| Objective:The literatures related to the prognosis of ovarian yolk sac tumor were collected firstly.Then tumor size,FIGO stage,serum AFP level and other factors were analyzed by using evidence-based medicine method to improve the credibility of evaluating the risk factors that affect overall survival of patients.Method:We collected the research on the prognostic factors of yolk sac tumor the ovary by Comprehensively searching Pub Med,Medline,EMbase,Cochrane Library,CNKI and VIP etc,and retrieved the corresponding references before November 2020.Two researchers respectively performed literature selection,evaluation by strictly implementing the inclusion and exclusion criteria,and Revman5.3 software was used to conduct statistical analysis on the extracted data.Results:This meta-analysis eventually included 14 literatures,8 studies in English and 6studies in Chinese,and all of 1077 patients.Meta-analysis was carried out on the extracted data,and the results were as follows:1.Compared with stage III-IV,the 3-year overall survival and 5-year overall survival of stage I-II were higher,and there was statistical differences(OR=14.29,95%CI:2.48-82.44,P=0.003;OR=6.22,95%CI:3.99-9.69,P<0.00001).2.There was no statistically significant difference in 5-year overall survival in compare tumor diameter>10cm to <10cm(OR=0.78,95%CI:0.24-2.51,P=0.68).3.There was no statistically significant impact on 5-year overall survival by comparing with the pure and mixed tumor pathological components(OR=0.80,95%CI:0.50-1.27,P=0.35).4.There was statistically significant impact on 5-year overall survival by comparing with the volume of ascites ≤ 100 ml and the volume of ascites >100ml(OR=4.13,95%CI:2.01-8.50,P=0.0001).5.Surgical approach:(1)For young patients,the 5-year overall survival of fertility-sparing surgery was higher than that of radical surgery,which was statistically significant(OR=1.99,95%CI:1.33-2.96,P=0.0007);(2)The effect of lymph node dissection on 5-year overall survival was statistically different from that of non-lymph node dissection(OR=2.55,95%CI:1.29-5.02,P=0.007);(3)The 5-year overall survival of patients with residual tumor was significantly reduced(OR=0.21,95%CI:0.12-0.37,P<0.00001).6.Adjuvant chemotherapy regimen:(1)The 5-year overall survival of patients without platinum in chemotherapy regimen was significantly decreased(OR=8.14,95%CI:3.56-18.59,P<0.00001).(2)Using BEP chemotherapy regimen significantly improved 5-year overall survival(OR=3.47,95%CI:1.96-6.15,P<0.0001).(3)The 5-year overall survival of chemotherapy courses≥4 was higher than that of chemotherapy courses <4,and the difference was statistically significant(OR=0.21,95%CI:0.08-0.55,P=0.001).7.Compared with the P53 positive group and negative group,which was statistically significant difference in 5-year overall survival(OR=0.52,95%CI:0.22-1.22,P=0.13).8.There was no statistically significant difference in 5-year overall surviva-l between preoperative serum AFP >10000ng/ml and ≤10000ng/ml(OR=1.60,95%CI:0.79-3.25,P=0.19).Conclusion:1.Tumor diameter,tumor pathological components,P53 gene protein and preoperative serum AFP level had no effects on the prognosis of ovarian yolk sac tumor.2.Ascites quantity and residual tumor were important factors affected on the prognosis of ovarian yolk sac tumor,among which ascites >100ml and residual tumor were the adverse prognostic factors.3.FIGO stage was an important factor affecting the prognosis of patients with ovarian yolk sac tumor.For young and early patients(stage I-II),fertility preservation surgery can improve the survival rate of ovarian yolk sac tumor patients.4.Lymph node dissection can improve the survival rate of ovarian yolk sac tumor patients and reduce the chance of recurrence.5.At least 4 courses of adjuvant chemotherapy after surgery can improve the prognosis of ovarian yolk sac tumor patients and increase overall survival. |
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