Climent Maria Teresa, Serra Anna, Llueca Maria, Llueca Antoni
Multidisciplinary Unit of Abdominopelvic Oncology Surgery (MUAPOS), Department of Obstetrics and Gynaecology, University General Hospital of Castellon, 12004 Castellon, Spain.
Oncological Surgery Research Group (OSRG), Department of Medicine, University Jaume I (UJI), 12004 Castellon, Spain.
Cancers (Basel). 2023 Jul 2;15(13):3470. doi: 10.3390/cancers15133470.
: The second cytoreductive surgery performed for a patient who has recurrent ovarian cancer remains controversial. Our study analyzes overall survival (OS) and disease-free survival (DFS) for cytoreductive surgery in addition to chemotherapy in recurrent ovarian cancer instead of chemotherapy alone. : A meta-analysis was conducted using PubMed and the Cochrane database of systematic reviews to select randomized controlled studies. In total, three randomized studies were used, employing a total of 1249 patients. : The results of our meta-analysis of these randomized controlled trials identified significant differences in OS (HR = 0.83, IC 95% 0.70-0.99, < 0.04) and DFS (HR = 0.63, IC 95% 0.55-0.72, < 0.000001). A subgroup analysis comparing complete cytoreductive surgery and surgery with residual tumor achieved better results for both OS (HR = 0.65, IC 95% 0.49-0.86, = 0.002) and DFS (HR = 0.67, IC 95% 0.53-0.82, = 0.0008), with statistical significance. : A complete secondary cytoreductive surgery (SCS) in recurrent ovarian cancer (ROC) demonstrates an improvement in the OS and DFS, and this benefit is most evident in cases where complete cytoreductive surgery is achieved. The challenge is the correct patient selection for secondary cytoreductive surgery to improve the results of this approach.
对于复发性卵巢癌患者进行的第二次减瘤手术仍存在争议。我们的研究分析了复发性卵巢癌患者在化疗基础上加做减瘤手术而非单纯化疗后的总生存期(OS)和无病生存期(DFS)。:使用PubMed和Cochrane系统评价数据库进行荟萃分析,以选择随机对照研究。总共使用了三项随机研究,涉及1249名患者。:我们对这些随机对照试验的荟萃分析结果显示,OS(HR = 0.83,95%置信区间0.70 - 0.99,P < 0.04)和DFS(HR = 0.63,95%置信区间0.55 - 0.72,P < 0.000001)存在显著差异。一项比较完全减瘤手术和有残留肿瘤手术的亚组分析显示,OS(HR = 0.65,95%置信区间0.49 - 0.86,P = 0.002)和DFS(HR = 0.67,95%置信区间0.53 - 0.82,P = 0.0008)均取得了更好的结果,具有统计学意义。:复发性卵巢癌(ROC)中进行完全的二次减瘤手术(SCS)可改善OS和DFS,且这种益处在实现完全减瘤手术的病例中最为明显。挑战在于正确选择适合二次减瘤手术的患者,以提高这种治疗方法的效果。