| Background:Ovarian cancer is a common malignant tumors of the female genital tract. The disease with occult onset can occur at any age, its histological type is complex, and always rapid onset. Due to the lack of specific symptoms and effective screening tools in early stage disease,70%patients is diagnosed at advanced stage. Widespread tumors in the pelvic cavity of a poor prognosis. Mortality rate ranks first in female reproductive system malignancies. Nowadays, the standard treatment to cure advanced ovarian cancer is still cytoreductive surgery and platinum-based adjuvant chemotherapy. A great many of well-known scholars lead in the systematic lymphadenectomy when treating ovarian cancer so as to improve the survival and quality of life of ovarian cancer patients. The role of systematic lymphadenectomy (SL) for improving overall survival (OS) in epithelial ovarian cancer (EOC) remains unclear. To evaluate the role of SL in EOC, we performed a meta-analysis for explore the efficacy of systematic lymphadenectomy for OS.Objective:To evaluate whether systematic lymphadenectomy will improve OS(overall survival)of ovarian cancer patients. Explore the value of systemic lymphadenectomy in ovarian cancer.Methods:We retrieval PUBMED database, MEDLINE database, EMBAS database, Cochrane Library, WANFANG database, CNKI and CBM in the internet. We also hand-search4jourals of obstetrics and gynecology include Chinese joural of Obstetrics and Gynecology, Chinese joural of Practical Gynecology and Obstetrics, Gynecology and Practical magazine, Reproduction and Contraceptive, the process of modem Gynecology. The literature search was limited to the period of January,1995, through December,2012. The language was restricted to English and Chinese. We selected EOC patients who had undergone staging surgery and systematic lymphadenectomy (Experimental group), and EOC patients who had not undergone lymph node resection (Control group). Evaluate the collected articles, excluded literature with a substandard purpose of this study and substandard quality requirements. Meta-analysis on the selected literature was processed by Revman5.0. Using the index of relative risk to express the result of the five-year overall survival between systematic lymphadenectomy group and non-systematic lymphadenectomy group, and explore factors affecting prognosis.Result:We analyzed8studies with ReviewManager5.0. This meta-analysis using a fixed-effect model demonstrated that SL improved5year OS compared with USL in all-stage disease (RR=1.05,95%Cl:1.04-1.07), and SL increased5year OS in patients with early stage disease (RR=1.06,95%Cl:1.04-1.08), whereas it could not improve5years OS statistically in advanced stage diseases(HR=1.04;95%CI=1.00～1.08). Moreover, SL does not relation to5year OS in patients with all-stage disease whether they underwent optimal debulking surgeryConclusions:These results show the possibility that SL can improve5year OS in EOC. But it did not increase the overall survival in advanced ovarian cancer. However, the efficacy of SL on5year OS is still unknown because of the lack of RCTs, which requires more relevant studies for investigating the role of SL in EOC. |
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