ABSTRACT
BACKGROUND: The endometrial carcinoma (EC) is the most frequently occurring female genital cancer. The authors performed this network meta-analysis to compare operative time and the incidence of bowel injury and wound infection of 3 operative approaches (laparoscopy, laparotomy, and laparoscopic-assisted vaginal hysterectomy [LAVH]) in the treatment of EC. METHODS: The Cochrane Library, PubMed, and Embase databases were searched. Randomized controlled trials (RCTs) for EC from the day of databases establishment to February 2017 were included. Direct and indirect evidences were combined to calculate the combined weighted mean difference (WMD) or odd ratio values and the surface under the cumulative ranking curve (SUCRA) value of 3 operative approaches in the treatment of EC. RESULTS: A total of 9 qualified RCTs were included into the study. The results showed that laparotomy had a shorter-operative time than LAVH (WMDâ=â-40.36, 95% confidence intervalâ=â-75.03 to -2.57). However, there was no significant difference in the incidence of bowel injury and wound infection among 3 operative approaches. Besides, the SUCRA values indicated that laparotomy had the shortest operative time but the incidence of bowel injury and wound infection was relatively higher. CONCLUSION: The results from this study indicate that laparotomy had highest incidence of bowel injury and wound infection but shortest operative time among 3 operative approaches in the treatment of EC.
Subject(s)
Endometrial Neoplasms/surgery , Hysterectomy/methods , Hysteroscopy/methods , Female , Humans , Hysterectomy, Vaginal/methods , Intestines/injuries , Operative Time , Postoperative Complications , Randomized Controlled Trials as Topic , Surgical Wound Infection/epidemiologyABSTRACT
BACKGROUND: Ovarian cancer (OC) is the 5th leading cause of cancer-related deaths around the world, and several chemotherapy regimens have been applied in the treatment of OC. We aim to compare toxicities of different chemotherapy regimens in the treatment of advanced ovarian cancer (AOC) using network meta-analysis. METHODS: Literature research in Cochrane Library, PubMed, and EMBASE was performed up to November 2015. Eligible randomized controlled trials (RCTs) of different chemotherapy regimens were included. Network meta-analysis combined direct and indirect evidence to assess pooled odds ratios (ORs) and draw the surface under the cumulative ranking (SUCRA) curves. RESULTS: Thirteen eligible RCTs were included in this network meta-analysis, including 8 chemotherapy regimens (paclitaxelâ+âcarboplatin [PC], pegylated liposomal doxorubicin [PLD]â+âcarboplatin, carboplatin, gemcitabineâ+âcarboplatin, paclitaxel, PCâ+âepirubicin, PCâ+âtopotecan, docetaxelâ+âcarboplatin). Gemcitabineâ+âcarboplatin regimen exerted higher incidence of anemia when compared with carboplatin and paclitaxel regimens. The incidence of febrile neutropenia of gemcitabineâ+âcarboplatin regimen was higher than that of PC, PLDâ+âcarboplatin, carboplatin, and PCâ+âtopotecan regimens. Topotecan PCâ+âepirubicin regimen had a higher toxicity, comparing with PC, PLDâ+âcarboplatin, and PCâ+âtopotecan regimens. As for thrombocytopenia, gemcitabineâ+âcarboplatin chemotherapy regimen produced an obviously higher toxicity than PC and carboplatin. As for nausea, PLDâ+âcarboplatin chemotherapy regimen had a significantly higher toxicity than that of carboplatin chemotherapy regimen. Moreover, when compared with PC and carboplatin chemotherapy regimens, the toxicity of PCâ+âepirubicin was greatly higher to patients with AOC. CONCLUSION: The nonhematologic toxicity of PLDâ+âcarboplatin regimen was higher than other regimens, which was clinically significant for the treatment of AOC.
