Lymphadenectomy for primary ovarian cancer: a systematic review and meta-analysis.
Lymph Node Excision
Meta-Analysis
Ovarian Neoplasms
Systematic Review
Journal
Journal of gynecologic oncology
ISSN: 2005-0399
Titre abrégé: J Gynecol Oncol
Pays: Korea (South)
ID NLM: 101483150
Informations de publication
Date de publication:
Sep 2020
Sep 2020
Historique:
received:
11
11
2019
revised:
18
04
2020
accepted:
26
04
2020
entrez:
19
8
2020
pubmed:
19
8
2020
medline:
2
9
2021
Statut:
ppublish
Résumé
To assess the effectiveness of lymphadenectomy at primary debulking surgery (PDS) on the survival of patients with epithelial ovarian cancer (EOC). 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. 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). 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.
Identifiants
pubmed: 32808497
pii: 31.e67
doi: 10.3802/jgo.2020.31.e67
pmc: PMC7440977
doi:
Types de publication
Journal Article
Meta-Analysis
Systematic Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
e67Informations de copyright
Copyright © 2020. Asian Society of Gynecologic Oncology, Korean Society of Gynecologic Oncology.
Déclaration de conflit d'intérêts
No potential conflict of interest relevant to this article was reported.
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