Background/Objectives: This systematic review and meta-analysis evaluates the oncological safety and outcomes of minimally invasive versus open interval debulking surgery after neoadjuvant chemotherapy in advanced ovarian cancer, addressing whether laparoscopy represents a safe alternative to the standard open procedure.Methods: The Ovid/Medline, Pubmed, and Cochrane databases were systematically screened for studies investigating surgical resection status and/or patient survival after laparotomy compared to minimally invasive interval debulking surgery for FIGO stage III-IV ovarian cancer. A meta-analysis was performed using a random-effects model and risk of bias was assessed.Results: Overall, 14 observational and randomized studies published between 2015 and 2024 with a total of 16,578 patients (4310 laparoscopy and 12,268 laparotomy) were included. A complete cytoreduction to no visible tumour was achieved significantly more often after minimally invasive surgery compared to laparotomy (RR = 1.12; 95% CI [1.01, 1.23];p= 0.03). Overall survival showed no significant difference between the two groups (HR = 0.81; 95%CI [0.64, 1.04]); progression-free survival was significantly more common after laparoscopy (HR = 0.67; 95% CI [0.48, 0.94];p= 0.02; I2= 55%;p= 0.07). Patients undergoing minimally invasive surgery experienced significantly fewer postoperative complications (RR = 0.50; 95% CI [0.33, 0.76];p≤ 0.001), a lower mean blood loss (165 mL vs. 325 mL; SMD −0.58, 95% CI [−0.82, −0.35];p≤ 0.001), a shorter mean hospital stay (3 days vs. 5 days; SMD −0.79, 95% CI [−1.06, −0.52],p≤ 0.001), and a faster initiation of adjuvant chemotherapy (mean 25 ± 32 days vs. 33 ± 28 days).Conclusions: This study indicates that laparoscopic interval debulking surgery is an oncologically safe alternative in selected patients with advanced-stage ovarian cancer. However, randomized controlled trials should confirm these findings as certainty of evidence is low and residual confounding cannot be excluded.Trial registration:PROSPERO Identifier CRD42024524725.
**背景/目的：** 本系统综述与荟萃分析旨在评估晚期卵巢癌新辅助化疗后，微创与开腹间歇性肿瘤细胞减灭术的肿瘤学安全性与结局，探讨腹腔镜手术是否可作为标准开腹手术的安全替代方案。 **方法：** 系统检索了Ovid/Medline、Pubmed和Cochrane数据库中，比较开腹手术与微创间歇性肿瘤细胞减灭术对FIGO III-IV期卵巢癌患者手术切除状态和/或生存情况的研究。采用随机效应模型进行荟萃分析，并评估偏倚风险。 **结果：** 共纳入2015年至2024年间发表的14项观察性和随机研究，总计16,578例患者（腹腔镜组4,310例，开腹组12,268例）。与开腹手术相比，微创手术实现肉眼无残留肿瘤的完全肿瘤细胞减灭术的比例显著更高（RR = 1.12；95% CI [1.01, 1.23]；p = 0.03）。两组间总生存期无显著差异（HR = 0.81；95% CI [0.64, 1.04]）；腹腔镜组的无进展生存期显著更优（HR = 0.67；95% CI [0.48, 0.94]；p = 0.02；I² = 55%；p = 0.07）。接受微创手术的患者术后并发症显著更少（RR = 0.50；95% CI [0.33, 0.76]；p ≤ 0.001），平均失血量更低（165 mL vs. 325 mL；SMD −0.58，95% CI [−0.82, −0.35]；p ≤ 0.001），平均住院时间更短（3天 vs. 5天；SMD −0.79，95% CI [−1.06, −0.52]，p ≤ 0.001），且辅助化疗开始时间更快（平均 25 ± 32 天 vs. 33 ± 28 天）。 **结论：** 本研究表明，对于经过选择的晚期卵巢癌患者，腹腔镜间歇性肿瘤细胞减灭术是一种肿瘤学上安全的替代方案。然而，由于证据确定性较低且不能排除残留混杂因素，这些发现尚需随机对照试验加以证实。 **试验注册：** PROSPERO标识符 CRD42024524725。
肿瘤(癌症)患者之家