*Conclusion@#The mean prevalence of abnormal histology of the appendix in patients diagnosed with borderline and malignant MOTs and underwent appendectomy during primary surgery is 3%–13%. There is no statistically significant difference in survival rate of patients who were diagnosed with borderline and malignant MOTs with or without appendectomy during primary surgery. The prediction interval for recurrence rate is 0%–100% with 95% confidence interval. There is no significant difference between the rate of complications in patients who underwent appendectomy and those without.