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Updated: Oct 29, 2025
Quantitation of Intra-peritoneal Ovarian Cancer Metastasis
Published on: July 18, 2016
Intraoperative Rupture of the Ovarian Capsule in Early-Stage Ovarian Cancer: A Meta-analysis
Shayan Dioun1, Jenny Wu, Ling Chen
1Columbia University College of Physicians and Surgeons, New York, New York; Duke University Medical Center, Durham, North Carolina; the Herbert Irving Comprehensive Cancer Center, New York, New York; New York Presbyterian Hospital, New York, New York; the Department of Obstetrics and Gynecology, Tokai University, Kanagawa, Japan; and the Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Southern California, Los Angeles, California.
Intraoperative ovarian capsule rupture during early-stage ovarian cancer surgery is linked to worse progression-free and overall survival. This finding highlights the importance of careful surgical technique to improve patient outcomes.
Area of Science:
- Gynecologic Oncology
- Surgical Oncology
- Evidence-Based Medicine
Background:
- Intraoperative ovarian capsule rupture is a potential complication during surgery for early-stage ovarian cancer.
- The impact of capsule rupture on patient survival outcomes remains a critical area of investigation.
Purpose of the Study:
- To systematically review and meta-analyze the association between intraoperative ovarian capsule rupture and survival in early-stage ovarian cancer patients.
- To evaluate the effects of capsule rupture on progression-free survival (PFS) and overall survival (OS).
Main Methods:
- A comprehensive literature search was conducted across multiple databases (PubMed, EMBASE, ClinicalTrials.gov, Scopus) up to August 2020.
- High-quality observational studies (Newcastle-Ottawa Scale score ≥7) comparing capsule rupture to no rupture were included.
- Random-effects models were employed for meta-analysis of oncologic outcomes.
Main Results:
- Seventeen studies involving 18,288 patients were included in the meta-analysis.
- Intraoperative capsule rupture was associated with significantly worse progression-free survival (HR 1.92, P<.001).
- Patients with capsule rupture also experienced significantly worse overall survival (HR 1.48, P=.003).
Conclusions:
- Intraoperative ovarian capsule rupture negatively impacts both progression-free and overall survival in women with early-stage ovarian cancer undergoing initial surgical management.
- These findings underscore the importance of minimizing capsule rupture during surgical procedures for early-stage ovarian cancer to optimize oncologic outcomes.
