scholarly journals EPV171/#106 The attributive value of comprehensive surgical staging in clinically early-stage epithelial ovarian carcinoma: a systematic review and meta-analysis

Author(s):  
R Van De Vorst ◽  
J Hoogendam ◽  
M Van Der Aa ◽  
P Witteveen ◽  
C Gerestein ◽  
...  
Author(s):  
Renée E.W.M. van de Vorst ◽  
Jacob P. Hoogendam ◽  
Maaike A. van der Aa ◽  
Petronella O. Witteveen ◽  
Ronald P. Zweemer ◽  
...  

Author(s):  
Renée van de Vorst ◽  
Jacob Hoogendam ◽  
Maaike van der Aa ◽  
Petronella Oda Witteveen ◽  
Ronald Zweemer ◽  
...  

Background: Tumor positivity and upstaging rates from various surgical staging components performed in clinically early-stage epithelial ovarian carcinoma (EOC) vary widely in literature. Objectives: To quantify tumor positivity and upstaging rates for all staging surgery components in EOC patients. Differences between subgroups based on their clinical and histological characteristics are explored. Search strategy: A systematic search using synonyms of ‘ovarian cancer’, ‘neoplasm staging’, and ’neoplasm metastasis’ was conducted in PubMed, Embase, and the Cochrane Library. Selection criteria: Meta-analysis was performed on 23 included studies, comprising 5194 clinical stage I or II EOC patients who underwent comprehensive surgical staging. Data Collection and Analysis: Studies were assessed using the Newcastle-Ottawa Scale risk-of-bias tool. Pooled proportions and 95% confidence intervals were calculated using an inverse variance weighted random-effects model. Main Results: Overall upstaging rate of clinically early-stage EOC patients was 18.7% (95%CI: 14.1-23.4%). Serous histology or high grade EOC showed the highest upstaging rate at 35.3% (95%CI: 21.8-48.7%) and 40.9% (95%CI: 35.6-46.2%). Lymph node involvement resulted in an upstaging rate of 8.7% (95%CI: 6.2-11.3%). Tumor was identified in uterus, cytology, peritoneal biopsies, omentum and appendix in 6.2% (95%CI: 1.8-10.7%), 18.4% (95%CI: 13.8-22.9%), 9.7% (95%CI: 3.8-15.6%), 5.2% (95%CI: 1.7-8.8%) and 3.6% (95%CI: 0.0-7.5%) of EOC patients. The corresponding upstaging rates were 5.9% (95%CI: 1.4-10.4%), 8.5% (95%CI: 1.8-15.2%), 3.5% (95%CI: 1.0-6.0%), 3.9% (95%CI: 1.4-6.3%) and 1.6% (95%CI: 0.0-3.4%), respectively. Conclusion: The attributive value of comprehensive surgical staging in clinically early-stage EOC patients remains substantial, particularly in serous and high grade tumors.


2017 ◽  
Vol 24 (4) ◽  
pp. 552-562 ◽  
Author(s):  
Giorgio Bogani ◽  
Chiara Borghi ◽  
Umberto Leone Roberti Maggiore ◽  
Antonino Ditto ◽  
Mauro Signorelli ◽  
...  

2017 ◽  
Vol 27 (4) ◽  
pp. 651-658 ◽  
Author(s):  
Michiel Simons ◽  
Leon Massuger ◽  
Jolien Bruls ◽  
Johan Bulten ◽  
Steven Teerenstra ◽  
...  

ObjectiveOverall, patients with mucinous ovarian carcinoma (MOC) are considered to have a better prognosis compared with the whole group of nonmucinous carcinomas. However, some studies indicate that patients with advanced-stage MOC might have a worse prognosis than those with advanced-stage serous ovarian carcinoma (SOC). We carried out a systematic review and meta-analysis of the current literature.Materials and MethodsA comprehensive literature search was carried out identifying 19 articles that compare survival of patients with MOC and patients with SOC. Meta-analyses were performed for risk ratio (RR) and hazard ratio (HR) for all International Federation of Gynecology and Obstetrics stages together, as well as for early- and advanced-stage diseases separately.ResultsOverall, patients with MOC showed a lower risk of dying within 5 years (RR, 0.67; 95% confidence interval [CI], 0.64–0.69; n = 45 333) and a longer survival (HR, 0.66; 95% CI, 0.58–0.75; HR, 0.88; 95% CI, 0.78–0.98, for univariate and multivariate analyses, respectively; n = 5540) compared with those with SOC. In contrast, in advanced-stage (International Federation of Gynecology and Obstetrics stages III and IV) disease, patients with MOC have a higher risk of dying within 5 years (RR, 1.15; 95% CI, 1.13–1.17; n = 36 113) and a shorter survival (HR, 1.82; 95% CI, 1.71–1.94; n = 19 907).ConclusionsPatients with advanced-stage MOC have a significantly worse prognosis compared with patients with SOC, whereas in early stage, the prognosis of patients with MOC is better.


2019 ◽  
Vol 154 (2) ◽  
pp. 308-313 ◽  
Author(s):  
E.M. Hengeveld ◽  
P.L.M. Zusterzeel ◽  
H. Lajer ◽  
C.K. Høgdall ◽  
M. Rosendahl

2002 ◽  
Vol 85 (2) ◽  
pp. 351-355 ◽  
Author(s):  
Tien Le ◽  
Allyson Adolph ◽  
G.V. Krepart ◽  
R. Lotocki ◽  
M.S. Heywood

2020 ◽  
Vol 14 (15) ◽  
pp. 1485-1500
Author(s):  
Lichao Yang ◽  
Chunmeng Wei ◽  
Yasi Li ◽  
Xiao He ◽  
Min He

Aim: The aim was to systematically investigate the miRNA biomarkers for early diagnosis of hepatocellular carcinoma (HCC). Materials & methods: A systematic review and meta-analysis of miRNA expression in HCC were performed. Results: A total of 4903 cases from 30 original studies were comprehensively analyzed. The sensitivity and specificity of miR-224 in discriminating early-stage HCC patients from benign lesion patients were 0.868 and 0.792, which were superior to α-fetoprotein. Combined miR-224 with α-fetoprotein, the sensitivity and specificity were increased to 0.882 and 0.808. Prognostic survival analysis showed low expression of miR-125b and high expression of miR-224 were associated with poor prognosis. Conclusion: miR-224 had a prominent diagnostic efficiency in early-stage HCC, with miR-224 and miR-125b being valuable in the prognostic diagnosis.


2019 ◽  
Vol 12 (8) ◽  
pp. 815-824 ◽  
Author(s):  
Anne Julienne Genuino ◽  
Usa Chaikledkaew ◽  
Due Ong The ◽  
Thanyanan Reungwetwattana ◽  
Ammarin Thakkinstian

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