The impact of hysterectomy on oncological outcomes in patients with borderline ovarian tumors: A systematic review and meta-analysis

Diego Raimondo, Antonio Raffone, Andrew Zakhari, Manuela Maletta, Giuseppe Vizzielli, Stefano Restaino, Antonio Travaglino, Srinivasan Krishnamurthy, Mohamed Mabrouk, Paolo Casadio, Antonio Mollo, Giovanni Scambia, Renato Seracchioli

Risultato della ricerca: Contributo in rivistaArticolo in rivista

Abstract

Background. Surgical management of Borderline ovarian tumors (BOT) can range from unilateral cystectomy to a more extensive surgical staging. However, the role of hysterectomy within the surgical staging is still debated.Aim. To assess the impact of hysterectomy on survival outcomes in BOT patients.Materials and methods. 5 electronic databases were searched from their inception to April 2021 for all peer reviewed, retrospective or prospective studies, which compared treatment including hysterectomy versus treatment not including hysterectomy for BOT, in terms of recurrence and/or death. Pooled odds ratios (OR) with 95% confidence interval for recurrence, death due to BOT and death of any cause were calculated comparing hysterectomy group versus no hysterectomy group. Subgroup analyses for recurrence were based on BOT histotype (mucinous and serous) and FIGO stage (I and II-III).Results. Twelve studies assessing 2223 patients were included. Compared to no hysterectomy group, hysterectomy group showed an OR of 0.23 (p = 0.00001) for recurrence, 1.26 (p = 0.77) for death due to BOT and 4.23 (p = 0.11) for death of any cause. At subgroup analyses, compared to no hysterectomy group, hysterectomy group showed an OR for recurrence of 0.21 (p = 0.003) in serous subgroup, of 0.46 (p = 0.18) in mucinous subgroup, of 0.23 (p = 0.0006) in FIGO stage I subgroup, and of 0.29 (p = 0.04) in FIGO stage II-III subgroup.Conclusions. Uterine-sparing surgery might be recommended in all BOT patients since it seems to increase the risk of recurrence, but not those of death due to disease or death of any cause. (C) 2022 Elsevier Inc. All rights reserved.
Lingua originaleEnglish
pagine (da-a)184-191
Numero di pagine8
RivistaGynecologic Oncology
Volume165
DOI
Stato di pubblicazionePubblicato - 2022

Keywords

  • Cancer
  • Carcinoma
  • Fertility-sparing
  • Morbidity
  • Mortality
  • Omentectomy
  • Salpingo-oophorectomy
  • Tumors
  • Uterus

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