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Abstract：
BACKGROUND: Although the use of adjuvant chemotherapy (AC) appears to be increasing over the past few years, several clinical trials and previous meta-analyses failed to determine whether AC could improve clinical outcomes in uterine leiomyosarcoma (uLMS). The aim of this systematic review and meta-analysis was to compare AC (with or without radiotherapy) versus observation (obs) after primary surgery in early stage uLMS.
METHODS: Randomized controlled (RCTs) and non-randomized studies (NRSs) were retrieved. Outcomes of interest were as follows: distant recurrence rate, locoregional recurrence rate and overall recurrence rate. Results about distant recurrence rate, locoregional recurrence rate and overall recurrence rate were compared by calculating odds ratios (ORs) with 95% confidence intervals (CIs); ORs were combined with Mantel-Haenszel method.
RESULTS: Nine studies were included in the analysis, involving 545 patients (AC: 252, obs: 293). Compared with obs, AC did not reduce locoregional and distant recurrence rate, with a pooled OR of 1.36 and 0.63, respectively. Similarly, administration of AC did not decrease overall recurrence rate in comparison to obs.
CONCLUSIONS: According to our results, AC (with or without radiotherapy) did not decrease recurrence rate in early stage uLMS; thus, the role of AC in this setting remains unclear.
METHODS: Randomized controlled (RCTs) and non-randomized studies (NRSs) were retrieved. Outcomes of interest were as follows: distant recurrence rate, locoregional recurrence rate and overall recurrence rate. Results about distant recurrence rate, locoregional recurrence rate and overall recurrence rate were compared by calculating odds ratios (ORs) with 95% confidence intervals (CIs); ORs were combined with Mantel-Haenszel method.
RESULTS: Nine studies were included in the analysis, involving 545 patients (AC: 252, obs: 293). Compared with obs, AC did not reduce locoregional and distant recurrence rate, with a pooled OR of 1.36 and 0.63, respectively. Similarly, administration of AC did not decrease overall recurrence rate in comparison to obs.
CONCLUSIONS: According to our results, AC (with or without radiotherapy) did not decrease recurrence rate in early stage uLMS; thus, the role of AC in this setting remains unclear.
摘要：
背景：尽管过去几年来辅助化疗（AC）的使用似乎在增加，多项临床试验和之前的荟萃分析未能确定AC是否能改善子宫平滑肌肉瘤(uLMS)的临床结局.这项系统评价和荟萃分析的目的是比较早期uLMS初次手术后的AC（有或没有放疗）与观察（obs）。
方法：检索随机对照研究（RCT）和非随机研究（NRS）。感兴趣的结果如下：远处复发率，局部复发率和总体复发率。关于远处复发率的结果，通过计算比值比(ORs)和95%置信区间(CIs)来比较局部区域复发率和总体复发率;ORs与Mantel-Haenszel方法相结合.
结果：九项研究被纳入分析，涉及545例患者（AC：252，obs：293）。与obs相比,AC并没有降低局部和远处的复发率，合并OR分别为1.36和0.63。同样，与obs相比,给予AC并未降低总复发率.
结论：根据我们的结果，AC（有或没有放疗）在早期uLMS中没有降低复发率；因此，AC在这种情况下的作用尚不清楚.
方法：检索随机对照研究（RCT）和非随机研究（NRS）。感兴趣的结果如下：远处复发率，局部复发率和总体复发率。关于远处复发率的结果，通过计算比值比(ORs)和95%置信区间(CIs)来比较局部区域复发率和总体复发率;ORs与Mantel-Haenszel方法相结合.
结果：九项研究被纳入分析，涉及545例患者（AC：252，obs：293）。与obs相比,AC并没有降低局部和远处的复发率，合并OR分别为1.36和0.63。同样，与obs相比,给予AC并未降低总复发率.
结论：根据我们的结果，AC（有或没有放疗）在早期uLMS中没有降低复发率；因此，AC在这种情况下的作用尚不清楚.
