| Objective To systematically evaluate the clinical characteristics and prognosis of Endometriosis-associated Ovarian Cancer(EAOC)by means of meta-analysis,so as to provide evidence-based medical basis for the early diagnosis and treatment of EAOC.Methods From January 2009 to December 2019,PubMed,EMBASE,MEDLINE,Cochrane Library,CNKI and Wanfang Data knowledge service platforms were searched for the relevant research on ovarian cancer associated with endometriosis.According to the established inclusion and exclusion criteria,articles were selected.The Newcastle-Ottawa Scale(NOS)was used to evaluate the quality of the included literature,meta-analysis was performed using the system evaluation software Revman 5.3 after data extraction.Results A total of 11 Chinese literatures and 10 English literatures were included in the screening.The total number of cases was 4,705,of which 878 were in the EAOC group.Non-Endometriosis-associated ovarian cancer(non-EAOC)Group of 3817 patients.The NOS-scale was used to evaluate the literature quality,and the included literature scores were 6-9 points.Meta analysis results show that compared with non-EAOC,the age of onset in patients in the EAOC group(OR =-5.14,95%CI [-6.06,-4.22],P = 0.00001),menopause(OR = 2.07,95% CI [1.15,3.73],P =0.02),preoperative sugar antigen-125 levels(OR = 1.71,95% CI [1.27,2.31],P =0.0005),menstrual disorders in clinical manifestations(OR = 2.50,95% CI[1.66,3.77],P <0.0001),infertility(OR = 3.84,95% CI [2.51,5.88],P <0.00001),tumor diameter less than 10cm(OR = 3.21,95% CI [2.22,4.64],P <0.00001),FIGO stage(OR=5.04,95% CI [4.19,6.06],P<0.00001),Grade classification(OR = 0.67,95% CI [0.46,0.98],P = 0.04),clear cell carcinoma(OR = 4.49,95% CI [2.79,7.25],P <0.00001),endometrioid carcinoma(OR = 3.54,95% CI [2.10,5.97],P <0.00001),lymph node metastasis(OR = 0.76,95% CI [ 0.28,2.03],P = 0.58),tumor reduction effect(OR = 2.80,95% CI [1.10,7.13],P = 0.03),and progression-free survival(HR= 0.72,95% CI [0.54,0.96],P = 0.02),the differences were statistically significant;while in clinical manifestations(pelvic mass OR = 0.68,95% CI [0.34,1.39],P =0.29,abdominal pain,OR = 1.67,95% CI [1.00,2.79],P = 0.05,irregular vaginal bleeding OR = 0.83,95% CI [0.33,2.11],P = 0.69),overall Survival rate(HR = 1.07,95% CI [0.78,1.46],P = 0.69)had no significant difference between EAOC and non-EAOC.Conclusion Compared with non-EAOC patients,EAOC patients are younger and have a higher proportion of menopause.They are mostly in the perimenopause period,and the clinical symptoms are not typical compared with the two.EAOC patients with normal CA-125 preoperative ratio,tumor diameter less than 10 cm,and high infertility rate,early stage of tumor,lower grade,low lymph node metastasis rate,good effect of tumor cytoreductive surgery,pathological types include clear cell carcinoma and uterus Endometrioid carcinoma is predominant.The progression-free survival rate of EAOC patients is higher than that of non-EAOC patients,but the overall survival rate is not significantly different from that of non-EAOC patients,so the prognosis of EAOC has not improved significantly. |
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