EP998 Comparison of laparoscopy and laparotomy in the surgical management of early-stage ovarian cancer

Ginjaume, N Garcia; Moreno, Carlos Alonso; Teixeira, Neusa; Garrayo, Sara Marin; Guiborg, R Luna; Negre, Ramon Rovira

doi:10.1136/ijgc-2019-esgo.1042

Cited by 1 publication

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“…Thirty-eight of these studies were excluded due to a lack of comparison of progression-free survival or overall survival between the intraoperative capsule rupture and no capsule rupture groups (19 studies), incorrect study type according to our inclusion criteria (13 studies), incorrect population (three studies), incorrect intervention (two studies), and duplicate populations (one study). 6,16–52 The data quality of the remaining articles was assessed using the Newcastle-Ottawa Scale (Appendix 2, available online at http://links.lww.com/AOG/C345). Seventeen studies met all the criteria for inclusion in our meta-analysis.…”

Section: Resultsmentioning

confidence: 99%

Intraoperative Rupture of the Ovarian Capsule in Early-Stage Ovarian Cancer

Dioun

Chen

et al. 2021

Obstetrics &Amp; Gynecology

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OBJECTIVE: To examine the effects of intraoperative ovarian capsule rupture on progression-free survival and overall survival in women who are undergoing surgery for early-stage ovarian cancer. DATA SOURCES: MEDLINE using PubMed, EMBASE (Elsevier), ClinicalTrials.gov, and Scopus (Elsevier) were searched from inception until August 11, 2020. METHODS OF STUDY SELECTION: High-quality studies reporting survival outcomes comparing ovarian capsule rupture to no capsule rupture among patients with early-stage epithelial ovarian cancer who underwent surgical management were abstracted. Study quality was assessed with the Newcastle-Ottawa Scale, and studies with scores of at least 7 points were included. TABULATION, INTEGRATION, AND RESULTS: The data were extracted independently by multiple observers. Random-effects models were used to pool associations and to analyze the association between ovarian capsule rupture and oncologic outcomes. Seventeen studies met all the criteria for inclusion in the meta-analysis. Twelve thousand seven hundred fifty-six (62.6%) patients did not have capsule rupture and had disease confined to the ovary on final pathology; 5,532 (33.7%) patients had intraoperative capsule rupture of an otherwise early-stage ovarian cancer. Patients with intraoperative capsule rupture had worse progression-free survival (hazard ratio [HR] 1.92, 95% CI 1.34–2.76, P<.001), with moderate heterogeneity (I2=41%, P=.07) when compared with those without capsule rupture. Pooled results from these studies showed a worse overall survival (HR 1.48, 95% CI 1.15–1.91, P=.003), with moderate heterogeneity (I2=53%, P=.02) when compared with patients without intraoperative capsule rupture. This remained significant in a series of sensitivity analyses. CONCLUSION: This systematic review and meta-analysis of high-quality observational studies shows that intraoperative ovarian capsule rupture results in decreased progression-free survival and overall survival in women with early-stage ovarian cancer who are undergoing initial surgical management. SYSTEMATIC REVIEW REGISTRATION: PROSPERO, CRD42021216561.

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Section: Resultsmentioning

confidence: 99%