Laparoscopy versus laparotomy for FIGO stage 1 ovarian cancer (Review)

Background This is an updated version of the original review that was first published in the Cochrane Database of Systematic Reviews 2008, Issue 4. Laparoscopy has become an increasingly common approach to surgical staging of apparent early-stage ovarian tumours. This review was undertaken to assess the available evidence on the benefits and risks of laparoscopy compared with laparotomy for the management of International Federation of Gynaecology and Obstetrics (FIGO) stage I ovarian cancer. Objectives To evaluate the benefits and risks of laparoscopy compared with laparotomy for the surgical treatment of FIGO stage I ovarian cancer (stages Ia, Ib and Ic). Search methods For the original review, we searched the Cochrane Gynaecological Cancer Group Trials (CGCRG) Register, Cochrane Central Register of Controlled Trials (CENTRAL 2007, Issue 2), MEDLINE, EMBASE, LILACS, Biological Abstracts and CancerLit from 1 January 1990 to 30 November 2007. We also handsearched relevant journals, reference lists of identified studies and conference abstracts. For this updated review, we extended the CGCRG Specialised Register, CENTRAL, MEDLINE, EMBASE and LILACS searches to 6 December 2011. Selection criteria Randomised controlled trials (RCTs), quasi-RCTs and prospective cohort studies comparing laparoscopic staging with open surgery (laparotomy) in women with stage I ovarian cancer according to FIGO. Data collection and analysis There were no studies to include, therefore we tabulated data from non-randomised studies (NRS) for discussion. Main results We performed no meta-analyses. Authors’ conclusions This review has found no good-quality evidence to help quantify the risks and benefits of laparoscopy for the management of earlystage ovarian cancer as routine clinical practice

Laparoscopy versus laparotomy for FIGO stage 1 ovarian cancer (Review)

Background Over the past ten years laparoscopy has become an increasingly common approach for the surgical removal of early stage ovarian tumours. There remains uncertainty about the value of this intervention. This review has been undertaken to assess the available evidence of the benefits and harms of laparoscopic surgery for the management of early stage ovarian cancer compared to laparotomy. Objectives To evaluate the benefits and harms of laparoscopy in the surgical treatment of FIGO stage I ovarian cancer (stages Ia, Ib and Ic) when compared with laparotomy. Search methods Trials were identified by searching the Cochrane Gynaecological Cancer Group Trials Register, Cochrane Central Register of Controlled Trials (CENTRAL),TheCochrane Library Issue 2, 2007,MEDLINE (January 1990 toNovember 2007), EMBASE (1990 toNovember 2007), LILACS (1990 toNovember 2007), BIOLOGICALABSTRACTS (1990 toNovember 2007) andCancerlit (1990 toNovember 2007). We also searched our own publication archives, based on prospective handsearching of relevant journals from November 2007. Reference lists of identified studies, gynaecological cancer handbooks and conference abstract were also scanned. Selection criteria Studies including patients with histologically proven stage I ovarian cancer according to the International Federation of Gynaecology and Obstetrics (FIGO). Studies comparing laparoscopic surgery with laparotomy for early stage ovarian cancer were only available from1990. It was anticipated that a very small number of randomised controlled trials (RCTs) were conducted studying themanagement of early stage ovarian cancer. Therefore, non-randomised comparative studies, cohort studies and case-controls studies, but not studies with historical controls, were also considered. Data collection and analysis Data extraction was performed independently by five review authors (LRM, DDR, MIR, MCB and MIE) who assessed study quality and quality of extracted data. Extracted data included trial characteristics, characteristics of the study participants, interventions and outcomes. The quality of non RCTs was assessed using appropriate quality evaluations tools from the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) and from the Newcastle-Ottawa tool for observational studies (NOS). Main results No RCTs were identified. Three observational studies were identified. Authors’ conclusions This review has found no evidence to help quantify the value of laparoscopy for the management of early stage ovarian cancer as routine clinical practice

Transmissão vertical do papilomavírus humano : uma revisão sistemática quantitativa

Para entendimento do modo exato de transmissão vertical e de seu risco em gestantes assintomáticas, bem como a relação entre a transmissão de HPV e o tipo de parto, foi proposta uma revisão sistemática quantitativa de coortes prospectivas. Foi realizada uma busca na Biblioteca Cochrane,MEDLINE, LILACS, CANCERLIT e EMBASE e nas referências dos estudos identificados. Nove estudos, que contaram com 2.111 gestantes e 2.113 recém-nascidos, foram incluídos de acordo com critério de seleção e foram analisados. O teste positivo para HPV na mãe aumentou o risco de transmissão vertical para HPV, com risco relativo (RR = 4,8; IC95%: 2,2-10,4). Foi observado um maior risco de infecção por HPV após parto vaginal (RR = 1,8; IC95%: 1,3-2,4). Os resultados dessa metanálise mostraram uma taxa de positividade para o DNA do HPV somente após o nascimento, porém a taxa de positividade para DNA do HPV em amostras de recém-nascidos não indica infecção; pode indicar apenas contaminação. Concluiuse que a transmissão perinatal de HPV pode ocorrer e, após parto vaginal, os recém nascidos têm risco maior para exposição ao vírus.In order to better understand the exact mode and risk of vertical transmission in asymptomatic pregnant women, as well as the relationship between HPV transmission and mode of delivery,we have proposed this systematic quantitative review of prospective cohort studies. A comprehensive search was performed in the Cochrane Library,MEDLINE, LILACS, CANCERLIT, and EMBASE, as well as in the reference lists from the identified studies. Nine primary studies, which included 2,111 pregnant women and 2,113 newborns, met our selection criteria and were analyzed. A positive HPV test in the mother increased the risk of vertical HPV transmission (RR: 4.8; 95%CI: 2.2-10.4).We also observed a higher risk of HPV infection after vaginal delivery than after cesarean section (RR: 1.8; 95%CI: 1.3-2.4). The results of this meta-analysis showed the HPV DNA-positive rate only after birth, but an HPV DNA-positive neonatal sample does not necessarily indicate infection; it could merely indicate contamination (perinatal HPV contamination may have occurred). Infants born through vaginal delivery were at higher risk of exposure to HPV

Transmissão vertical do papilomavírus humano : uma revisão sistemática quantitativa

Para entendimento do modo exato de transmissão vertical e de seu risco em gestantes assintomáticas, bem como a relação entre a transmissão de HPV e o tipo de parto, foi proposta uma revisão sistemática quantitativa de coortes prospectivas. Foi realizada uma busca na Biblioteca Cochrane,MEDLINE, LILACS, CANCERLIT e EMBASE e nas referências dos estudos identificados. Nove estudos, que contaram com 2.111 gestantes e 2.113 recém-nascidos, foram incluídos de acordo com critério de seleção e foram analisados. O teste positivo para HPV na mãe aumentou o risco de transmissão vertical para HPV, com risco relativo (RR = 4,8; IC95%: 2,2-10,4). Foi observado um maior risco de infecção por HPV após parto vaginal (RR = 1,8; IC95%: 1,3-2,4). Os resultados dessa metanálise mostraram uma taxa de positividade para o DNA do HPV somente após o nascimento, porém a taxa de positividade para DNA do HPV em amostras de recém-nascidos não indica infecção; pode indicar apenas contaminação. Concluiuse que a transmissão perinatal de HPV pode ocorrer e, após parto vaginal, os recém nascidos têm risco maior para exposição ao vírus.In order to better understand the exact mode and risk of vertical transmission in asymptomatic pregnant women, as well as the relationship between HPV transmission and mode of delivery,we have proposed this systematic quantitative review of prospective cohort studies. A comprehensive search was performed in the Cochrane Library,MEDLINE, LILACS, CANCERLIT, and EMBASE, as well as in the reference lists from the identified studies. Nine primary studies, which included 2,111 pregnant women and 2,113 newborns, met our selection criteria and were analyzed. A positive HPV test in the mother increased the risk of vertical HPV transmission (RR: 4.8; 95%CI: 2.2-10.4).We also observed a higher risk of HPV infection after vaginal delivery than after cesarean section (RR: 1.8; 95%CI: 1.3-2.4). The results of this meta-analysis showed the HPV DNA-positive rate only after birth, but an HPV DNA-positive neonatal sample does not necessarily indicate infection; it could merely indicate contamination (perinatal HPV contamination may have occurred). Infants born through vaginal delivery were at higher risk of exposure to HPV

Laparoscopy versus laparotomy for FIGO stage 1 ovarian cancer (Protocol)

This is the protocol for a review and there is no abstract. The objectives are as follows: The objective of this review will be to evaluate the impact of laparoscopy in the surgical treatment for FIGO stage I ovarian cancer (stages Ia,Ib, Ic) when compared with laparotomy. The following issues will be addressed in this review: (1) Is laparoscopy (intervention group) effective in improving overall survival compared with laparotomy (control group) in patients with FIGO Stage I ovarian cancer? (2) Is laparoscopy (intervention group) effective in reducing progression-free survival compared with laparotomy (control group) in patients with FIGO Stage I ovarian cancer? (3) Does primary laparoscopy result in less surgical complications than laparotomy (control group) in patients with FIGO Stage I ovarian cancer? (4) Does primary laparoscopy (intervention group) result in more local recurrence (port site) than laparotomy (control group) in midline incision in patients with FIGO Stage I ovarian cancer? (5) Does primary laparoscopy (intervention group) result in more distant recurrence than laparotomy (control group) in patients with FIGO Stage I ovarian cancer? (6) Does primary laparoscopy (intervention group) result more tumour spillage at the time of surgery than laparotomy (control group) in patients with FIGO Stage I ovarian cancer

Laparoscopy versus laparotomy for FIGO stage 1 ovarian cancer (Review)

Background Over the past ten years laparoscopy has become an increasingly common approach for the surgical removal of early stage ovarian tumours. There remains uncertainty about the value of this intervention. This review has been undertaken to assess the available evidence of the benefits and harms of laparoscopic surgery for the management of early stage ovarian cancer compared to laparotomy. Objectives To evaluate the benefits and harms of laparoscopy in the surgical treatment of FIGO stage I ovarian cancer (stages Ia, Ib and Ic) when compared with laparotomy. Search methods Trials were identified by searching the Cochrane Gynaecological Cancer Group Trials Register, Cochrane Central Register of Controlled Trials (CENTRAL),TheCochrane Library Issue 2, 2007,MEDLINE (January 1990 toNovember 2007), EMBASE (1990 toNovember 2007), LILACS (1990 toNovember 2007), BIOLOGICALABSTRACTS (1990 toNovember 2007) andCancerlit (1990 toNovember 2007). We also searched our own publication archives, based on prospective handsearching of relevant journals from November 2007. Reference lists of identified studies, gynaecological cancer handbooks and conference abstract were also scanned. Selection criteria Studies including patients with histologically proven stage I ovarian cancer according to the International Federation of Gynaecology and Obstetrics (FIGO). Studies comparing laparoscopic surgery with laparotomy for early stage ovarian cancer were only available from1990. It was anticipated that a very small number of randomised controlled trials (RCTs) were conducted studying themanagement of early stage ovarian cancer. Therefore, non-randomised comparative studies, cohort studies and case-controls studies, but not studies with historical controls, were also considered. Data collection and analysis Data extraction was performed independently by five review authors (LRM, DDR, MIR, MCB and MIE) who assessed study quality and quality of extracted data. Extracted data included trial characteristics, characteristics of the study participants, interventions and outcomes. The quality of non RCTs was assessed using appropriate quality evaluations tools from the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) and from the Newcastle-Ottawa tool for observational studies (NOS). Main results No RCTs were identified. Three observational studies were identified. Authors’ conclusions This review has found no evidence to help quantify the value of laparoscopy for the management of early stage ovarian cancer as routine clinical practice