Quality of life outcomes following surgery for advanced ovarian cancer: a systematic review and meta-analysis

Abstract

Background Quality of life after ovarian cancer treatment is an important goal for patients. Complex debulking surgeries and platinum based chemotherapy are often required but quality of life after surgery is rarely reported. Objectives To describe quality of life outcomes after surgery for advanced ovarian cancer in a systematic review and meta-analysis. Search strategy MEDLINE, EMBASE, and CENTRAL through March 2019 with no language restrictions. Selection criteria Included studies reported quality of life in women diagnosed with primary advanced ovarian cancer, fallopian tube carcinoma or primary peritoneal cancer undergoing cytoreduction surgery. Data collection and analysis Data on extent and timing of surgery, quality of life outcomes, and surgical complications were extracted and study quality assessed. Results Three randomized controlled trials comparing primary surgery to neoadjuvant chemotherapy had heterogeneous quality of life outcomes with no difference between arms, although there was a clinical improvement in global quality of life scores in both arms at 6 months compared with baseline. Data from two observational studies showed no meaningful difference in quality of life scores between patients undergoing standard or extensive surgery at 6 months. Conclusions There was no clinically important difference in the quality of life of patients undergoing either primary debulking surgery or neoadjuvant chemotherapy. There is insufficient evidence on quality of life outcomes of patients undergoing extensive or ultra-radical surgery compared with those undergoing less extensive surgery. Quality of life outcomes matter to patients, but there is little evidence to inform patient choice regarding the extent of surgery.