Does Neoadjuvant Chemotherapy Increase Optimal Cytoreduction Rate in Advanced Ovarian Cancer? Meta-Analysis of 21 Studies

被引:172
作者
Kang, Sokbom [1 ]
Nam, Byung-Ho [2 ]
机构
[1] Natl Canc Ctr, Res Inst Hosp, Branch Uterine Canc, Goyang 411769, Gyeonggi, South Korea
[2] Natl Canc Ctr, Res Inst Hosp, Branch Canc Biostat, Ctr Clin Trials, Goyang 411769, Gyeonggi, South Korea
关键词
INTERVAL DEBULKING SURGERY; SURGICAL CYTOREDUCTION; RETROSPECTIVE ANALYSIS; TUMOR DEBULKING; META-REGRESSION; SURVIVAL; MANAGEMENT; CARCINOMA; INADEQUATE; ADJUVANT;
D O I
10.1245/s10434-009-0558-6
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
The purpose of the current study is to analyze the existing data regarding neoadjuvant chemotherapy (NAC) in advanced epithelial ovarian cancer (EOC) using a random-effects model and to determine whether NAC can improve the rate of optimal cytoreduction. Between 1989 and 2008, data of 21 studies were retrieved via a MEDLINE search. Meta-regression analysis based on a random-effects model was performed to assess the prognostic value of clinical variables. The patients who received NAC had a lower risk of suboptimal cytoreduction than the patients with favorable conditions (pooled odds ratio, 0.50; 95% confidence interval, 0.29-0.86; P = 0.012 with DerSimonian-Laird model). Meta-regression analysis revealed that heterogeneity in year of publication, taxane use, and optimal cytoreduction rate influenced median overall survival significantly (P = 0.002, P = 0.007, and P = 0.012, respectively). However, the between-studies variation of the number of NAC cycles did not influence survival (P = 0.701). The current meta-analysis showed that NAC helped the gynecologic oncologist achieve an increased rate of optimal cytoreduction.
引用
收藏
页码:2315 / 2320
页数:6
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