| Objective: To use meta analysis to study the survival benefit and adverse effects rate of cytoreduction surgical procedures combined with Hyperthermic Intraperitoneal Chemotherapy(HIPEC)in the treatment of epithelial ovarian cancer.Methods: Use computer to search PubMed,Cochrane library,Embase,Google Scholar,CNKI,Wanfang,Weipu and other databases from January1980 to January 2021 about tumor cytoreductive surgery combined with intraperitoneal hyperthermic perfusion chemotherapy for the treatment of epithelial ovarian cancer Randomized controlled studies and case-control studies.Revmen5.4 software was used for statistical analysis to study the statistical differences between the experimental group and the observation group in Overall Survival(OS),Progression Free Survival(PFS),each year’s survival rate,total effective rates,and the incidence of adverse effects.Using subgroups at the same time to analyze the influencing factors of patients’ overall survival for further research.Results: Through literature screening,a total of 19 literatures meeting the criteria were contained in the study.Among them,there are 8 in English and11 in Chinese.There are 1836 subjects in the study,922 were in the experimental group,and 914 were in the control group.The results of Meta analysis are as follows: 1.Overall survival and progression-free survival: after cytoreduction surgical procedures combined with Hyperthermic Intraperitoneal Chemotherapy(referred to as group H),compared with non-combined Hyperthermic Intraperitoneal Chemotherapy(referred to as non-H group),it can prolong the the overall survival of ovarian cancer patients(HR=0.62,95%CI: 0.50,0.77,P<0.00001),prolong the progression-free survival of patients(HR=0.61,95%CI: 0.51,0.73,P<0.00001);2.Each Annual survival rate: HIPEC can improve the 2-year survival rate of epithelial ovarian cancer(OR=2.32,95%CI: 1.75,3.06,P<0.00001),3-year survival rate(OR=2.53,95%CI: 2.00,3.21,P<0.00001)and 5-year survival rate(OR=2.06,95%CI: 1.50,2.84,P<0.00001).3.Total effective rate: Compared with the two groups,group H can increase the total effective rate of patients(OR=2.99,95%CI: 2.07,4.31,P<0.00001).4.The incidence of adverse reactions:Compared with the two groups,adverse reactions in the gastrointestinal tract(OR=1.40,95%CI: 1.00,1.94,P=0.05),bone marrow suppression(OR=0.98,95%CI: 0.69,1.39,P=0.92),liver and kidney dysfunction(OR=0.71,95%CI:0.48,1.06,P=0.09)and other adverse reaction rates were not statistically significant.5.Overall survival subgroup analysis results: The results of the overall survival subgroup analysis showed that for stage Ⅲ epithelial ovarian cancer,HIPEC can prolong the overall survival of patients(P<0.05),while for stage Ⅰ-Ⅳ epithelial ovarian cancer,HIPEC has no effect on the overall survival of patients,(P=0.49);HIPEC prolonged the overall survival of primary epithelial ovarian cancer,HR=0.62,95%CI: 0.49,0.78,P<0.0001,while for recurrent epithelial ovarian cancer,HIPEC could not extend The overall survival time,HR=0.64,95%CI: 0.41,1.00,P=0.05;HIPEC perfusion medication and perfusion time do not affect the overall survival of epithelial ovarian cancer;the satisfactory tumor cell reduction ratio is less than 60%,HR= 0.83,95%CI: 0.38,1.81,P=0.63,when the satisfactory tumor cell reduction ratio is greater than or equal to 60%,HR=0.61,95%CI: 0.48,0.78,P<0.05,indicating the greater the degree of tumor cell reduction High,the overall survival of the HIPEC group can be significantly prolonged.Conclusions:1.In the treatment of epithelial ovarian cancer,cytoreductive surgery combined with Hyperthermic Intraperitoneal Chemotherapy can significantly prolong the overall survival and progression free survival of patients,increase the survival rate of patients in 2 years,3 years,and 5 years,and at the same time improve The total effective rate of treatment.2.In the treatment of epithelial ovarian cancer,there was no difference in the incidence of adverse reactions between the HIPEC group and the non-HIPEC group.3.According to subgroup analysis,for recurrent epithelial ovarian cancer,HIPEC cannot prolong its overall survival;for stage Ⅲ epithelial ovarian cancer,HIPEC can significantly prolong its overall survival;HIPEC perfusion medication and perfusion time do not affect the epithelium The overall survival period of sexual ovarian cancer;the higher the degree of tumor cell reduction,HIPEC can significantly prolong the overall survival of patients.4.The current regimens,perfusion time,perfusion medication and other aspects of various institutions of Hyperthermic Intraperitoneal Chemotherapy are uneven,and it is necessary to further standardize the treatment of multi-center,large-sample randomized controlled studies,so as to further clarify the efficacy of HIPEC and solve clinical related problems. |
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