Secondary cytoreductive surgery is a treatment option for relapsed platinum-sensitive epithelial ovarian cancer, but no clear indications are defined for the procedure. This systematic review aims to establish clear indications and compare outcomes versus standard-of-care chemotherapy. We conducted an electronic literature search across three databases and identified 2033 articles, including three phase 3 randomized controlled trials (RCT). The review adhered to PRISMA 2020 guidelines and was registered in PROSPERO (no. CRD42022379817). Despite varying patient selection methods, surgery plus chemotherapy demonstrated significantly prolonged progression-free survival compared to chemotherapy alone. However, overall survival outcomes were inconsistent: while GOG-0213 did not show extended overall survival, recent studies with stricter defined criteria for surgery (SOC-1 and DESKTOP-III) reported improved overall survival with the addition of surgery. Morbidity and mortality rates were low, with no difference in quality of life between the surgery and no-surgery groups. In conclusion, cytoreductive surgery presents a promising option for recurrent epithelial ovarian cancer treatment. Nonetheless, well-defined selection criteria appear crucial for achieving increased overall survival compared to conventional treatment.
二次肿瘤细胞减灭术是治疗复发性铂敏感上皮性卵巢癌的一种选择，但目前该手术尚无明确的适应症界定。本系统性综述旨在明确手术适应症，并比较其与标准化疗方案的疗效差异。我们通过三个数据库进行电子文献检索，共纳入2033篇文献，其中包括三项III期随机对照试验。本综述遵循PRISMA 2020指南，并在PROSPERO平台注册（编号CRD42022379817）。尽管患者选择方法存在差异，但手术联合化疗组相较于单纯化疗组显示出显著延长的无进展生存期。然而总生存期结果存在不一致性：GOG-0213研究未显示手术能延长总生存期，而采用更严格手术筛选标准的最新研究（SOC-1和DESKTOP-III）表明手术联合化疗可改善总生存期。手术相关并发症发生率和死亡率较低，且手术组与非手术组的生活质量无显著差异。综上所述，肿瘤细胞减灭术为复发性上皮性卵巢癌的治疗提供了新选择。但与传统治疗相比，制定明确的手术筛选标准对提高患者总生存期至关重要。
肿瘤(癌症)患者之家