Objectives Favorable survival outcomes for patients with advanced stage epithelial ovarian cancer (ASEOC) is associated with complete cytoreduction. In this meta-analysis we evaluate the therapeutic role of cardiophrenic lymph nodes (CPLNs) resection ASEOC who have undergone cytoreductive surgery.
Methods Embase, Medline, Web of science, Cochrane Library and Google scholar were searched for articles published in English from their inception to November 2020. Meta-analysis was conducted to determine the prognostic impact of surgical outcome, postoperative complications and survival.
Results Fifteen relevant articles, 727 patients with CPLNs adenopathy and 981 patients without CPLNs adenopathy, were analyzed. Higher percentage of ascites, intra and extra abdominal metastases was observed in CPLNs adenopathy group. The mean size of pre-operative CPLNs was 9.1± 3.75mm. Eighty-two percent of enlarged CPLN were histological confirmed. No difference in surgical outcome and perioperative complication was observed between both groups. Meta-analysis showed that patients with CPLNs adenopathy had a significantly increased risk of disease recurrence (OR 4.56, 95% CI 1.98–10.51, P<0.001) and dying from disease (OR 2.96, 95% CI 2.08- 4.22, p<0.001) in comparison to those without CPLNs adenopathy.
Conclusions Patients with CPLNs adenopathy had higher tumor burden intra and extra-abdominally and decreased survival compared to patients without CPLNs adenopathy. There is not enough available data to confirm the therapeutic role of CPLNs resection. Therefore, a randomized controlled trial should be conducted to demonstrate the benefit of CPLNs resection in cytoreductive surgery.
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