What do systematic reviews say?

Surgery plus whole brain radiotherapy (WBRT) vs stereotactic radiosurgery

It is very uncertain whether surgery plus whole brain radiotherapy (WBRT) changes overall survival compared with stereotactic radiosurgery (very low certainty).

• Surgery versus stereotactic radiotherapy for people with single or solitary brain metastasis 2018 · Cochrane Headline outcomes only
  HR 0.92 [0.48, 1.77]
  1 study · 64 participants
  Very low

Surgery plus whole brain radiotherapy (WBRT) vs stereotactic radiosurgery plus WBRT

Surgery plus whole brain radiotherapy (WBRT) showed no clear difference in overall survival compared with stereotactic radiosurgery plus WBRT (low certainty).

• Surgery versus stereotactic radiotherapy for people with single or solitary brain metastasis 2018 · Cochrane Headline outcomes only
  HR 0.53 [0.2, 1.42]
  1 study · 21 participants
  Low

Neoadjuvant chemotherapy prior to interval surgery (NACT) vs surgery followed by chemotherapy (PDS)

Neoadjuvant chemotherapy prior to interval surgery (NACT) showed no clear difference in overall survival ( compared with surgery followed by chemotherapy (PDS) (high certainty).

• Neoadjuvant chemotherapy before surgery versus surgery followed by chemotherapy for initial treatment in advanced… 2021 · Cochrane Headline outcomes only
  HR 0.96 [0.86, 1.08]
  4 studies · 2000 participants
  High

iMRI image‐guided surgery vs surgery

The review found no eligible studies for this question.

• Intraoperative imaging technology to maximise extent of resection for glioma: a network meta‐analysis 2021 · Cochrane Headline outcomes only
  no estimate extracted
  Studies not reported
  No studies found
• Intraoperative imaging technology to maximise extent of resection for glioma 2018 · Cochrane Headline outcomes only
  no estimate extracted
  Studies not reported
  No studies found

5‐ALA image‐guided surgery vs surgery

The review found no eligible studies for this question.

• Intraoperative imaging technology to maximise extent of resection for glioma: a network meta‐analysis 2021 · Cochrane Headline outcomes only
  no estimate extracted
  Studies not reported
  No studies found
• Intraoperative imaging technology to maximise extent of resection for glioma 2018 · Cochrane Headline outcomes only
  no estimate extracted
  Studies not reported
  No studies found

Neuronavigation image‐guided surgery vs surgery

The review found no eligible studies for this question.

• Intraoperative imaging technology to maximise extent of resection for glioma: a network meta‐analysis 2021 · Cochrane Headline outcomes only
  no estimate extracted
  Studies not reported
  No studies found
• Intraoperative imaging technology to maximise extent of resection for glioma 2018 · Cochrane Headline outcomes only
  no estimate extracted
  Studies not reported
  No studies found

Ultra‐radical (extensive) surgery vs surgery

It is very uncertain whether ultra‐radical (extensive) surgery changes survival (overall and disease‐ specific) compared with standard surgery (very low certainty).

• Ultra‐radical (extensive) surgery versus standard surgery for the primary cytoreduction of advanced epithelial ovarian… 2022 · Cochrane Headline outcomes only
  HR 0.6 [0.43, 0.82]
  2 studies · 397 participants
  Very low

Radiosurgery alone vs WBRT and radiosurgery

Radiosurgery alone showed no clear difference in overall survivalNo. of participants: 403(3 RCTs) compared with WBRT and radiosurgery (moderate certainty).

• Whole brain radiotherapy for the treatment of newly diagnosed multiple brain metastases 2018 · Cochrane Headline outcomes only
  HR 1 [0.8, 1.25]
  Studies not reported
  Moderate

Whole brain radiation therapy (WBRT) + stereotactic radiosurgery (SRS) vs WBRT

Whole brain radiation therapy (WBRT) + stereotactic radiosurgery (SRS) showed no clear difference in overall survival compared with WBRT (moderate certainty).

• Whole brain radiation therapy (WBRT) alone versus WBRT and radiosurgery for the treatment of brain metastases 2017 · Cochrane Headline outcomes only
  HR 0.82 [0.65, 1.02]
  2 studies · 358 participants
  Moderate

Whole brain radiation therapy (WBRT) + stereotactic radiosurgery (SRS) vs WBRT

WBRT and radiosurgery showed no clear difference in overall survivalNo. of participants: 358(2 RCTs) compared with WBRT (moderate certainty).

• Whole brain radiotherapy for the treatment of newly diagnosed multiple brain metastases 2018 · Cochrane Headline outcomes only
  HR 0.61 [0.27, 1.39]
  Studies not reported
  Moderate

Interferon + chemotherapy vs chemotherapy alone

Interferon + chemotherapy may leads to higher overall survival compared with chemotherapy alone (low certainty).

• Interferon after surgery for women with advanced (Stage II‐IV) epithelial ovarian cancer 2013 · Cochrane Headline outcomes only
  HR 1.14
  2 studies · 244 participants
  Low

Interferon vs observation

Interferon showed no clear difference in overall survival compared with observation alone (low certainty).

• Interferon after surgery for women with advanced (Stage II‐IV) epithelial ovarian cancer 2013 · Cochrane Headline outcomes only
  HR 1.14 [0.84, 1.55]
  2 studies · 370 participants
  Low

Hormone replacement therapy (HRT) vs no HRT

Hormone replacement therapy (HRT) may leads to lower overall survival compared with no HRT (low certainty).

• Hormone replacement therapy after surgery for epithelial ovarian cancer 2020 · Cochrane Headline outcomes only
  HR 0.71 [0.54, 0.93]
  3 studies · 350 participants
  Low

Concomitant (concurrent) chemoradiotherapy vs radical surgery

• Type II or type III radical hysterectomy compared to chemoradiotherapy as a primary intervention for stage IB2… 2018 · Cochrane Headline outcomes only
  no estimate extracted
  Studies not reported
  Very low

Intervention not reported

• Adjuvant (post‐surgery) chemotherapy for early stage epithelial ovarian cancer 2015 · Cochrane Headline outcomes only
  no estimate extracted
  1008 participants
  High

Intervention not reported

The intervention showed no clear difference in overall Survival (median (low certainty).

• Surgery or radiosurgery plus whole brain radiotherapy versus surgery or radiosurgery alone for brain metastases 2014 · Cochrane Headline outcomes only
  HR 1.11 [0.83, 1.48]
  5 studies · 663 participants
  Low

Intervention not reported

• Adjuvant (post‐surgery) chemotherapy for early stage epithelial ovarian cancer 2015 · Cochrane Headline outcomes only
  no estimate extracted
  925 participants
  High

Laparoscopy vs laparotomy

Laparoscopy showed no clear difference in overall survival (survival until death from all causes) compared with laparotomy (moderate certainty).

• Laparoscopy versus laparotomy for the management of early stage endometrial cancer 2018 · Cochrane Headline outcomes only
  HR 1.04 [0.86, 1.25]
  6 studies · 3993 participants
  Moderate

Small‐volume residual disease (SVRD) (< 1 cm) vs NMRD

Small‐volume residual disease (SVRD) < 1 cm probably leads to higher overall survival: Median length of compared with NMRD (moderate certainty).

• Impact of residual disease as a prognostic factor for survival in women with advanced epithelial ovarian cancer after… 2022 · Cochrane Headline outcomes only
  HR 2.03 [1.8, 2.29]
  17 studies · 9404 participants
  Moderate

Large‐volume residual disease (LVRD) > 1 cm vs small‐volume residual disease (SVRD) < 1 cm

It is very uncertain whether large‐volume residual disease (LVRD) > 1 cm changes overall survival: Median length of compared with small‐volume residual disease (SVRD) < 1 cm (very low certainty).

• Impact of residual disease as a prognostic factor for survival in women with advanced epithelial ovarian cancer after… 2022 · Cochrane Headline outcomes only
  HR 1.6 [1.21, 2.11]
  6 studies · 1572 participants
  Very low