A Meta-analysis On The Effects Of Postoperative Adjuvant Treatment On The Prognosis With Advanced Ovarian Borderline Tumors

Objective:To systematically analyze the effects of postoperative adjuvant treatment on recurrence rate and mortality of patients with advanced ovarian borderline tumors on the basis of evidence-based medicine,thus provide theoretical basis for clinical practice.Methods:The literature about advangced(FIGO II-IV)ovarian borderline tumors were searched to find the related studies in Pubmed,Medline,Embase,Cochrane Library,CNKI,Wanfang Data,and VIP Database from Januarary 1990 to Januarary2018 by a computer,and We search for follow-up references related to advangced(FIGO II-IV)ovarian borderline tumors.These literatures screened were and extracted independently by two investigators according to the inclusion criteria and exclusion criteria.The quality evaluation of these Literatures was performed according to non-randomized controlled trials.A meta-analysis was conducted on Rev Man 5.3.software.Results:A total of 27 studies were finally selected meeting inclusion criteria and exclusion criteria regarding the comparison of FIGOII-IV stage borderline ovarian tumor cases with and without postoperative adjuvant treatment,which are retrospective case-control studies,including 7 Chinese studies and 20 foreign studies.The results were as follows:(1)There was no significant difference in the recurrence rate between the FIGOII-IV stageovarian borderline tumor in the group with and without postoperative adjuvant treatment(P>0.05).The subgroup analysis showed that the differences between recurrence rates of the FIGOII-IV stage ovarian borderline tumor in the group with and without postoperative adjuvant chemotherapy show no statistical significance.And there was no significant difference in the recurrence rate between the FIGOII or III-IV ovarian borderline tumor in the group with and without postoperative adjuvant treatment(P>0.05).(2)The difference in therecurrence rate between the FIGOII-IV stage,serous and peritoneal implantation ovarian borderline tumor in the group with and without postoperative adjuvant treatment show no statistical significance.(P>0.05).(3)The mortality rate of FIGOII-IV stage ovarian borderline tumor in the group with postoperative adjuvant treatment are higher than that group without postoperative adjuvant treatment(P=0.03<0.05).And the difference shows statistical significance.Subgroup analysis showed that the mortality rate of postoperative adjuvant chemotherapy group and other postoperative adjuvant treatmentare are higher than the group without postoperative adjuvant treatment.And the difference shows no statistical significance(P>0.05).(4)In the comparison of descriptive clinical outcomes,the progression-free survival rate of patients with postoperative platinum-based chemotherapy was lower than that of patients without postoperative adjuvant chemotherapy(P=0.01<0.05).And the difference was statistically significant.However,No statistical significance was found for overall survival rate,3-year progression-free survival rate,5-year survival rate,and 10-year survival rate between the ovarian borderline tumor in the group with and without postoperative adjuvant treatment(P>0.05).Conclusions:1.Postoperative adjuvant therapy can not reduce the recurrence rate of patients with FIGOII-IV ovarian borderline tumors,even if with FIGOIII-IV stage,there is no obvious effect;2.For serous and peritoneal ovarian borderline tumors,postoperative adjuvant therapy can not reduce the recurrence rate;3.Postoperative adjuvant therapy can not reduce the mortality rate of patients with FIGOII-IV ovarian borderline tumors,but increases their mortality rate;4.Postoperative platinum-based chemotherapy reduced progression-free survival rate,and postoperative adjuvant therapy did not affect overall survival rate,3-year progression-free survival rate,5-year survival rate,and 10-year survival rate.