The purpose of this study is to look at the impact of intraoperative ovarian capsule rupture on progression-free survival and overall survival in women receiving surgery for early-stage ovarian cancer. From its beginning until August 11, 2020, MEDLINE, PubMed, EMBASE,, and Scopus were searched. Abstracted were high-quality studies that compared ovarian capsule rupture versus no capsule rupture in individuals with early-stage epithelial ovarian cancer who had surgical treatment. The Newcastle-Ottawa Scale was used to measure study quality, and papers with at least 7 points were included. Multiple observers extracted the data separately. To collect associations and assess the relationship between ovarian capsule rupture and oncologic outcomes, random-effects models were utilized. The meta-analysis included seventeen papers that satisfied all of the criteria. On final pathology, 12,766 individuals did not have capsule rupture and had disease limited to the ovary; 5,532 patients had intraoperative capsule rupture of an otherwise early-stage ovarian cancer. When compared to those who did not have intraoperative capsule rupture, patients with intraoperative capsule rupture had a worse progression-free survival rate with considerable variability. When compared to patients who did not have intraoperative capsule rupture, the pooled data from these trials indicated a poorer overall survival with considerable heterogeneity. A series of sensitivity studies revealed that this remained significant.

According to this systematic review and meta-analysis of high-quality observational data, intraoperative ovarian capsule rupture reduces progression-free survival and overall survival in women with early-stage ovarian cancer who are having their first surgical treatment.