{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,16]],"date-time":"2025-12-16T12:29:35Z","timestamp":1765888175262,"version":"3.46.0"},"reference-count":24,"publisher":"Walter de Gruyter GmbH","issue":"2","license":[{"start":{"date-parts":[[2019,6,1]],"date-time":"2019-06-01T00:00:00Z","timestamp":1559347200000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2019,6,26]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec id=\"j_pp-2019-0014_s_011_w2aab3b7b4b1b6b1aab1c16b1Aa\">\n                    <jats:title id=\"d5917655e8976_w2aab3b7b4b1b6b1aab1c16b1aAa\">Background<\/jats:title>\n                    <jats:p>The primary treatment for advanced ovarian cancer is aggressive cytoreductive surgery (CRS), which is associated with considerable morbidity. The aim of this meta-analysis is to compare morbidity associated with primary CRS and secondary CRS for recurrent disease.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"j_pp-2019-0014_s_012_w2aab3b7b4b1b6b1aab1c16b2Aa\">\n                    <jats:title id=\"d5917655e8985_w2aab3b7b4b1b6b1aab1c16b2aAa\">Methods<\/jats:title>\n                    <jats:p>A literature search was performed using Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines for publications reporting morbidity and mortality in patients undergoing CRS in primary and recurrent ovarian malignancy. Embase, Medline, Pubmed, Pubmed Central, clinicaltrials. gov and Cochrane databases were searched. Two independent reviewers applied inclusion and exclusion criteria to select included papers. A total of 215 citations were reviewed; 6 studies comprising 641 patients were selected for the analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"j_pp-2019-0014_s_013_w2aab3b7b4b1b6b1aab1c16b3Aa\">\n                    <jats:title id=\"d5917655e8994_w2aab3b7b4b1b6b1aab1c16b3aAa\">Results<\/jats:title>\n                    <jats:p>Results were reported as mean differences or pooled odds ratios (OR) with 95\u2006% confidence intervals (95\u2006% CI). The overall morbidity rate was 38.4\u2006%, and this did not differ between the two groups (p=0.97). This did not change when only Clavien-Dindo grade 3 and 4 morbidities were accounted for (14\u2006% primary CRS, 15\u2006% recurrent, p=0.83). Compared to primary CRS, secondary CRS was associated with a similar operative time (mean 400\u2006min, I2=79\u2006%, p=0.45), rate of bowel resection (I2=75\u2006%, p=0.37) and transfusion requirements (MD \u2013 0.7\u2006L, I2=76\u2006%, p=0.45). The mortality rate in both groups was too low to allow for meaningful meta-analysis, with four deaths in the group undergoing primary cytoreductive surgery (1.0\u2006%) and two deaths in the group with recurrent disease (0.9\u2006%).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"j_pp-2019-0014_s_014_w2aab3b7b4b1b6b1aab1c16b4Aa\">\n                    <jats:title id=\"d5917655e9003_w2aab3b7b4b1b6b1aab1c16b4aAa\">Conclusions<\/jats:title>\n                    <jats:p>In conclusion, secondary CRS for recurrent ovarian cancer is a safe and feasible option in carefully pre-selected patients with comparable morbidity to primary CRS.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1515\/pp-2019-0014","type":"journal-article","created":{"date-parts":[[2019,6,28]],"date-time":"2019-06-28T05:04:23Z","timestamp":1561698263000},"source":"Crossref","is-referenced-by-count":10,"title":["Morbidity and mortality in women with advanced ovarian cancer who underwent primary cytoreductive surgery compared to cytoreductive surgery for recurrent disease: a meta-analysis"],"prefix":"10.1515","volume":"4","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6470-9364","authenticated-orcid":false,"given":"Helena C.","family":"Bartels","sequence":"first","affiliation":[{"name":"Ireland East Hospital Gynaeoncology Group , Mater Misericordiae University , Dublin , Ireland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ailin C.","family":"Rogers","sequence":"additional","affiliation":[{"name":"Department of Surgery , Mater Misericordiae University Hospital , Dublin , Ireland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"James","family":"Postle","sequence":"additional","affiliation":[{"name":"Ireland East Hospital Gynaeoncology Group , Mater Misericordiae University , Dublin , Ireland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Conor","family":"Shields","sequence":"additional","affiliation":[{"name":"Department of Surgery , Mater Misericordiae University Hospital , Dublin , Ireland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jurgen","family":"Mulsow","sequence":"additional","affiliation":[{"name":"Department of Surgery , Mater Misericordiae University Hospital , Dublin , Ireland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John","family":"Conneely","sequence":"additional","affiliation":[{"name":"Department of Surgery , Mater Misericordiae University Hospital , Dublin , Ireland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Donal J.","family":"Brennan","sequence":"additional","affiliation":[{"name":"Ireland East Hospital Gynaeoncology Group , Mater Misericordiae University , Dublin , Ireland"},{"name":"UCD School of Medicine, National Maternity Hospital , Holles Street , Dublin , Ireland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"374","published-online":{"date-parts":[[2019,6,28]]},"reference":[{"key":"2025120909240994308_j_pp-2019-0014_ref_001_w2aab3b7b4b1b6b1ab1b6b1Aa","doi-asserted-by":"crossref","unstructured":"Siegel RL, Fedewa SA, Miller KD, Goding-Sauer A, Pinheiro PS, Martinez-Tyson D, et al. 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