The attributive value of comprehensive surgical staging in clinically early-stage epithelial ovarian carcinoma: A systematic review and meta-analysis
| Autor: | Ronald P. Zweemer, Petronella O. Witteveen, Renée E.W.M. van de Vorst, Maaike A. van der Aa, J P Hoogendam, Cornelis G. Gerestein |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
0301 basic medicine
medicine.medical_specialty Carcinoma Ovarian Epithelial Gastroenterology Metastasis 03 medical and health sciences 0302 clinical medicine Internal medicine Cytology medicine Humans Stage (cooking) Lymph node Neoplasm Staging Ovarian Neoplasms business.industry Obstetrics and Gynecology medicine.disease Appendix Serous fluid 030104 developmental biology medicine.anatomical_structure Oncology 030220 oncology & carcinogenesis Meta-analysis Lymphatic Metastasis Female Ovarian cancer business |
| Zdroj: | Gynecologic oncology. 161(3) |
| ISSN: | 1095-6859 |
| Popis: | Background Tumor positivity and upstaging rates from various surgical staging steps performed in clinically early-stage epithelial ovarian carcinoma (EOC) vary widely in literature. Aim To quantify tumor positivity and upstaging rates for all staging surgery steps in EOC patients. Differences between subgroups based on their clinical and histological characteristics are explored. Methods A systematic search using synonyms of ‘ovarian cancer’, ‘neoplasm staging’, and ‘neoplasm metastasis' was conducted in PubMed, Embase, and the Cochrane Library. Meta-analysis was performed on 23 included studies, comprising 5194 clinical stage I or II EOC patients who underwent comprehensive surgical staging. Studies were assessed using the Newcastle-Ottawa Scale risk-of-bias tool. Pooled proportions and 95% confidence intervals were calculated using an inverse variance weighted random-effects model. Results Overall upstaging rate of clinically early-stage EOC patients was 18.7% (95%CI: 14.1–23.4%). Serous histology or high grade EOC showed the highest upstaging rate at 35.3% (95%CI: 21.8–48.7%) and 40.9% (95%CI: 35.6–46.2%). Lymph node involvement resulted in an upstaging rate of 8.7% (95%CI: 6.2–11.3%). Tumor was identified in uterus, cytology, peritoneal biopsies, omentum and appendix in 6.2% (95%CI: 1.8–10.7%), 18.4% (95%CI: 13.8–22.9%), 9.7% (95%CI: 3.8–15.6%), 5.2% (95%CI: 1.7–8.8%) and 3.6% (95%CI: 0.0–7.5%) of EOC patients. The corresponding upstaging rates were 5.9% (95%CI: 1.4–10.4%), 8.5% (95%CI: 1.8–15.2%), 3.5% (95%CI: 1.0–6.0%), 3.9% (95%CI: 1.4–6.3%) and 1.6% (95%CI: 0.0–3.4%), respectively. Conclusion The attributive value of comprehensive surgical staging in clinically early-stage EOC patients remains substantial, particularly in serous and high grade tumors. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Full Text from ScienceDirect