Objective: To evaluate the role of systematic lymphadenectomy in low-grade serous ovarian cancer (LGSOC) and determine its impact on clinical outcomes in overall survival (OS) and disease-free survival (DFS) terms. Methods: A comprehensive, systematic computer literature search on PubMed was performed using the following Medical Subject Headings (MeSH) terms: “low grade serous ovarian cancer” AND/OR “lymphadenectomy” AND/OR “staging” AND/OR “ovarian cancer” AND/OR “cytoreduction”. Separate searches were performed with MeSH terms on MEDLINE and EMBASE to extract all the relevant literature available. We included only patients with histologically confirmed LGSOC. Results: Three studies were considered in the quantitative analysis. Systematic lymphadenectomy in LGSOC failed to provide a significant OS or PFS benefit in LGSOC when compared to no lymphadenectomy in the entire (all the stages) population (for OS: HR = 1.15, 95% CI [0.42, 3.18] I2 = 84% and for PFS: HR = 1.46, 95% CI [0.63, 3.41], I2 = 71%), nor did it in the subtype analysis regarding FIGO stages. For FIGO early-stage I-II LGSOC, the DFS data were pooled (HR = 1.48, 95% CI [0.58, 3.78], I2 = 75%). In patients with advanced-stage (FIGO II–IV), we also failed to prove survival benefit for lymphadenectomy in OS (HR = 1.74, 95% CI [0.87, 3.48], I2 = 11%) or DFS (HR = 1.48, 95% CI [0.58, 3.78], I2 = 75%) compared to no lymphadenectomy. Conclusion: More extensive prospective research is mandatory to understand the real impact of lymphadenectomy on survival in LGSOC. The existing literature does not provide strong evidence.
目的：评估系统性淋巴结切除术在低级别浆液性卵巢癌（LGSOC）中的作用，并确定其对总生存期（OS）和无病生存期（DFS）的临床影响。方法：在PubMed数据库中使用以下医学主题词（MeSH）进行系统性计算机文献检索：“低级别浆液性卵巢癌”和/或“淋巴结切除术”和/或“分期”和/或“卵巢癌”和/或“肿瘤细胞减灭术”。同时在MEDLINE和EMBASE数据库中使用MeSH词进行独立检索，以提取所有相关文献。仅纳入经组织学确诊的LGSOC患者。结果：定量分析共纳入三项研究。在全体（所有分期）LGSOC患者中，与未行淋巴结切除术相比，系统性淋巴结切除术未能显著改善OS或PFS（OS：HR=1.15，95% CI [0.42, 3.18]，I2=84%；PFS：HR=1.46，95% CI [0.63, 3.41]，I2=71%）。针对FIGO分期的亚组分析也未显示生存获益。在FIGO I-II期早期LGSOC患者中，合并DFS数据显示无显著差异（HR=1.48，95% CI [0.58, 3.78]，I2=75%）。在晚期（FIGO II-IV期）患者中，与未行淋巴结切除术相比，淋巴结切除术同样未显示出OS（HR=1.74，95% CI [0.87, 3.48]，I2=11%）或DFS（HR=1.48，95% CI [0.58, 3.78]，I2=75%）的生存获益。结论：需要更广泛的前瞻性研究以明确淋巴结切除术对LGSOC患者生存的真实影响。现有文献未能提供有力证据。
肿瘤(癌症)患者之家