CONCLUSIONS
This meta-analysis demonstrated that 18.7% of the clinically early-stage EOC patients are upstaged based on comprehensive surgical staging. Patients with serous and high grade EOC have the highest risk of being upstaged. Tumor positive uterus, cytology, peritoneal, omentum, and appendix samples do occur frequently, but lead substantially less frequent to a higher stage (1.6-8.5%) due to their overlap. This meta-analysis provides a better insight to both patient and clinician into the individual contribution of each component in surgical staging.