title: A meta-analysis on the impact of platinum-based adjuvant treatment on the outcome of borderline ovarian tumors with invasive implants.
abstract: BACKGROUND
  Treatment of borderline ovarian tumors (BOTs) remains contentious, and there is no consensus regarding therapy for BOTs with invasive implants (BOTi). The benefits of platinum-based adjuvant treatment were evaluated in patients with BOTi at primary diagnosis.
  
  
  METHODS
  The PubMed database was systematically searched for articles using the following terms: ((borderline) OR (low malignant potential) AND (ovarian)) AND ((tumor) OR (cancer)) AND (invasive implants) AND ((follow-up) OR (survival) OR (treatment) OR (chemotherapy) OR (adjuvant treatment) OR (surgery) OR (surgical treatment)).
  
  
  RESULTS
  We identified 27 articles including 3,124 patients, 181 with invasive implants. All studies provided information regarding mortality or recurrence rates. Central pathological examination was performed in 19 studies. Eight studies included more than 75% stage I patients; 7 included only advanced-stage patients, and 14 included only serous BOT. The pooled recurrence estimates for both treatment groups (adjuvant treatment: 44.0%, upfront surgery: 21.3%) did not differ significantly (p = .114). A meta-analysis of the 6 studies providing separate mortality data for both treatment groups favored surgical treatment only, but this difference did not reach statistical significance (.05 < p < .1; odds ratio: 0.33; 95% confidence interval: 0.09-1.71; p = .086). We were unable to pool the results of the included studies because not all studies registered events in both treatment groups. Egger's regression indicated low asymmetry of the studies (p = .39), and no heterogeneity was found (I(2) = 0%).
  
  
  CONCLUSIONS
  We did not find evidence supporting platinum-based adjuvant therapy for BOT with invasive implants.
authors.affiliation: Department of Gynecology, Campus Virchow, Charité Medical University of Berlin, Berlin, Germany ines.mv@gmail.com.
authors.forename: Ines
authors.initials: I
authors.lastname: Vasconcelos
authors.affiliation: Department of Gynecology, Campus Virchow, Charité Medical University of Berlin, Berlin, Germany.
authors.forename: Jessica
authors.initials: J
authors.lastname: Olschewski
authors.affiliation: Department of Gynecology, Campus Virchow, Charité Medical University of Berlin, Berlin, Germany.
authors.forename: Ioana
authors.initials: I
authors.lastname: Braicu
authors.affiliation: Department of Gynecology, Campus Virchow, Charité Medical University of Berlin, Berlin, Germany.
authors.forename: Jalid
authors.initials: J
authors.lastname: Sehouli
mesh_terms: D017024:Chemotherapy, Adjuvant; D003131:Combined Modality Therapy; D018284:Cystadenocarcinoma, Serous / Q000188:drug therapy* / Q000473:pathology; D004343:Drug Implants / Q000009:adverse effects; D005260:Female; D006801:Humans; D009364:Neoplasm Recurrence, Local / Q000188:drug therapy* / Q000473:pathology; D009367:Neoplasm Staging; D010051:Ovarian Neoplasms / Q000188:drug therapy* / Q000473:pathology; D010984:Platinum / Q000008:administration & dosage; D016896:Treatment Outcome
chemical_list: D004343:Drug Implants; D010984:Platinum
keywords: Adjuvant treatment; Borderline ovarian tumors; Chemotherapy; Implants; Platinum-based treatment