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      Influence of lymphadenectomy on survival and recurrence in patients with early-stage epithelial ovarian cancer: a meta-analysis

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          Abstract

          Background

          This meta-analysis aimed to evaluate the effectiveness of lymphadenectomy on survival and recurrence in patients with early-stage epithelial ovarian cancer (eEOC).

          Methods

          Relevant studies were searched from four online databases. Hazard ratios (HRs) with 95% confidence intervals (CIs) or risk ratios (RRs) with 95% CIs were used to evaluate the effects of lymphadenectomy on overall survival (OS), progression-free survival (PFS), and recurrence rates. A subgroup analysis was performed to explore the sources of heterogeneity, followed by sensitivity and publication bias assessments.

          Results

          Fourteen articles involving 22,178 subjects were included. Meta-analysis revealed that lymphadenectomy was significantly associated with improved OS (HR = 0.72; 95% CI:0.61, 0.84; P < 0.001), improved PFS (HR = 0.74; 95% CI: 0.67, 0.80; P < 0.001), and reduced recurrence rates (RR = 0.72; 95% CI: 0.60, 0.85; P < 0.001). Subgroup analysis showed that factors including area, histology, and source of the control group were significantly related to improved OS and PFS in patients with eEOC. Sensitivity analysis showed that the combined results were stable and reliable, and no significant publication bias was observed.

          Conclusions

          Patients with eEOC can benefit from lymphadenectomy, with improved survival outcomes (OS and PFS) and a lower recurrence rate.

          Supplementary Information

          The online version contains supplementary material available at 10.1186/s12905-023-02615-6.

          Highlights

          1. The clinical outcomes of eEOC patients who did and did not undergo lymphadenectomy were compared.

          2. Lymphadenectomy was associated with better survival outcomes in patients with eEOC.

          3. Lymphadenectomy was associated with a lower recurrence rate in patients with eEOC.

          Supplementary Information

          The online version contains supplementary material available at 10.1186/s12905-023-02615-6.

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          Most cited references45

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          Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries

          This article provides an update on the global cancer burden using the GLOBOCAN 2020 estimates of cancer incidence and mortality produced by the International Agency for Research on Cancer. Worldwide, an estimated 19.3 million new cancer cases (18.1 million excluding nonmelanoma skin cancer) and almost 10.0 million cancer deaths (9.9 million excluding nonmelanoma skin cancer) occurred in 2020. Female breast cancer has surpassed lung cancer as the most commonly diagnosed cancer, with an estimated 2.3 million new cases (11.7%), followed by lung (11.4%), colorectal (10.0 %), prostate (7.3%), and stomach (5.6%) cancers. Lung cancer remained the leading cause of cancer death, with an estimated 1.8 million deaths (18%), followed by colorectal (9.4%), liver (8.3%), stomach (7.7%), and female breast (6.9%) cancers. Overall incidence was from 2-fold to 3-fold higher in transitioned versus transitioning countries for both sexes, whereas mortality varied <2-fold for men and little for women. Death rates for female breast and cervical cancers, however, were considerably higher in transitioning versus transitioned countries (15.0 vs 12.8 per 100,000 and 12.4 vs 5.2 per 100,000, respectively). The global cancer burden is expected to be 28.4 million cases in 2040, a 47% rise from 2020, with a larger increase in transitioning (64% to 95%) versus transitioned (32% to 56%) countries due to demographic changes, although this may be further exacerbated by increasing risk factors associated with globalization and a growing economy. Efforts to build a sustainable infrastructure for the dissemination of cancer prevention measures and provision of cancer care in transitioning countries is critical for global cancer control.
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            Measuring inconsistency in meta-analyses.

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              Bias in meta-analysis detected by a simple, graphical test

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                Author and article information

                Contributors
                dline2024@163.com
                Zhangdan2049@163.com
                304815777@qq.com
                hayyshc@njmu.edu.cn
                Journal
                BMC Womens Health
                BMC Womens Health
                BMC Women's Health
                BioMed Central (London )
                1472-6874
                4 September 2023
                4 September 2023
                2023
                : 23
                : 474
                Affiliations
                [1 ]GRID grid.89957.3a, ISNI 0000 0000 9255 8984, Department of Emergency, , The Affiliated Huai’an No. 1 People’s Hospital of Nanjing Medical University, ; Huai’an, 223300 Jiangsu China
                [2 ]GRID grid.89957.3a, ISNI 0000 0000 9255 8984, Department of Obstetrics and Gynecology, , The Affiliated Huai’an No. 1 People’s Hospital of Nanjing Medical University, ; Huanghe Road West,, Huai’an, 223300 Jiangsu China
                [3 ]GRID grid.89957.3a, ISNI 0000 0000 9255 8984, Department of General Practice, , The Affiliated Huai’an No. 1 People’s Hospital of Nanjing Medical University, ; Huai’an, 223300 Jiangsu China
                Article
                2615
                10.1186/s12905-023-02615-6
                10478186
                37667358
                370441af-0dd6-4e12-8c25-65ec415f63d1
                © BioMed Central Ltd., part of Springer Nature 2023

                Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

                History
                : 21 March 2023
                : 23 August 2023
                Categories
                Research
                Custom metadata
                © BioMed Central Ltd., part of Springer Nature 2023

                Obstetrics & Gynecology
                early-stage epithelial ovarian cancer,lymphadenectomy,overall survival,progression-free survival,recurrence rate

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