Results
A total of 651 studies were initially retrieved from database search.
Fifteen results were duplicates. Through 3 phases of screening, 614
studies were excluded (466 irrelevant studies, 79 review articles, 61
conference abstracts, 6 ineligible study designs, and a single case
study). Eventually, 22 comparative studies (6,825 patients) met our
inclusion criteria and were eligible for pooled analysis. Flowchart of
selection process is demonstrated in figure 1.
Study design and selection criteria of included studies are summarized
in Table S1. Of all studies, 19 were retrospectively conducted (9,
14-31) and three were randomized clinical trials (RCTs) (10, 32, 33).
All studies were published between 1995 and 2019 and included patient
data collected between 1985 and 2019. Sixteen studies investigated women
with advanced disease; 7 studies included patients with FIGO stage III
and IV (9, 18, 20, 22, 24, 26, 27), 4 studies included FIGO stage IIIC
to IV (14-16, 28), 2 study included stages IIIB to IV (19, 33), 2
included stage IIB to IV (10, 25), and 1 study included stage IIIC only
(23). Early stages were addressed by 3 studies (stage I- IIIa (21),
stage I and II (32), and stage I (34)). Three studies include all stage
in their cohort (17, 29, 30). Women who received neoadjuvant
chemotherapy followed by debulking surgery were exclusively selected in
7 studies (9, 14, 15, 19, 20, 28, 34). Assessment of risk of bias is
summarized in Figure S1.