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    The content on this page is not current guidance and is only for the purposes of the consultation process.

    The evidence assessed

    Rapid review of literature

    The medical literature was searched to identify studies and reviews relevant to maximal effort cytoreductive surgery (also known as extensive or ultra-radical surgery) for advanced ovarian cancer. The following databases were searched, covering the period from their start to 14 June 2022: MEDLINE, PREMEDLINE, EMBASE, Cochrane Library and other databases. Trial registries and the internet were also searched. No language restriction was applied to the searches (see the literature search strategy). Relevant published studies identified during consultation or resolution that are published after this date may also be considered for inclusion.

    The inclusion criteria were applied to the abstracts identified by the literature search. If selection criteria could not be determined from the abstracts the full paper was retrieved.

    Inclusion criteria for identification of relevant studies

    Characteristic

    Criteria

    Publication type

    Clinical studies were included. Emphasis was placed on identifying good quality studies.

    Abstracts were excluded if no clinical outcomes were reported, or if the paper was a review, editorial, or a laboratory or animal study.

    Conference abstracts were also excluded because of the difficulty of appraising study methodology, unless they reported specific adverse events that were not available in the published literature.

    Patient

    Patients with advanced ovarian cancer.

    Intervention/test

    Maximal effort cytoreductive, extensive or ultra-radical surgery

    Outcome

    Articles were retrieved if the abstract contained information relevant to the safety and/or efficacy.

    Language

    Non-English-language articles were excluded unless they were thought to add substantively to the English-language evidence base.

    List of studies included in the IP overview

    This IP overview is based on over 12,000 patients from 9 cohort studies, 1 non-randomised comparative study, 1 systematic review and 1 case series (Sundar 2022, Soo Hoo 2015, Cummins 2022, Dahm Kahler 2021, Falconer 2020, Horowitz 2015, Tseng 2018, Angeles 2022, Phillips 2019, Palmqvist 2022, Hiu 2022, Ehmann 2021). In addition, a systematic review that includes 18,579 patients who had primary cytoreductive surgery for ovarian cancer has been included (Di Donato 2017).

    Other studies that were considered to be relevant to the procedure but were not included in the main summary of the key evidence are listed in the appendix.