Myhr Andrea Svennevik, Bjørge Line, Torkildsen Cecilie Fredvik
Faculty of Medicine, University of Bergen, 5009 Bergen, Norway.
Centre for Cancer Biomarkers, Department of Clinical Science, University of Bergen, 5009 Bergen, Norway.
Cancers (Basel). 2024 Jul 22;16(14):2613. doi: 10.3390/cancers16142613.
Secondary cytoreductive surgery is a treatment option for relapsed platinum-sensitive epithelial ovarian cancer, but no clear indications are defined for the procedure. This systematic review aims to establish clear indications and compare outcomes versus standard-of-care chemotherapy. We conducted an electronic literature search across three databases and identified 2033 articles, including three phase 3 randomized controlled trials (RCT). The review adhered to PRISMA 2020 guidelines and was registered in PROSPERO (no. CRD42022379817). Despite varying patient selection methods, surgery plus chemotherapy demonstrated significantly prolonged progression-free survival compared to chemotherapy alone. However, overall survival outcomes were inconsistent: while GOG-0213 did not show extended overall survival, recent studies with stricter defined criteria for surgery (SOC-1 and DESKTOP-III) reported improved overall survival with the addition of surgery. Morbidity and mortality rates were low, with no difference in quality of life between the surgery and no-surgery groups. In conclusion, cytoreductive surgery presents a promising option for recurrent epithelial ovarian cancer treatment. Nonetheless, well-defined selection criteria appear crucial for achieving increased overall survival compared to conventional treatment.
二次肿瘤细胞减灭术是复发性铂敏感上皮性卵巢癌的一种治疗选择，但该手术尚无明确的适应证。本系统评价旨在明确其适应证，并比较与标准治疗化疗相比的疗效。我们在三个数据库中进行了电子文献检索，共识别出2033篇文章，其中包括三项3期随机对照试验（RCT）。本评价遵循PRISMA 2020指南，并在PROSPERO（编号CRD42022379817）注册。尽管患者选择方法各异，但与单纯化疗相比，手术加化疗的无进展生存期显著延长。然而，总生存结果并不一致：GOG-0213研究未显示总生存期延长，而近期对手术标准定义更严格的研究（SOC-1和DESKTOP-III）报告称，加用手术可改善总生存期。手术的发病率和死亡率较低，手术组与非手术组的生活质量无差异。总之，肿瘤细胞减灭术是复发性上皮性卵巢癌治疗的一个有前景的选择。尽管如此，明确的选择标准对于实现比传统治疗更高的总生存期似乎至关重要。
