Tertiary cytoreductive surgery (TCS) for recurrent ovarian cancer was studied to determine its clinical efficacy. You can search MEDLINE, PubMed, Embase (Elsevier), ClinicalTrials.gov, Scopus (Elsevier), and Web of Science for studies published between 4/9/2021 and the time of conception. Studies were abstracted that compared the disease-specific survival (DSS) and overall survival (OS) of women who had optimal cytoreductive surgery at the time of TCS with those who had inadequate cytoreductive surgery. The Quality in prognosis studies (QUIPS) tool was used to assess the studies’ quality. Data was collected independently by multiple observers. Randomized-effects models were used to pool relationships and analyze the connection between survival and surgical outcomes. About 10 studies met all the criteria for inclusion in the systematic review. Patients who had optimal tertiary cytoreductive surgery had lower heterogeneity (I2 = 0%, P=0.41) and better disease-specific survival (HR = 0.35; 95% CI, 0.19-0.64; P<0.001) than those who had subpar surgery. Significant heterogeneity (I2=59%, P=0.09) was found when comparing patients who had poor tertiary cytoreductive surgery to those who did not, but the former group had a better overall survival rate (HR=0.34; 95% CI, 0.15-0.74, P<0.007). This was still highly relevant even when considering the results of other sensitivity analyses. The limited number of papers prevented us from conducting additional subgroup analyses comparing the efficacy of tertiary cytoreductive surgery and chemotherapy. This systematic review and meta-analysis of observational studies found that optimal tertiary cytoreductive surgery for recurrent ovarian cancer was associated with better OS and DSS survival compared to suboptimal tertiary cytoreductive surgery.
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