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手术重新分期对交界性卵巢肿瘤患者复发的影响:一项荟萃分析。

Impact of surgical restaging on recurrence in patients with borderline ovarian tumors: A meta-analysis.

机构信息

Department of Gynecology, Poissy-St Germain hospital, Poissy, France.

Department of Surgical Oncology, Institut Curie, St Cloud, France.

出版信息

Eur J Obstet Gynecol Reprod Biol. 2020 May;248:227-232. doi: 10.1016/j.ejogrb.2020.03.023. Epub 2020 Mar 19.

Abstract

OBJECTIVE

The benefits of restaging surgery for patients with a borderline ovarian tumor (BOT) discovered on initial surgery are debatable. We performed a meta-analysis to evaluate the role of restaging surgery on recurrence in patients with BOTs.

STUDY DESIGN

We systematically reviewed published studies comparing restaging surgery and incomplete surgery in BOT patients from January 1985 to December 2017. Endpoints were recurrence and mortality rates. Study design features that possibly affected participant selection, reporting of recurrence and death, and manuscript publication were assessed. For pooled estimates of the effect of restaging surgery on recurrence, fixed-effect meta-analytical models were used.

RESULTS

Of the 577 articles initially selected, four retrospective observational studies (Restaging group: 166 patients; Non-Restaging group: 394 patients) met our research criteria. No significant differences in terms of recurrence between the two groups were observed (pooled Peto Odds Ratio [OR] = 0.88; 95 % confidence interval [CI]: 0.41-1.92). The number of deaths was insufficient for statistical analysis.

CONCLUSIONS

This meta-analysis based on retrospective studies, suggests that restaging surgery does not significantly reduce recurrence in patients with BOT.

摘要

目的

对于在初次手术时发现的交界性卵巢肿瘤(BOT)患者,再次手术的获益存在争议。我们进行了一项荟萃分析,以评估再次手术对 BOT 患者复发的作用。

研究设计

我们系统地回顾了 1985 年 1 月至 2017 年 12 月期间比较再次手术与不完全手术治疗 BOT 患者的已发表研究。终点是复发率和死亡率。评估了可能影响患者选择、复发和死亡报告以及论文发表的研究设计特征。对于再次手术对复发影响的效应的汇总估计,使用固定效应荟萃分析模型。

结果

最初选择的 577 篇文章中,有 4 项回顾性观察研究(再次手术组:166 例患者;非再次手术组:394 例患者)符合我们的研究标准。两组之间在复发方面无显著差异(汇总 Peto 优势比[OR] = 0.88;95%置信区间[CI]:0.41-1.92)。死亡人数不足以为统计分析提供依据。

结论

基于回顾性研究的这项荟萃分析表明,再次手术并不能显著降低 BOT 患者的复发率。

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