| Background:Ovarian cancer is the second malignant tumors of female reproductive system in common,early symptoms of ovarian cancer are hiding and ovaries located in the depths of the pelvic,so it is hard to diagnosis early ovarian cancer,up to 70%-80%of patients are diagnosed with advanced-stage EOC.Epithelial ovarian cancer early appear pelvic or abdominal cavity spread planting and lymph node metastasis,so it is the highest mortality of reproductive system tumors.Although it has been confirmed that the pelvic and paraaortic lymph node metastasis are associate with the poor prognosis of patients,systematic lymphadenectomy for improving the survival rate of ovarian cancer was unable to agree on which is right.In order to clarify the clinical value of systemic lymph node dissection for ovarian cancer,the meta analysis is done to study the effect of systemic lymph node dissection on the prognosis of ovarian cancer.Objective:By comparing epithelial ovarian cancer’s 5-year overall survival rates between systemic lymphadenectomy and unsystemic lymphadenectomy to evaluate the influence of systemic lymphadenectomy for overall survival in Epithelial Ovarian Cancer.Methods:1.two reviewers using the computer retrieval PUBMED,MEDLINE,COCHRANE LIBRARY,CNKI,CBM,WANFANG database,and also hand-search four journal of obstetrics and gynecology,such as Chinese journal of practical gynecology,progress in obstetrics and gynecology,Journal of Practical Obstetrics and Gynecology,the language was limited to English and Chinese,the literature search time limit for January 1,1990 to October 1,2016.Search on systemic lymphadenectomy of controlled clinical trials,randomized controlled trials,and other related research literature,and literature screening according to the inclusion criteria and exclusion criteria.2.Using RevMan 5.3 software make meta analysis to all independent research into the standard line,calculating the RR value to compare epithelial ovarian cancer’s 5-year overall survival rates between systemic lymphadenectomy and unsystemic lymphadenectomy to evaluate the influence of systemic lymphadenectomy for overall survival in epithelial ovarian cancer.then,performed subgroup analysis according to type,cancer stage and residual tumor by dividing articles.Result:15 related studies and a total of 3915 patients were included in the meta analysis,5-year overall survival rate in the lymphadenectomy group was higher than that in the unsystematic lymphadenectomy group was revealed by pooled relative ratios in all qualified studies(RR=0.83,95%CI:0.77-0.90,P<0.00001).which was same in the subgroup analysis of observational studies(RR=0.78,95%CI:0.71-0.85,P<0.00001)but not in randomized controlled trials(RR=0.99,95%CI:0.85-1.15,P=0.90).Line according to the tumor stage to make subgroup analysis,both early(RR=0.77,95%:0.62-0.98,P=0.03)and advanced epithelial ovarian cancer patients(RR=0.84,95%CI:0.76-0.93,P=0.0006)with systemic lymphadenectomy can improve patient’s 5-year survival rate.However,for patients underwent optimal debulking surgery,whether early(RR=0.84,95%CI:0.58-1.22,P=0.35)or late(RR=0.96,95%CI:0.83-1.12,P=0.61),there was no statistically significant difference.Conclusions:Systemic lymphadenectomy may improve the 5-year survival rate of epithelial ovarian cancer patients,but for patients who underwent optimal debulking surgery it is difficult to improve the prognosis.due to the limited number of research take into,and the less number of randomized controlled trials,the effect of systemic lymphadenectomy on the prognosis of patients with epithelial ovarian cancer remains to be further discussed. |
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