Effects Of Surgical Treatment On The Recurrence And Prognosis Of Serous And Mucinous Borderline Ovarian Tumors:A Meta-Analysis

Objective:The purpose of this study is to explore the effect of surgical treatment of serous and mucinous borderline ovarian tumors on the prognosis of patients.Methods:Searched published in PubMed,Medline,Cochrane Library database and China CNKI,VIP database,Wanfang database(VIP)literature,The time limit for retrieval is the Chinese and English literature published from October 1,1990 to October 1,2017.At the same time,references are also retrieved to find more related research.Literature screening and collection extraction according to inclusion and exclusion criteria.random-orfixed-effects meta-analytical models were used after assessing cross-study heterogeneity.Result:A total of 19 observational studies,including 2843 patients,were included in the paper.The meta analysis showed that patients with CSS had a lower recurrence rate than the ISS patients(OR=0.61,95%CI:0.45-0.81,P<0.05,I~2=26.8).However,there is no significant difference in mortality(OR=1.04,95%CI:0.49-2.18,z=0.09,P=0.93,I ~2=0%).Subgroup analysis based on histology:there is no significant difference in the recurrence rate between CSS and ISS in two studies that only include ovarian mucinous borderline tumors(OR=0.41,95%CI:0.13-1.32,I ~2=0%).In the other 17studies,the results showed that CSS had a lower recurrence rate(OR=0.62,95%CI:0.46-0.84,I ~2=33.1%).There was no significant difference in the recurrence rate between CSS and ISS in four studys only including FSS analysis(OR=0.51,95%CI:0.22-1.20,I ~2=0%).In four studies of lymph node dissection in mucinous borderline tumors,there was no significant difference in recurrence rate between lymph nodes(OR=074,95%CI:0.25-2.22,I ~2=0%).In patients with fertility preserving surgery,unilateral salpingo-oophorectomy can reduce the recurrence rate(OR=3.54,95%CI:1.43-8.78,I ~2=0%).The results of publication bias and sensitivity analysis show,In the comparison of recurrence rate and survival rate between CSS and ISS,the results of Egger test were(P=0.80 and P=0.16),and the results of Begg test were(P=0.57 andP=0.25),P values were all greater than 0.05,and funnel plot was symmetrical,so there was no obvious publication bias.Conclusions:1.The recurrence rate of patients with serous borderline tumors can be reduced by complete surgical staging;no effect on the recurrence rate of mucinous borderline tumors;there is no effect on the recurrence,whether or not the row is in full staging during the retention of fertility.2.Complete Surgical Staging of ovarian borderline tumors has no effect on the survival rate.3.whether or not lymph node excision has no effect on recurrence rate of ovarian mucinous borderline tumor.4.In patients with fertility preserving surgery,unilateral salpingo-oophorectomy can reduce the recurrence rate.