AlBatool AlMahdy

and 12 more

Background: Standard management of ovarian cancer is surgical debulking and adjuvant chemotherapy. The role of systematic lymphadenectomy, as a part of debulking, has been controversial. Objective: To assess prognostic value of systematic lymphadenectomy in women with ovarian cancer based on stage, control group and type of chemotherapy Search strategy: A literature search was conducted on SCOPUS, PUBMED, COCHRANE, MEDLINE, and WEB OF SCIENCE databases. Selection criteria: All comparative studies that assess outcomes of systematic lymphadenectomy in patients with ovarian cancer were eligible. Data Collection and Analysis: overall survival was analyzed by pooling log hazard ratio (HR) and standard error of multivariable Cox regression models. MOGGE Meta-analysis Matrix is a novel illustration tool that was used to demonstrate multiple subgroup analyses of included studies. Main results: Twenty-two studies were eligible. Systematic lymphadenectomy was associated with better overall survival, that was close to significance, compared to control group (HR 0.93, 95%CI 0.86-1.00). Among women treated with adjuvant chemotherapy, overall survival improved in women with stage IIB-IV who underwent systematic lymphadenectomy (HR 0.91, 95%CI 0.84-0.99) and was most significant among patients with III to IV (HR 0.85, 95%CI 0.73-0.99). Systematic lymphadenectomy did not improve survival in women who received neoadjuvant chemotherapy (HR 0.97, 95%CI 0.73-1.29). Systematic lymphadenectomy was associated with improved progress-free survival compared to control group (HR 0.88, 95%CI 0.79-0.99). Conclusion: Data from clinical trials do not support role of systematic lymphadenectomy in advanced ovarian cancer. However, further studies may be warranted to assess substage-specific survival outcomes in women with advanced stages.