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Intraoperative Rupture of the Ovarian Capsule in Early-Stage Ovarian Cancer: A Meta-analysis.

Publication ,  Journal Article
Dioun, S; Wu, J; Chen, L; Kaplan, S; Huang, Y; Melamed, A; Gockley, A; St Clair, CM; Hou, JY; Tergas, AI; Khoury-Collado, F; Machida, H ...
Published in: Obstetrics and gynecology
August 2021

To examine the effects of intraoperative ovarian capsule rupture on progression-free survival and overall survival in women who are undergoing surgery for early-stage ovarian cancer.MEDLINE using PubMed, EMBASE (Elsevier), ClinicalTrials.gov, and Scopus (Elsevier) were searched from inception until August 11, 2020.High-quality studies reporting survival outcomes comparing ovarian capsule rupture to no capsule rupture among patients with early-stage epithelial ovarian cancer who underwent surgical management were abstracted. Study quality was assessed with the Newcastle-Ottawa Scale, and studies with scores of at least 7 points were included.The data were extracted independently by multiple observers. Random-effects models were used to pool associations and to analyze the association between ovarian capsule rupture and oncologic outcomes. Seventeen studies met all the criteria for inclusion in the meta-analysis. Twelve thousand seven hundred fifty-six (62.6%) patients did not have capsule rupture and had disease confined to the ovary on final pathology; 5,532 (33.7%) patients had intraoperative capsule rupture of an otherwise early-stage ovarian cancer. Patients with intraoperative capsule rupture had worse progression-free survival (hazard ratio [HR] 1.92, 95% CI 1.34-2.76, P<.001), with moderate heterogeneity (I2=41%, P=.07) when compared with those without capsule rupture. Pooled results from these studies showed a worse overall survival (HR 1.48, 95% CI 1.15-1.91, P=.003), with moderate heterogeneity (I2=53%, P=.02) when compared with patients without intraoperative capsule rupture. This remained significant in a series of sensitivity analyses.This systematic review and meta-analysis of high-quality observational studies shows that intraoperative ovarian capsule rupture results in decreased progression-free survival and overall survival in women with early-stage ovarian cancer who are undergoing initial surgical management.PROSPERO, CRD42021216561.

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Published In

Obstetrics and gynecology

DOI

EISSN

1873-233X

ISSN

0029-7844

Publication Date

August 2021

Volume

138

Issue

2

Start / End Page

261 / 271

Related Subject Headings

  • Survival Rate
  • Rupture
  • Progression-Free Survival
  • Ovary
  • Ovarian Neoplasms
  • Obstetrics & Reproductive Medicine
  • Intraoperative Complications
  • Humans
  • Female
  • Disease Progression
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Dioun, S., Wu, J., Chen, L., Kaplan, S., Huang, Y., Melamed, A., … Wright, J. D. (2021). Intraoperative Rupture of the Ovarian Capsule in Early-Stage Ovarian Cancer: A Meta-analysis. Obstetrics and Gynecology, 138(2), 261–271. https://doi.org/10.1097/aog.0000000000004455
Dioun, Shayan, Jenny Wu, Ling Chen, Samantha Kaplan, Yongmei Huang, Alexander Melamed, Allison Gockley, et al. “Intraoperative Rupture of the Ovarian Capsule in Early-Stage Ovarian Cancer: A Meta-analysis.Obstetrics and Gynecology 138, no. 2 (August 2021): 261–71. https://doi.org/10.1097/aog.0000000000004455.
Dioun S, Wu J, Chen L, Kaplan S, Huang Y, Melamed A, et al. Intraoperative Rupture of the Ovarian Capsule in Early-Stage Ovarian Cancer: A Meta-analysis. Obstetrics and gynecology. 2021 Aug;138(2):261–71.
Dioun, Shayan, et al. “Intraoperative Rupture of the Ovarian Capsule in Early-Stage Ovarian Cancer: A Meta-analysis.Obstetrics and Gynecology, vol. 138, no. 2, Aug. 2021, pp. 261–71. Epmc, doi:10.1097/aog.0000000000004455.
Dioun S, Wu J, Chen L, Kaplan S, Huang Y, Melamed A, Gockley A, St Clair CM, Hou JY, Tergas AI, Khoury-Collado F, Machida H, Mikami M, Matsuo K, Hershman DL, Wright JD. Intraoperative Rupture of the Ovarian Capsule in Early-Stage Ovarian Cancer: A Meta-analysis. Obstetrics and gynecology. 2021 Aug;138(2):261–271.

Published In

Obstetrics and gynecology

DOI

EISSN

1873-233X

ISSN

0029-7844

Publication Date

August 2021

Volume

138

Issue

2

Start / End Page

261 / 271

Related Subject Headings

  • Survival Rate
  • Rupture
  • Progression-Free Survival
  • Ovary
  • Ovarian Neoplasms
  • Obstetrics & Reproductive Medicine
  • Intraoperative Complications
  • Humans
  • Female
  • Disease Progression