Objective To systematically evaluate the efficiency of fertility-sparing surgery (FSS) compared with radical comprehensive surgery (RCS) in early stage epithelial ovarian cancer (eEOC). Methods We searched databases including PubMed, EMbase, The Cochrane Library (Issue 8, 2016), Web of Knowledge, CBM, WanFang Data and CNKI to collect the studies about FSS compared with RCS for eEOC from ineaption to August 10th, 2016. Two reviewers independently evaluated the eligibility of identified studies and extracted the data. Then, meta-analysis was performed using Stata 12.0 software. Results Eight studies involving 2 561 patients were included. The results of meta-analysis showed that: compared with RCS, the aggregated RR of overall survival (OS) of FSS (univariate analysis: RR=1.03, 95%CI 0.98 to 1.07,P=0.815; multivariate analysis: RR=0.81, 95%CI 0.52 to 1.28,P=0.255), the cumulative disease free survival (DFS) of FSS (univariate analysis: RR=1.02, 95%CI 0.96 to 1.09,P=0.968; multivariate analysis: RR=1.24, 95%CI 0.65 to 2.39,P=0.115) and the recurrence of FSS (RR=0.86, 95%CI 0.57 to 1.30,P=0.902), there was no significant difference. This pattern also emerged in the subgroup analysis for FIGO IA and IC patients, and the results showed that there was no significant difference between FSS and RCS in IA patients (OS: RR=0.99, 95%CI 0.98 to 1.02,P=0.186; DFS: RR=1.01, 95%CI 0.95 to 1.06,P=0.541); and IC patients (OS: RR=0.95, 95%CI 0.86 to 1.04,P=0.251; DFS: RR=0.94, 95%CI 0.80 to 1.11,P=0.664). Conclusion In eEOC, FSS does not have a negative effect on oncological outcomes compared with RCS. However, well-designed and large-scale trials are needed to verify this outcome in the future.
