原发性晚期和复发性子宫内膜癌盆腔切除术的生存期和围手术期结果：一项系统回顾和荟萃分析

IF 2.9 2区医学 Q2 ONCOLOGY

Ejso Pub Date : 2025-09-11 DOI:10.1016/j.ejso.2025.110436

Antonio Raffone , Giulia Pellecchia , Sara Pregnolato , Diego Raimondo , Antonio Travaglino , Daniele Neola , Lorenza Driul , Francesco Fanfani , Martina Arcieri , Maria Giovanna Vastarella , Stefano Restaino , Luigi Cobellis , Renato Seracchioli , Giuseppe Vizzielli

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引用次数: 0

摘要

目的评价复发晚期子宫内膜癌（EC）患者盆腔切除术（PE）的生存率、围手术期并发症及死亡率。方法对7个电子数据库进行系统回顾和荟萃分析，检索从建立到2024年5月所有同行评审的研究，这些研究报告的研究结果至少为复发和/或晚期EC患者PE的5年总生存期（OS）。我们的主要结果是PE的5年生存率，以及所有关于PE生存的可提取结果[总生存率，5年和总疾病特异性生存率（DSS）， 5年和总无进展生存率（PFS）]和围手术期死亡率和并发症。生存率、围手术期死亡率和并发症以个体和汇总估计计算，置信区间（CI）为95%。根据复发性或晚期EC分别计划对所有研究结果进行亚组分析。结果纳入6项研究，共166例患者。在晚期或复发性EC接受PE的女性中，5年生存率为41.7% (95% CI: 25.6 - 57.8%)；5年dss为30.4% (95% CI: 14.9 - 45.8%)；总体DSS为26.6% (95% CI: 10.6 - 42.5%)；5年pfs患者占51.8% (95% CI: 25.6 - 78.0%)；围手术期死亡率为9.7% (95% CI: 5.7 - 16.1%)；56.1% （95% CI: 32.3 ~ 76.4%）出现围手术期并发症。亚组分析只适用于“复发性EC”亚组，结果甚至更糟。结论在晚期或复发性EC患者中，PE生存率不高，围手术期死亡率和并发症发生率相对较高。这些结果在复发性EC亚组中进一步恶化。然而，它们应该得到更多最新研究的证实。

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Survival and perioperative outcomes of pelvic exenteration in primary advanced and recurrent endometrial carcinoma: A systematic review and meta-analysis

Objective

To assess survival and perioperative complications and mortality of pelvic exenteration (PE) in recurrent and advanced endometrial carcinoma (EC) patients.

Methods

A systematic review and a meta-analysis was performed searching 7 electronic databases from their inception to May 2024 for all peer-reviewed studies that reported as a study outcome at least the 5 years-overall survival (OS) of PE in recurrent and/or advanced EC patients.

Our outcomes were 5 year-OS from PE as primary outcome, and all extractable outcomes about PE survival [overall OS, 5 year- and overall disease specific survival (DSS), 5 year- and overall progression free survival (PFS)] and perioperative mortality and complications.

Rates of survival outcomes and perioperative mortality and complications were calculated as individual and pooled estimates, with 95 % confidence intervals (CI).

Subgroup analyses were planned for all study outcomes based on recurrent or advanced EC, separately.

Results

6 studies with 166 patients were included. In women underwent PE for advanced or recurrent EC, pooled rate was: 41.7 % (95 % CI: 25.6–57.8 %) for 5 year-OS; 30.4 % (95 % CI: 14.9–45.8 %) for 5 year-DSS; 26.6 % (95 % CI: 10.6–42.5 %) for overall DSS; 51.8 % (95 % CI: 25.6–78.0 %) for 5 year-PFS; 9.7 % (95 % CI: 5.7–16.1 %) for perioperative mortality; 56.1 % (95 % CI: 32.3–76.4 %) for perioperative complications. Subgroup analyses were suitable exclusively in the “recurrent EC” subgroup and showed even worsened outcomes.

Conclusions

In women with advanced or recurrent EC, PE shows not encouraging survival outcomes, with relatively high rates of perioperative mortality and complications. These outcomes further worsened in the subgroup of only recurrent EC. However, they should be confirmed by more updated studies.

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来源期刊

Ejso 医学-外科

CiteScore

6.40

自引率

2.60%

发文量

1148

审稿时长

41 days

期刊介绍： JSO - European Journal of Surgical Oncology ("the Journal of Cancer Surgery") is the Official Journal of the European Society of Surgical Oncology and BASO ~ the Association for Cancer Surgery. The EJSO aims to advance surgical oncology research and practice through the publication of original research articles, review articles, editorials, debates and correspondence.