Secondary cytoreductive surgery in platinum-sensitive relapsed ovarian cancer: a meta-analysis of randomized controlled trials.

IF 2.1 3区医学 Q2 OBSTETRICS & GYNECOLOGY

Archives of Gynecology and Obstetrics Pub Date : 2024-12-16 DOI:10.1007/s00404-024-07863-x

Qingqing Lin, Wenchao Liu, Yanglong Guo, Xinyu Wang

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引用次数: 0

Abstract

Purpose: To evaluate the role of secondary cytoreduction in patients with platinum-sensitive recurrent ovarian cancer.

Methods: The PubMed, Medline, Embase, Cochrane Library and Web of Science databases were searched. Randomized controlled trials (RCTs) that compare secondary cytoreduction plus chemotherapy with chemotherapy alone in patients with platinum-sensitive relapsed ovarian cancer were selected. Pooled hazard ratios (HR) with 95% confidence intervals (CIs) were calculated.

Results: There was no difference in overall survival (OS) between the surgery group and no surgery group (HR = 0.89; 95% CI 0.77, 1.04; p = 0.14), but secondary cytoreduction showed a significant improvement in progression-free survival (PFS) (HR = 0.67; 95% CI 0.54, 0.76; p < 0.00001). A subgroup analysis comparing the complete gross resection subpopulation with the no surgery group achieved a significant longer OS (HR = 0.70, 95% CI 0.58-0.85; p = 0.0003) and a greater PFS benefit (HR = 0.56, 95% CI 0.48-0.66; p < 0.00001). In addition, as compared with incomplete resection, the OS benefit of complete gross resection was more evident (HR = 0.51, 95% CI 0.37-0.69; p < 0.0001).

Conclusions: In women with platinum-sensitive recurrent ovarian cancer, although secondary cytoreduction followed by chemotherapy resulted in longer PFS than chemotherapy alone, it did not lead to significant benefit in OS. However, when complete gross resection was achieved, it significantly prolonged OS and provided a greater PFS benefit.

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目的：评估二次细胞减灭术在铂敏感复发性卵巢癌患者中的作用：方法：检索 PubMed、Medline、Embase、Cochrane Library 和 Web of Science 数据库。选择了对铂敏感复发性卵巢癌患者进行二次细胞减灭术加化疗与单纯化疗比较的随机对照试验（RCT）。计算了汇总的危险比（HR）及95%置信区间（CI）：结果：手术组与不手术组的总生存期（OS）无差异（HR = 0.89; 95% CI 0.77, 1.04; p = 0.14），但二次细胞减灭术显著改善了无进展生存期（PFS）（HR = 0.67; 95% CI 0.54, 0.76; p 结论：手术组与不手术组的总生存期无差异（HR = 0.89; 95% CI 0.77, 1.04; p = 0.14），但二次细胞减灭术显著改善了无进展生存期（PFS）：对于铂敏感复发性卵巢癌患者，虽然二次细胞减灭术后化疗的无进展生存期比单纯化疗更长，但并不能明显改善OS。然而，如果实现了完全的大体切除，则可显著延长患者的生存期，并为患者带来更多的 PFS 益处。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Archives of Gynecology and Obstetrics 医学-妇产科学

CiteScore

4.70

自引率

15.40%

发文量

493

审稿时长

1 months

期刊介绍： Founded in 1870 as "Archiv für Gynaekologie", Archives of Gynecology and Obstetrics has a long and outstanding tradition. Since 1922 the journal has been the Organ of the Deutsche Gesellschaft für Gynäkologie und Geburtshilfe. "The Archives of Gynecology and Obstetrics" is circulated in over 40 countries world wide and is indexed in "PubMed/Medline" and "Science Citation Index Expanded/Journal Citation Report". The journal publishes invited and submitted reviews; peer-reviewed original articles about clinical topics and basic research as well as news and views and guidelines and position statements from all sub-specialties in gynecology and obstetrics.