Article Text

Download PDFPDF

EPV171/#106 The attributive value of comprehensive surgical staging in clinically early-stage epithelial ovarian carcinoma: a systematic review and meta-analysis
  1. R Van De Vorst1,
  2. J Hoogendam1,
  3. M Van Der Aa2,
  4. P Witteveen3,
  5. C Gerestein1 and
  6. R Zweemer1
  1. 1University Medical Center Utrecht, Imaging and Oncology, Utrecht, Netherlands
  2. 2Netherlands Comprehensive Cancer Organization, Research, Utrecht, Netherlands
  3. 3University Medical Center Utrecht, Medical Oncology, Utrecht, Netherlands


Objectives To quantify tumor positivity and upstaging rates for all staging surgery steps in EOC patients. Differences between subgroups based on their clinical and histological characteristics are explored.

Methods A systematic search using synonyms of ‘ovarian cancer’, ‘neoplasm staging’, and ’neoplasm metastasis’ was conducted in PubMed, Embase, and the Cochrane Library. Meta-analysis was performed on 23 included studies, comprising 5194 clinical stage I or II EOC patients who underwent comprehensive surgical staging. Studies were assessed using the Newcastle-Ottawa Scale risk-of-bias tool. Pooled proportions and 95% confidence intervals were calculated using an inverse variance weighted random-effects model.

Results Overall upstaging rate of clinically early-stage EOC patients was 18.7% (95%CI: 14.1–23.4%). Serous histology or high grade EOC showed the highest upstaging rate at 35.3% (95%CI: 21.8–48.7%) and 40.9% (95%CI: 35.6–46.2%). Lymph node involvement resulted in an upstaging rate of 8.7% (95%CI: 6.2–11.3%). Tumor was identified in uterus, cytology, peritoneal biopsies, omentum and appendix in 6.2% (95%CI: 1.8–10.7%), 18.4% (95%CI: 13.8–22.9%), 9.7% (95%CI: 3.8–15.6%), 5.2% (95%CI: 1.7–8.8%) and 3.6% (95%CI: 0.0–7.5%) of EOC patients. The corresponding upstaging rates were 5.9% (95%CI: 1.4–10.4%), 8.5% (95%CI: 1.8–15.2%), 3.5% (95%CI: 1.0–6.0%), 3.9% (95%CI: 1.4–6.3%) and 1.6% (95%CI: 0.0–3.4%), respectively.

Conclusions The attributive value of comprehensive surgical staging in clinically early-stage EOC patients remains substantial, particularly in serous and high grade tumors.

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.