{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,18]],"date-time":"2026-05-18T04:19:08Z","timestamp":1779077948958,"version":"3.51.4"},"reference-count":39,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2025,1,15]],"date-time":"2025-01-15T00:00:00Z","timestamp":1736899200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Intl J Gynecology &amp; Obste"],"published-print":{"date-parts":[[2025,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Management of recurrent endometrial carcinoma (EC) represents a challenge. Although a complete resection of visible disease at secondary surgery (R0) is recommended, the impact of R0 on survival outcomes is unclear and pooled data are lacking.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective<\/jats:title><jats:p>To quantitatively assess the impact of R0 on survival outcomes in women with EC recurrence.<\/jats:p><\/jats:sec><jats:sec><jats:title>Search Strategy<\/jats:title><jats:p>A systematic review and meta\u2010analysis was performed searching eight electronic databases from their inception up to January 2024.<\/jats:p><\/jats:sec><jats:sec><jats:title>Selection Criteria<\/jats:title><jats:p>All peer\u2010reviewed studies that assessed quantitatively the impact of R0 on survival outcomes in women at first EC recurrence were included.<\/jats:p><\/jats:sec><jats:sec><jats:title>Data Collection and Analysis<\/jats:title><jats:p>Hazard ratio (HR) with 95% confidence interval (CI) for death of any cause and secondary recurrent or progressive disease in women with EC recurrence who underwent R0 compared to non\u2010optimal secondary surgical cytoreduction (R1) were pooled and assessed at both univariable and multivariable analyses.<\/jats:p><\/jats:sec><jats:sec><jats:title>Main Results<\/jats:title><jats:p>Three studies with 442 patients were included. At univariate analysis, in women with EC recurrence and R0 compared to women with EC recurrence and R1, pooled HR was 0.451 (95% CI: 0.319\u20130.638) for death from any cause, and 0.517 (95% CI: 0.298\u20130.895; <jats:italic>p<\/jats:italic>\u2009=\u20090.019) for recurrent or progressive disease.<\/jats:p><jats:p>At multivariate analysis, in women with EC recurrence and R0 compared to women with EC recurrence and R1, pooled HR was 0.447 (95% CI: 0.255\u20130.783; <jats:italic>p<\/jats:italic>\u2009=\u20090.005) for death from any cause, and 0.585 (95% CI: 0.359\u20130.952; <jats:italic>p<\/jats:italic>\u2009=\u20090.031) for recurrent or progressive disease.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>In women with EC recurrence, R0 is an independent prognostic factor, decreasing the risk of death from any cause by approximatively 55%, and of recurrent or progressive disease by approximatively 40%, compared to R1.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ijgo.16146","type":"journal-article","created":{"date-parts":[[2025,1,15]],"date-time":"2025-01-15T11:17:17Z","timestamp":1736939837000},"page":"119-129","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Impact of optimal secondary cytoreductive surgery on survival outcomes in women with recurrent endometrial carcinoma: A systematic review and meta\u2010analysis"],"prefix":"10.1002","volume":"170","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5443-2333","authenticated-orcid":false,"given":"Antonio","family":"Raffone","sequence":"first","affiliation":[{"name":"Department of Woman, Child and General and Specialized Surgery University of Campania \"Luigi Vanvitelli\"  Naples Italy"},{"name":"Department of Medical and Surgical Sciences (DIMEC) University of Bologna  Bologna Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0644-0301","authenticated-orcid":false,"given":"Giulia","family":"Pellecchia","sequence":"additional","affiliation":[{"name":"Department of Medicine University of Udine  Udine Italy"},{"name":"Clinic of Obstetrics and Gynecology \"Santa Maria Della Misericordia\" University Hospital Azienda Sanitaria\u00a0Universitaria Friuli Centrale  Udine Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sara","family":"Pregnolato","sequence":"additional","affiliation":[{"name":"Department of Medicine University of Udine  Udine Italy"},{"name":"Clinic of Obstetrics and Gynecology \"Santa Maria Della Misericordia\" University Hospital Azienda Sanitaria\u00a0Universitaria Friuli Centrale  Udine Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3235-4378","authenticated-orcid":false,"given":"Diego","family":"Raimondo","sequence":"additional","affiliation":[{"name":"Division of Gynecology and Human Reproduction Physiopathology IRCCS Azienda Ospedaliero\u2010Universitaria di Bologna  Bologna Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4002-1618","authenticated-orcid":false,"given":"Antonio","family":"Travaglino","sequence":"additional","affiliation":[{"name":"Pathology Unit, Department of Medicine and Technological Innovation University of Insubria  Varese Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6723-0415","authenticated-orcid":false,"given":"Daniele","family":"Neola","sequence":"additional","affiliation":[{"name":"Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine University of Naples Federico II  Naples Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1896-9410","authenticated-orcid":false,"given":"Lorenza","family":"Driul","sequence":"additional","affiliation":[{"name":"Department of Medicine University of Udine  Udine Italy"},{"name":"Clinic of Obstetrics and Gynecology \"Santa Maria Della Misericordia\" University Hospital Azienda Sanitaria\u00a0Universitaria Friuli Centrale  Udine Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5911-8255","authenticated-orcid":false,"given":"Giovanni","family":"Scambia","sequence":"additional","affiliation":[{"name":"Gynecologic Oncology Unit, Department of Woman and Child Health and Public Health Fondazione Policlinico Universitario A. 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