Does neoadjuvant chemotherapy increase optimal cytoreduction rate in advanced ovarian cancer? Meta-analysis of 21 studies.
BACKGROUND
The purpose of the current study is to analyze the existing data regarding neoadjuvant chemotherapy (NAC) in advanced epithelial ovarian cancer (EOC) using a random-effects model and to determine whether NAC can improve the rate of optimal cytoreduction.


METHODS
Between 1989 and 2008, data of 21 studies were retrieved via a MEDLINE search. Meta-regression analysis based on a random-effects model was performed to assess the prognostic value of clinical variables.


RESULTS
The patients who received NAC had a lower risk of suboptimal cytoreduction than the patients with favorable conditions (pooled odds ratio, 0.50; 95% confidence interval, 0.29-0.86; P = 0.012 with DerSimonian-Laird model). Meta-regression analysis revealed that heterogeneity in year of publication, taxane use, and optimal cytoreduction rate influenced median overall survival significantly (P = 0.002, P = 0.007, and P = 0.012, respectively). However, the between-studies variation of the number of NAC cycles did not influence survival (P = 0.701).


CONCLUSIONS
The current meta-analysis showed that NAC helped the gynecologic oncologist achieve an increased rate of optimal cytoreduction.
Kang
Sokbom
S
Branch of Uterine Cancer, Research Institute and Hospital, National Cancer Center, Goyang, South Korea. sokbom@ncc.re.kr
Nam
Byung-Ho
BH
D000368:Aged; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D009375:Neoplasms, Glandular and Epithelial / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery; D010051:Ovarian Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery
D000970:Antineoplastic Agents