| Objects:This study compared neoadjuvant chemotherapy combined with interval debulking surgery with primary debulking surgery to analyze the value and prognosis of neoadjuvant chemotherapy combined with interval debulking surgery in patients with stage III-IV ovarian cancer.Methods:Including the keywords"ovarian cancer","interval debulking surgery","neoadjuvant chemotherapy",electronic search Pubmed,Web of science,Cochrane library,Wanfang database,China Knowledge Network Database(CNKI),China Biomedical Literature Database(CBM)Such as database search related literature,the search time from the database construction database until December 2018,including randomized controlled trials of neoadjuvant chemotherapy combined with interval debulking surgery in advanced ovarian cancer,and at the same time Manually search for references related to this.Then,through the two experts,the literature screening,literature quality evaluation,and related data extraction will be carried out in turn.If there is a disagreement between the two parties in the process of verification,it needs to be solved by the third evaluator or discussed with each other.Finally,all data needs to be meta-analyzed by statistical software RevMan5.3.Results:Finally,25 randomized controlled trials of neoadjuvant chemotherapy combined with interval debulking surgery in advanced ovarian cancer were included in the screening.A total of 4324 patients were divided into 7 groups,namely:NACT-IDS and PDS intraoperative blood group,NACT-IDS and PDS operation time group,NACT-IDS and PDS hospitalization time group,NACT-IDS and PDS clinical efficacy group,NACT-IDS and PDS surgery-related adverse reaction event(Level3/4)group,NACT-IDS and PDS 3-year survival rate group,NACT-IDS and PDS5-year survival rate group.Meta-analysis results showed:(1)NACT-IDS can significantly reduce intraoperative blood loss in patients with advanced ovarian cancer[MD=-270.67;95%CI:(-403.20,-138.14);P<0.05;(40)~2=98%];(2)NACT-IDS can significantly shorten the operation time of patients with advanced ovarian cancer[MD=-57.95;95%CI:(-77.32,-38.59);P<0.05;(40)~2=97%];(3)NACT-IDS group and PDS group have no hospitalization time for advanced ovarian cancer patients Significant differences,the difference was not statistically significant[MD:-2.35;95%CI:(-5.11,0.41);P=0.10;(40)~2=70%];(4)NACT-IDS can significantly improve the clinical efficacy of patients with advanced ovarian cancer[OR=1.42;95%CI:(1.28,1.58);P<0.05;(40)~2=31%];(5)NACT-IDS can significantly reduce the incidence of adverse events(Level 3/4)in patients with advanced ovarian cancer[OR=0.33;95%CI:(0.18,0.57);P<0.05;(40)~2=98%];(6)NACT-IDS can improve the 3-year survival rate of patients with advanced ovarian cancer,the difference is statistically significant[RR:1.28;95%CI:(1.11,1.48);P<0.05;(40)~2=0%](7)There was no significant difference in5-year survival rate between NACT-IDS and PDS group,and the difference was not statistically significant[RR:1.23;95%CI:(0.65,2.33);P=0.52;(40)~2=83%].Conclusions:Neoadjuvant chemotherapy combined with interval debulking surgery can improve the clinical efficacy of patients with advanced ovarian cancer,reduce surgical complications,and reduce intraoperative blood loss and operation time.However,there is no sufficient evidence to prove that it can be significant.To improve the survival of patients with advanced ovarian cancer,for patients with stage III-IV ovarian cancer,how to choose the right time for neoadjuvant chemotherapy combined with interval debulking surgery,a large number of evidence-based medical data accumulation and research to confirm. |
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