Impact of residual disease as a prognostic factor for survival in women with advanced epithelial ovarian cancer after primary surgery

Objectives: This is a protocol for a Cochrane Review (prognosis). The objectives are as follows:. To assess the impact of residual disease after primary surgery on survival outcomes. In separate analyses, primary surgery will include both upfront debulking surgery followed by adjuvant chemotherapy (UDS) and neoadjuvant chemotherapy followed by interval debulking surgery (IDS). We will consider each residual disease threshold as a separate prognostic factor. Investigation of sources of heterogeneity We will examine differences between FIGO stages III and IV in different thresholds of residual disease after primary surgery. We will consider factors such as age, grade, length of follow-up, type and experience of surgeon and type of surgery in the interpretation of any heterogeneity. We will also perform sensitivity analyses to distinguish between studies that include 0 cm in residual disease (RD) categories of < 1 cm and those that do not. This may be applicable to comparisons involving RD < 1 cm with the exception of RD < 1 cm versus RD = 0 cm. We will evaluate women undergoing UDS and IDS in separate analyses.