Comparison Between Synchronous Primary Cancers Of The Endometrium With Ovary And Ovarian Metastasis:A Meta Analysis

Objective:Using Mate analysis method to systematically evaluate the clinical characteristics with prognosis between synchronous primary cancers of the endometrium and ovary(SPCEO)and endometial cancer with ovarian metastasis(ECOM),in order to strengthen the clinical understanding of gynecologic oncologists for SPCEO,and provide a basis for selecting a reasonable treatment for patients with SPCEO.The idea,through further analysis of relevant risk factors,provides evidence basis for prognosis.Methods : Using Computer retrieved studies about SPCEO and ECMO from PubMed,FMRS,Embase,Elsevier,Medline,Cochrane Libary,China Biomedical Medicine(CBM),WanFang data-base,China Knowledge Network(CNKI)from Jan.2008 to Jan.2019.The language is limited to chinese and english.The quality of the included literature was evaluated using the evaluation criteria of the quality evaluation tool scale for non-randomized experimental studies.The quality evaluation tool is methodological index for non-randomized studies(MINORS).the research indicators was performed by Meta analysis with Recman 5.3 software.Result:After strict screening according to the established criteria,the last 14 articles were included in our study,all of them were retrospective case studies,5Chinese literature,9 English literature,covering 764 patients in total,of whom there was 354 cases of SPCEO(accounted for 4.39% of endometrial cancer in the same period)and 410 of ECOM(accounted for 5.08% of endometrial cancer in the same period).The Mate analysis results showed that the incidence of SPCEO in EC patients was 0.05,95% CI(0.04 ~ 0.07);the incidence of ECMO in EC patients was 0.06,95% CI(0.04 ~ 0.08).Compared with ECOM patients,clinical manifestations of SPCEO patients(abnormal uterine bleeding : OR = 0.21,95% CI: 0.07 ~ 0.59;pelvic mass: OR = 6.21,95% CI: 1.43 ~ 26.95),age of onset(MD =-6.01,95% CI:-9.64 to-2.39),menopause(OR = 4.75,95% CI: 2.21 to 10.24),differentiation degree of endometrial cancer(OR = 7.66,95% CI: 4.72 to 12.44),endometrial cancer stage(stage III OR=0.04,95% CI: 0.02-0.08;stage IV: OR=0.05,95% CI: 0.02-0.15),cervical infiltration(OR=0.29,95% CI: 0.16-0.50),myometrial infiltration(OR=0.14,95% CI: 0.09~0.21),lymph node metastasis(OR=0.24,95% CI: 0.14~0.40),and 5survival rate(OR=3.57,95% CI: 2.28-5.56),the differences were statistically significant(P<0.05).Ascites,ascites cytologic detection,and endometrioid carcinoma were not statistically significant difference between SPCEO and ECOM(P>0.05).Conclusion:The incidence of SPCEO and ECOM was similar in EC patients,and the age of onset of SPCEO patients was younger than ECOM patients.Compared with ECOM patients,the clinical manifestations of SPCEO patients were common in pelvic masses,but there were no typical clinical symptoms.Most patients in SPCEO were not menopausal,had earlier stage and had better grades.The risk of cervical invasion,myometrial invasion,and lymph node metastasis was significantly less than that of ECOM patients.SPCEO patients were significantly better than ECOM patients in 1-year survival rate,3-year survival rate,and 5-year survival rate.