Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Meta-Analysis
. 2016 Nov 2:6:35914.
doi: 10.1038/srep35914.

Neoadjuvant chemotherapy for Patients with advanced epithelial ovarian cancer: A Meta-Analysis

Long-Jia Zeng  1 , Chun-Lin Xiang  2 , Yi-Zhen Gong  3 , Yan Kuang  1 , Fang-Fang Lu  1 , Su-Yi Yi  1 , Yue Zhang  1 , Meng Liao  1
Affiliations
Meta-Analysis

Neoadjuvant chemotherapy for Patients with advanced epithelial ovarian cancer: A Meta-Analysis

Long-Jia Zeng et al. Sci Rep. .

Abstract

The value of neoadjuvant chemotherapy (NAC) has not yet been fully defined. We aimed to systematically evaluate the influence of neoadjuvant chemotherapy (NAC) on survival and complete cytoreduction after debulking surgery in advanced epithelial ovarian cancer (AEOC) patients. We searched PubMed, Embase, and the Cochrane Central Register of Controlled Trials for the randomized controlled trials (RCTs) comparing NAC and primary debulking surgery (PDS) in AEOC patients. The last search date is February 25, 2016. Cochrane systematic evaluation was used to evaluate bias risk of included studies. RevMan 5.3 software was used for statistical analysis. A total of 4 RCTs involving 1922 patients were included. Compared with PDS, NAC may contribute to the completeness of debulking removal [no residual disease (RR: 2.37; 95%CI: 1.94-2.91; P<0.00001), residual disease ≤1 cm (RR: 1.28; 95%CI: 1.04-1.57; P = 0.02), optimal cytoreduction rate (RR: 1.76; 95%CI: 1.57-1.98; P<0.00001)], but there were no significant differences in both groups with regard to overall survival (HR: 0.94; 95%Cl: 0.81-1.08; P = 0.38) and progression-free survival (HR: 0.89; 95%Cl: 0.77-1.03; P = 0.12). This meta-analysis indicates that the higher rate of optimal debulking made NAC more favorable as a treatment option for AEOC patients with non-inferior survival compared with PDS.

PubMed Disclaimer

Figures

Figure 1
Figure 1. Flow diagram of literature search.
RCT, randomized controlled trial.
Figure 2
Figure 2. Assessment of quality of selected RCTs.
Low risk of bias (green circles), unclear risk of bias (yellow circles) and high risk of bias (red circles).
Figure 3
Figure 3. Forest plot for overall survival.
NAC, neoadjuvant chemotherapy followed by interval debulking surgery; PDS, primary cytoreductive surgery followed by systemic chemotherapy.
Figure 4
Figure 4. Forest plot for progression-free survival.
NAC, neoadjuvant chemotherapy followed by interval debulking surgery; PDS, primary cytoreductive surgery followed by systemic chemotherapy.
Figure 5
Figure 5. Forest plot for extent of surgical debulking.
The definition of optimal cytoreductive surgery is residual tumor diameter ≤1 cm or no residual disease after debulking surgery; NAC, neoadjuvant chemotherapy followed by interval debulking surgery; PDS, primary cytoreductive surgery followed by systemic chemotherapy.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Kehoe S. et al.. Primary chemotherapy versus primary surgery for newly diagnosed advanced ovarian cancer (CHORUS): an open-label, randomised, controlled, non-inferiority trial. Lancet. 386, 249–257 (2015). - PubMed
    1. Vergote I. et al.. Neoadjuvant chemotherapy or primary surgery in stage IIIC or IV ovarian cancer. N. Engl. J. Med. 363, 943–953 (2010). - PubMed
    1. National Comprehensive Cancer Network. NCCN Clinical Practice Guidelines in Oncology: original cancer including fallopian tube cancer and primary peritoneal cancer. v. 2. Avaible at www. nccn. org (2015).
    1. Rose P. G. et al.. Secondary surgical cytoreduction for advanced ovarian carcinoma. N. Engl. J. Med. 351, 2489–2497 (2004). - PubMed
    1. van der Burg M. E. et al.. The effect of debulking surgery after induction chemotherapy on the prognosis in advanced epithelial ovarian cancer. Gynecological Cancer Cooperative Group of the European Organization for Research and Treatment of Cancer. N. Engl. J. Med. 332, 629–634 (1995). - PubMed

Publication types

MeSH terms