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Abstract Background This systematic review and meta-analysis aimed to investigate the survival outcomes following cytoreductive surgery (CRS) in patients with primary stage IV endometrial cancer (EC). Methods We systematically searched the Cochrane Library, Embase, MEDLINE/PubMed, and Web of Science for original studies reporting survival outcomes of primary stage IV EC after complete, optimal, and incomplete CRS. Pooled hazard ratios (HRs) for overall survival (OS) comparing optimal CRS with incomplete CRS were calculated using a random-effects model. Heterogeneity was assessed using the I2 and the Q-test. Results Twelve studies, including 748 patients, were analysed. 187 patients underwent complete CRS, and 146 patients optimal CRS. Ten studies reported a significant OS benefit after complete (18–48 months) and optimal CRS (13–34 months) compared to incomplete CRS (7–19 months). A benefit was also observed in patients with serous EC or extra- abdominal metastasis. Meta-analysis showed improved OS after complete/optimal vs. incomplete CRS (HR = 0.38, 95% CI 0.21–0.69, p = 0.0016). Heterogeneity was substantial between studies (I2 = 76.7%, p |
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