Pubblicazioni

Autori:

Zorzato, Pier Carlo; Uccella, Stefano; Biancotto, Giulia; Bosco, Mariachiara; Festi, Anna; Franchi, Massimo; Garzon, Simone

Titolo:

Intrauterine manipulator during hysterectomy for endometrial cancer: a systematic review and meta-analysis of oncologic outcomes

Anno:

2024

Tipologia prodotto:

Articolo in Rivista

Tipologia ANVUR:

Articolo su rivista

Lingua:

Inglese

Formato:

Elettronico

Referee:

No

Nome rivista:

American Journal of Obstetrics and Gynecology

ISSN Rivista:

0002-9378

N° Volume:

230

Numero o Fascicolo:

2

Intervallo pagine:

185-198

Parole chiave:

Endometrial Neoplasms; Hysterectomy; Intrauterine manipulator; Lymphovascular space invasion; Overall survival; Peritoneal cytology; Recurrence-free survival

Breve descrizione dei contenuti:

Objective: To assess the effects on oncological outcomes of intrauterine manipulator use during laparoscopic hysterectomy for endometrial cancer. Data sources: A systematic literature search was performed by an expert librarian in multiple electronic databases from inception to January 31, 2023. Study eligibility criteria: We included all studies in the English language that compared oncologic outcomes (recurrence-free, cause-specific, or overall survival) between endometrial cancer patients who underwent total laparoscopic or robotic hysterectomy for endometrial cancer with versus without the use of an intrauterine manipulator. Studies comparing only peritoneal cytology status or lymphovascular space invasion were summarized for completeness. No selection criteria were applied to the study design. Study appraisal and synthesis methods: Four reviewers independently reviewed studies for inclusion, assessed their risk of bias, and extracted data. Pooled hazard ratios (HRs) with 95% confidence intervals (CIs) were estimated for oncologic outcomes using the random effect model. Heterogeneity was quantified using the I2 tests. Publication bias was assessed by Funnel plot and Egger's test. Results: Out of 350 identified references, we included two randomized controlled trials and twelve observational studies for a total of 14 studies and 5,019 patients. The use of an intrauterine manipulator during hysterectomy for endometrial cancer was associated with a pooled HR for recurrence of 1.52 (95% CI: 0.99 - 2.33; p = 0.05; I2 = 31%; Chiˆ2 p-value = 0.22). Pooled HR for recurrence was 1.48 (95% CI: 0.25 - 8.76; p = 0.62; I2 = 67%; Chiˆ2 p-value = 0.08) when only randomized controlled trials were considered. Pooled HR for overall survival was 1.07 (95% CI: 0.65 - 1.76; p = 0.79; I2 = 44%; Chiˆ2 p-value = 0.17). The rate of positive peritoneal cytology or lymphovascular space invasion did not differ using an intrauterine manipulator. Conclusions: The intrauterine manipulator use during hysterectomy for endometrial cancer was not significantly associated with recurrence-free and overall survival nor with positive peritoneal cytology or lymphovascular space invasion, but further prospective studies are needed. Systematic review registration: PROSPERO: CRD42022310042.

Id prodotto:

135301

Handle IRIS:

11562/1106026

ultima modifica:

22 gennaio 2025

Citazione bibliografica:

Zorzato, Pier Carlo; Uccella, Stefano; Biancotto, Giulia; Bosco, Mariachiara; Festi, Anna; Franchi, Massimo; Garzon, Simone, Intrauterine manipulator during hysterectomy for endometrial cancer: a systematic review and meta-analysis of oncologic outcomes «American Journal of Obstetrics and Gynecology» , vol. 230 , n. 2 , 2024 , pp. 185-198

Consulta la scheda completa presente nel repository istituzionale della Ricerca di Ateneo