Author:
Liu Yan,Geng Feng,Zhang Hongyang,Xue Jing,Chu Ran
Abstract
Abstract
Background
Ovarian clear cell carcinoma (OCCC) shares treatment strategies with epithelial ovarian cancer (EOC). Due to OCCC's rarity, there's a lack of prospective studies on its surgery, resulting in heterogeneous and limited existing data. This study aims to clarify the prognostic significance of lymphadenectomy in OCCC patients.
Methods
We systematically searched Web of Science, Scopus, PubMed, and Google Scholar until July 2023 for studies investigating lymphadenectomy's effects on OCCC patients. We calculated pooled hazard ratios (HR) with 95% confidence intervals (CI). This study is registered in PROSPERO (CRD42021270460).
Results
Among 444 screened articles, seven studies (2883 women) met inclusion criteria. Our analysis revealed that lymphadenectomy significantly improved disease-specific survival (DSS) (HR = 0.76, 95%CI = 0.60–0.95, P = 0.02) and disease-free survival (DFS) (HR = 0.58, 95%CI = 0.34–0.99, P = 0.05). However, it did not significantly affect overall survival (OS) (HR = 0.80, 95%CI = 0.60–1.06, P = 0.12) or progression-free survival (PFS) (HR = 0.95, 95%CI = 0.64–1.42, P = 0.79). Notably, some earlier studies reported no survival benefit, warranting cautious interpretation.
Conclusion
Lymphadenectomy does not significantly enhance OS and PFS for OCCC but does improve DFS and DSS. Tailoring treatment to individual patient profiles is imperative for optimal outcomes. Precise preoperative or intraoperative lymph node metastasis detection is essential for identifying candidates benefiting from lymphadenectomy. Collaborative international efforts and an OCCC database are pivotal for refining future treatment strategies.
Publisher
Springer Science and Business Media LLC
Reference49 articles.
1. Schiller W. Mesonephroma ovarii. American Journal of Cancer. 1939;35(1):1–21.
2. Serov SF, Scully RE, Sobin LH. Histological typing of ovarian tumours. Geneva: WHO; 1973. p. 37–39.
3. Prat J, D’Angelo E, Espinosa I. Ovarian carcinomas: at least five different diseases with distinct histological features and molecular genetics. Hum Pathol. 2018;80:11–27.
4. Gadducci A, Multinu F, Cosio S, Carinelli S, Ghioni M, Aletti GD. Clear cell carcinoma of the ovary: Epidemiology, pathological and biological features, treatment options and clinical outcomes. Gynecol Oncol. 2021;162(3):741–50.
5. Zhu C, Zhu J, Qian L, Liu H, Shen Z, Wu D, et al. Clinical characteristics and prognosis of ovarian clear cell carcinoma: a 10-year retrospective study. BMC Cancer. 2021;21(1):322.