1st Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, Alexandra Hospital, National and Kapodistrian University of Athens, 10679 Athens, Greece.
Department of Clinical Therapeutics, Division of Oncology, Alexandra Hospital, National and Kapodistrian University of Athens, 10679 Athens, Greece.
Curr Oncol. 2022 Aug 15;29(8):5763-5773. doi: 10.3390/curroncol29080454.
The purpose of the present systematic review is to clarify whether adjuvant chemotherapy improves survival rates in women with stage IC1 ovarian cancer. We searched Medline, Scopus, Clinicaltrials.gov, EMBASE, Cochrane Central Register of Controlled Trials CENTRAL and Google Scholar. We considered comparative observational studies and randomized trials that investigated survival outcomes (progression-free (PFS) and overall survival (OS)) among women with intraoperative rupture of early-stage epithelial ovarian cancer who received adjuvant chemotherapy and those that did not. Eleven studies, which recruited 7556 patients, were included. The risk of bias was defined as moderate after assessment with the Risk of Bias in non-Randomized Trials tool. Meta-analysis was performed with RStudio. Seven studies investigated the impact of adjuvant chemotherapy on recurrence-free survival of patients experiencing intraoperative cyst rupture for otherwise stage I ovarian cancer. The outcome was not affected by the use of adjuvant chemotherapy as the effect estimate was not significant (HR 1.24, 95% CI 0.74, 2.04). The analysis of data from 5 studies similarly revealed that overall survival rates were comparable among the two groups (HR 0.75, 95% CI 0.54, 1.05). This meta-analysis did not detect any benefit from adjuvant chemotherapy for stage IC ovarian cancer patients with cyst rupture. However, conclusions from this investigation are limited by a study population which included multiple histologic subtypes, high and low grade tumors and incompletely staged patients.
本系统评价的目的是阐明辅助化疗是否能提高 IC1 期卵巢癌女性的生存率。我们检索了 Medline、Scopus、Clinicaltrials.gov、EMBASE、Cochrane 中央对照试验注册中心 CENTRAL 和 Google Scholar。我们考虑了比较观察性研究和随机试验，这些研究调查了接受辅助化疗和未接受辅助化疗的早期上皮性卵巢癌术中破裂的女性的生存结局（无进展生存期 (PFS) 和总生存期 (OS)）。纳入了 11 项研究，共招募了 7556 名患者。使用非随机试验风险偏倚评估工具评估风险偏倚为中度。使用 RStudio 进行荟萃分析。有 7 项研究调查了辅助化疗对术中囊破裂的 I 期卵巢癌患者无复发生存的影响。由于效果估计不显著（HR 1.24，95%CI 0.74，2.04），因此辅助化疗的使用并未影响结果。对 5 项研究的数据进行分析同样表明，两组的总生存率相当（HR 0.75，95%CI 0.54，1.05）。这项荟萃分析没有发现辅助化疗对囊破裂的 IC 期卵巢癌患者有任何益处。然而，由于研究人群包括多种组织学亚型、高低级别肿瘤和分期不完整的患者，因此该研究的结论受到限制。
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