BACKGROUND: The impact of intraoperative rupture on prognosis is controversial in early-stage epithelial ovarian cancer (EOC). Thus, we performed a meta-analysis to determine its impact and to evaluate factors to increase its risk. METHODS: We searched PubMed, Embase, and the Cochrane Library till May 2011, and 9 eligible studies including 2382 patients were evaluated. All patients were classified into three groups: no rupture; intraoperative rupture; preoperative involvement. RESULTS: Preoperative involvement decreased progression-free survival when compared with intraoperative rupture (PFS; HR, 1.47; 95% CI, 1.01-2.14), which also showed poorer PFS than no rupture (HR, 2.41; 95% CI, 1.74-3.33). Although preoperative involvement reduced PFS when compared with intraoperative rupture (HR, 2.63; 95% CI, 1.11-6.20), there was no difference in it between intraoperative rupture and no rupture in patients who underwent complete surgical staging operation and adjuvant platinum-based chemotherapy if needed (HR, 1.49; 95% CI, 0.45-4.95). Furthermore, adhesion to adjacent tissues, grade 2 or 3 disease were more common (ORs, 2.01 and 2.47; 95% CIs, 1.20-3.37 and 1.12-5.46), whereas mucinous tumor was less frequent (OR, 0.51; 95% CI, 0.37-0.72) in intraoperative rupture than in no rupture. CONCLUSIONS: Intraoperative rupture may not decrease PFS when compared with no rupture in patients with early-stage EOC who underwent complete surgical staging operation and adjuvant platinum-based chemotherapy. Furthermore, more adhesion to adjacent tissues and grade 2 or 3 disease, and less mucinous tumor are expected to increase the risk of intraoperative rupture.
BACKGROUND: The impact of intraoperative rupture on prognosis is controversial in early-stage epithelial ovarian cancer (EOC). Thus, we performed a meta-analysis to determine its impact and to evaluate factors to increase its risk. METHODS: We searched PubMed, Embase, and the Cochrane Library till May 2011, and 9 eligible studies including 2382 patients were evaluated. All patients were classified into three groups: no rupture; intraoperative rupture; preoperative involvement. RESULTS: Preoperative involvement decreased progression-free survival when compared with intraoperative rupture (PFS; HR, 1.47; 95% CI, 1.01-2.14), which also showed poorer PFS than no rupture (HR, 2.41; 95% CI, 1.74-3.33). Although preoperative involvement reduced PFS when compared with intraoperative rupture (HR, 2.63; 95% CI, 1.11-6.20), there was no difference in it between intraoperative rupture and no rupture in patients who underwent complete surgical staging operation and adjuvant platinum-based chemotherapy if needed (HR, 1.49; 95% CI, 0.45-4.95). Furthermore, adhesion to adjacent tissues, grade 2 or 3 disease were more common (ORs, 2.01 and 2.47; 95% CIs, 1.20-3.37 and 1.12-5.46), whereas mucinous tumor was less frequent (OR, 0.51; 95% CI, 0.37-0.72) in intraoperative rupture than in no rupture. CONCLUSIONS:Intraoperative rupture may not decrease PFS when compared with no rupture in patients with early-stage EOC who underwent complete surgical staging operation and adjuvant platinum-based chemotherapy. Furthermore, more adhesion to adjacent tissues and grade 2 or 3 disease, and less mucinous tumor are expected to increase the risk of intraoperative rupture.
Authors: W Glenn McCluggage; Meagan J Judge; Blaise A Clarke; Ben Davidson; C Blake Gilks; Harry Hollema; Jonathan A Ledermann; Xavier Matias-Guiu; Yoshiki Mikami; Colin J R Stewart; Russell Vang; Lynn Hirschowitz Journal: Mod Pathol Date: 2015-06-19 Impact factor: 7.842
Authors: Leonardo Gomes da Fonseca; Aloísio Felipe-Silva; Samanta Cabral Severino da Silva; Paulo Francisco Ramos Margarido; Elias Abdo; Paulo Marcelo Gehm Hoff Journal: Autops Case Rep Date: 2014-06-30