Background Quality of life after ovarian cancer treatment is an important goal for patients. Complex debulking surgeries and platinum based chemotherapy are often required but quality of life after surgery is rarely reported.
Objectives To describe quality of life outcomes after surgery for advanced ovarian cancer in a systematic review and meta-analysis.
Search strategy MEDLINE, EMBASE, and CENTRAL through March 2019 with no language restrictions.
Selection criteria Included studies reported quality of life in women diagnosed with primary advanced ovarian cancer, fallopian tube carcinoma or primary peritoneal cancer undergoing cytoreduction surgery.
Data collection and analysis Data on extent and timing of surgery, quality of life outcomes, and surgical complications were extracted and study quality assessed.
Results Three randomized controlled trials comparing primary surgery to neoadjuvant chemotherapy had heterogeneous quality of life outcomes with no difference between arms, although there was a clinical improvement in global quality of life scores in both arms at 6 months compared with baseline. Data from two observational studies showed no meaningful difference in quality of life scores between patients undergoing standard or extensive surgery at 6 months.
Conclusions There was no clinically important difference in the quality of life of patients undergoing either primary debulking surgery or neoadjuvant chemotherapy. There is insufficient evidence on quality of life outcomes of patients undergoing extensive or ultra-radical surgery compared with those undergoing less extensive surgery. Quality of life outcomes matter to patients, but there is little evidence to inform patient choice regarding the extent of surgery.
- ovarian cancer
- quality of life
- extensive surgery
- ultra-radical surgery
- debulking surgery
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Contributors SK, JL, SS and CC conceived the study. SK wrote the first draft. JL contributed as a second reviewer. SS and CC supervised the protocol and systematic review process. SK edited the final manuscript and all authors read and approved the final manuscript.
Funding This study protocol and systematic review is supported and funded by the National Institute for Health and Care Excellence (NICE), Birmingham and Brunel External Assessment Centre, University of Birmingham, Edgbaston, Birmingham. The views expressed are those of the authors and are not necessarily those of NICE or the University of Birmingham.
Competing interests The authors (SK, JL, SK and SS) declare that they have no competing interests. CC reports grants from the National Institute for Health and Care Excellence. SK reports other payments for lectures from Roche, others from Astra Zeneca, outside the submitted work.
Patient consent for publication Not required.
Provenance and peer review Not commissioned; externally peer reviewed.
Data availability statement Data are available in a public, open access repository. All data relevant to the study are included in the article or uploaded as supplementary information.