Carlo Ronsini, Francesca Pasanisi, Giada Andreoli, Pasquale De Franciscis, Luigi Cobellis, Giuseppe Vizzielli, Stefano Restaino, Paola Romeo, Vittorio Palmara, Stefano Cianci
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引用次数: 0
Abstract
Background: Epithelial Ovarian Cancer is one of the most lethal cancers among gynecologic malignancies. The disease metastasizes mainly through the peritoneal spread in the abdomen and through the lymphatic system. Lymph node involvement is present in 48% up to 75% of cases of advanced-stage ovarian cancer (ASOC). In this context, the aim of our study is to analyze the current literature on the topic and to investigate survival outcomes in patients affected by advanced-stage ovarian cancer undergoing lymphadenectomy.
Methods: Following the recommendations in the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement, we systematically searched the Pubmed and Scopus databases in June 2022 since the first publication. We made no limitations on the country. We included the studies containing disease-free survival (DFS) and Overall Survival (OS) data. Only comparative studies with a direct comparison between Lymphadenectomy and its avoidance were included for meta-analysis.
Results: 18 studies fulfilled the inclusion criteria. The overall OS, DFS, and RR were comparable in the studies. 26965 patients were enrolled in the meta-analysis. Patients were analyzed concerning OS and DFS. Meta-analysis highlighted statistically significant higher OS than the lymphadenectomy group (RR 1.31 [95% CI 1.16-1.48] p < .00001), and no statistically different DFS RR 1.23 [95% CI 0.82-1.92] p = 0.25).
Conclusion: Our analysis showed a protective role of lymphadenectomy in advanced ovarian cancer, with a reduction in death risk.Systematic Review Registration: www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022341646, Identifier CRD42022341646.
背景:上皮性卵巢癌是妇科恶性肿瘤中最致命的肿瘤之一。这种疾病主要通过腹膜扩散到腹部和通过淋巴系统转移。48%至75%的晚期卵巢癌(ASOC)病例存在淋巴结受累。在此背景下,我们研究的目的是分析当前关于该主题的文献,并调查晚期卵巢癌行淋巴结切除术患者的生存结果。方法:按照PRISMA (Preferred Reporting Items for Systematic Reviews and meta - analysis)声明中的建议,自论文首次发表以来,于2022年6月系统检索Pubmed和Scopus数据库。我们没有对这个国家设限。我们纳入了包含无病生存期(DFS)和总生存期(OS)数据的研究。荟萃分析只纳入了直接比较淋巴结切除术和避免淋巴结切除术的比较研究。结果:18项研究符合纳入标准。两组研究的总OS、DFS和RR具有可比性。26965名患者纳入meta分析。分析患者的OS和DFS。荟萃分析显示,与淋巴结切除术组相比,OS有统计学意义(RR 1.31 [95% CI 1.16-1.48] p p = 0.25)。结论:我们的分析显示淋巴结切除术对晚期卵巢癌具有保护作用,可降低死亡风险。系统评价注册:www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022341646,标识符CRD42022341646。
期刊介绍:
Evidence of surgical interventions go back to prehistoric times. Since then, the field of surgery has developed into a complex array of specialties and procedures, particularly with the advent of microsurgery, lasers and minimally invasive techniques. The advanced skills now required from surgeons has led to ever increasing specialization, though these still share important fundamental principles.
Frontiers in Surgery is the umbrella journal representing the publication interests of all surgical specialties. It is divided into several “Specialty Sections” listed below. All these sections have their own Specialty Chief Editor, Editorial Board and homepage, but all articles carry the citation Frontiers in Surgery.
Frontiers in Surgery calls upon medical professionals and scientists from all surgical specialties to publish their experimental and clinical studies in this journal. By assembling all surgical specialties, which nonetheless retain their independence, under the common umbrella of Frontiers in Surgery, a powerful publication venue is created. Since there is often overlap and common ground between the different surgical specialties, assembly of all surgical disciplines into a single journal will foster a collaborative dialogue amongst the surgical community. This means that publications, which are also of interest to other surgical specialties, will reach a wider audience and have greater impact.
The aim of this multidisciplinary journal is to create a discussion and knowledge platform of advances and research findings in surgical practice today to continuously improve clinical management of patients and foster innovation in this field.