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Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet]. York (UK): Centre for Reviews and Dissemination (UK); 1995-.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet].

Fertility-sparing surgery in ovarian cancer: a systematic review

Review published: 2013.

Bibliographic details: du Bois A, Heitz F, Harter P.  Fertility-sparing surgery in ovarian cancer: a systematic review. Onkologie 2013; 36(7-8): 436-443. [PubMed: 23921764]

Abstract

BACKGROUND: Ovarian cancer is rarely diagnosed in women of reproductive age; however, this coincidence seems to increase due to changes in lifestyle. Available evidence on the prognostic impact of fertility-sparing surgery (FSS) is sparse, and there is an emerging need to consolidate such evidence.

MATERIALS AND METHODS: Systematic review of the literature, including testing for heterogeneity and meta-analytical odds ratio (OR) calculations.

RESULTS: 15 studies comprising 913 patients met the inclusion criteria for this review. Out of the 913 patients undergoing FSS, 11.4% developed recurrence during observation. Stage IB/C tumors were nearly twice as likely to recur as stage IA tumors (OR 1.72, 95% confidence interval (CI) 1.12-2.64, p < 0.05), and the risk of recurrence was 4 times higher in G2/3 compared to G1 tumors (4.26, 95% CI 2.31-7.86, p < 0.0001; and stage IC/G2/3 vs. stage IC/G1: OR 2.04, 95% CI 0.86-4.85, p > 0.05). A non-significant risk elevation was attributed to stage IC/G1 compared to stage IA/G1 (OR 1.48, 95% CI 0.66-3.16, p > 0.05).

CONCLUSIONS: FSS with unilateral salpingo-oophorectomy is only advisable for unilateral grade 1 tumors. Further studies employing contemporary classification criteria, such as low- versus highgrade malignancies, a strictly standardized regimen of surgical staging, and meticulous reporting of recurrence localization, may help develop more differentiated recommendations.

© 2013 S. Karger GmbH, Freiburg.

CRD has determined that this article meets the DARE scientific quality criteria for a systematic review.

Copyright © 2014 University of York.

PMID: 23921764

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