What have we learnt from meta-analyses in ovarian cancer?
BACKGROUND
Meta-analyses aim to provide an overview of certain key questions such as optimal chemotherapy, dose-response relationships, and factors predicting long-term survival.


METHODS
A review was done of recently published meta-analyses trying to answer the above questions.


RESULTS
Two studies suggest that platinum containing combination chemotherapy is superior with regard to survival. Both show the limitation of all meta-analyses with variations in terms of follow-up and in trial details, and the conclusions must be regarded as tentative. Prospective studies which have attempted to confirm the importance of cisplatin dose-intensity (as opposed to total dose) have actually failed to do so. Two meta-analyses found a strong correlation between surgical complete response and survival. In a Dutch long-term follow-up study of about 400 cases cisplatin combination, pathologically documented complete remission, optimal debulking, and grade all were associated with a significant survival benefit. The results of other analyses, suggesting that the treatment centre involved, and adherence to study protocols, are independent prognostic factors are particularly provocative.


CONCLUSIONS
Recognizing their limitations, meta-analyses are intended to stimulate ideas for future trials and as such have a positive impact.
Kaye
S B
SB
CRC Department of Medical Oncology, Beatson Oncology Centre, Western Infirmary, Glasgow, UK.
van Houwelingen
H C
HC
D002986:Clinical Trials as Topic; D005260:Female; D006801:Humans; D015201:Meta-Analysis as Topic; D010051:Ovarian Neoplasms / Q000188:drug therapy* / Q000401:mortality*; D011379:Prognosis; D011446:Prospective Studies