Survival Effect Of Systematic Aortic And Pelvic Lymphadenectomy For Advanced Epithelial Ovarian Cancer During The Cytoreductive Surgery: A Meta-Analysis

Objective:To evaluate the relative effect of syetematic aortic and pelvic lymphadenectomy followed by cytoreductive surgery in patients with advanced epithelial ovarian cancer,and to analyze factors influencing the efficacy.Materials and method:A systematic review of syetematic aortic and pelvic lymphadenectomy followed by cytoreductive surgery was performed by searching the data bases including PUBMED,China National Knowledge Infrastructure and CBM. Literature references were checked at the same time.Languages was restricted to Chinese and English.Data including overall survival,the incidence of perioperative complication and the overall survival undering optimal cytoreductive sugery were extracted from the lympadenectomy arms and the control arms respectively.Using the index of relative risk to express the result for the categorical variable.Results:Five cohorts of patients with advanced epithelial ovarian cancer, involving 913 patients were included.Including 1 RCT and 4 CCT.None of the CCT described randomization or usage of double blinded method.There was no statistically significant between the systematic lymphadenectomy and the control arms in the 5-year overall survival(RR=1.17,95%CI:0.98～1.39,P=0.08);The incidence of perioparative complication was higher in the lymphadenectomy arms than in the no-lymphadenectomy arms(RR=1.58,95%CI:1.15～2.18,P=0.005). Undering optimal cytoreductive sugery,the 3-year and 5-year overall survival were no statistically significant between the lymphadenectomy arms and the control arms (RR=1.06,95%CI:0.94～1.20,P=0.35;RR=1.17,95%CI:0.98～1.39,P=0.08 respectively).Conclusion:Aortic and pelvic lymphadeneetomy followed by cytoreductve surgery cann't improve 3-year or 5-year overall survival in patients with advanced epithelia ovarian cancer.The incidence of perioperative complication was higher in the lymphadenetomy arms.