Findings

What do systematic reviews say?

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Evidence found and GRADE certainty

43 questions · 45 findings · 7 reviews · Gynaecological, Neuro-oncology and Orphan Cancer

No studies found 3 · 6.7%GRADE not reported 3 · 6.7%Very low 9 · 20%Low 7 · 15.6%Moderate 17 · 37.8%High 6 · 13.3%

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

Overall survival ( · women with advanced ovarian epithelial cancer

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

1 finding from 1 review

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

Progression‐free survival · women with advanced ovarian epithelial cancer

Neoadjuvant chemotherapy prior to interval surgery (NACT) showed no clear difference in progression‐free survival ( compared with surgery followed by chemotherapy (PDS) (moderate certainty).

1 finding from 1 review

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

Surgically‐related severe adverse effects (grade 3+) ‐ stoma formation (within 30 days of surgery) · women with advanced ovarian epithelial cancer

Neoadjuvant chemotherapy prior to interval surgery (NACT) probably leads to lower surgically‐related severe adverse effects (grade 3+) ‐ stoma… compared with surgery followed by chemotherapy (PDS) (moderate certainty).

1 finding from 1 review

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

Surgically‐related severe adverse effects (grade 3+) ‐ bowel resection (within 30 days of surgery) · women with advanced ovarian epithelial cancer

Neoadjuvant chemotherapy prior to interval surgery (NACT) probably leads to lower surgically‐related severe adverse effects (grade 3+) ‐ bowel… compared with surgery followed by chemotherapy (PDS) (moderate certainty).

1 finding from 1 review

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

Surgically‐related severe adverse effects (grade 3+) ‐ postoperative G3+ events (within 30 days of surgery) · women with advanced ovarian epithelial cancer

Neoadjuvant chemotherapy prior to interval surgery (NACT) probably leads to lower surgically‐related severe adverse effects (grade 3+) ‐ postoperative… compared with surgery followed by chemotherapy (PDS) (moderate certainty).

1 finding from 1 review

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

Surgically‐related postoperative mortality (28 days to 6 months of surgery4) · women with advanced ovarian epithelial cancer

Neoadjuvant chemotherapy prior to interval surgery (NACT) leads to lower surgically‐related postoperative mortality (28 days to 6 months of… compared with surgery followed by chemotherapy (PDS) (high certainty).

1 finding from 1 review

Hysterectomy (radical) with neoadjuvant chemotherapy vs chemoradiotherapy alone

Death (all causes) · women with locally advanced cervical cancer

Hysterectomy (radical) with neoadjuvant chemotherapy showed no clear difference in overall survival Median compared with chemoradiotherapy alone (moderate certainty).

1 finding from 1 review

Hysterectomy (radical) with neoadjuvant chemotherapy vs chemoradiotherapy alone

SAEs and toxicity · women with locally advanced cervical cancer

It is very uncertain whether hysterectomy (radical) with neoadjuvant chemotherapy changes SAEs and toxicity compared with chemoradiotherapy alone (very low certainty).

1 finding from 1 review

Hysterectomy (simple or radical) with neoadjuvant chemotherapy vs Radiotherapy alone

Death (all causes) · women with locally advanced cervical cancer

Hysterectomy (simple or radical) with neoadjuvant chemotherapy probably leads to lower overall survival Median compared with radiotherapy alone (moderate certainty).

1 finding from 1 review

Hysterectomy (simple or radical) with neoadjuvant chemotherapy vs Radiotherapy alone

Disease or progression‐free survival Median · women with locally advanced cervical cancer

Hysterectomy (simple or radical) with neoadjuvant chemotherapy showed no clear difference in disease‐ or progression‐free survival Median compared with radiotherapy alone (moderate certainty).

1 finding from 1 review

Hysterectomy (simple or radical) with neoadjuvant chemotherapy vs Radiotherapy alone

Severe adverse events and toxicity · women with locally advanced cervical cancer

Hysterectomy (simple or radical) with neoadjuvant chemotherapy showed no clear difference in severe adverse events and toxicity compared with radiotherapy alone (low certainty).

1 finding from 1 review

GnRH agonist plus chemotherapy vs chemotherapy alone

Menstruation recovery or maintenance: · premenopausal women with malignant conditions, receiving GnRH agonist before or in parallel to chemotherapy

GnRH agonist plus chemotherapy may leads to higher menstruation recovery or maintenance: compared with chemotherapy alone (low certainty).

2 findings from 1 review

GnRH agonist plus chemotherapy vs chemotherapy alone

Premature ovarian failure · premenopausal women with malignant conditions, receiving GnRH agonist before or in parallel to chemotherapy

GnRH agonist plus chemotherapy probably leads to lower premature ovarian failure compared with chemotherapy alone (moderate certainty).

1 finding from 1 review

GnRH agonist plus chemotherapy vs chemotherapy alone

Pregnancy · premenopausal women with malignant conditions, receiving GnRH agonist before or in parallel to chemotherapy

GnRH agonist plus chemotherapy showed no clear difference in pregnancy compared with chemotherapy alone (low certainty).

1 finding from 1 review

GnRH agonist plus chemotherapy vs chemotherapy alone

Ovulation · premenopausal women with malignant conditions, receiving GnRH agonist before or in parallel to chemotherapy

GnRH agonist plus chemotherapy may leads to higher ovulation compared with chemotherapy alone (low certainty).

1 finding from 1 review

GnRH agonist plus chemotherapy vs chemotherapy alone

Adverse effects: hot flush · premenopausal women with malignant conditions, receiving GnRH agonist before or in parallel to chemotherapy

It is very uncertain whether gnRH agonist plus chemotherapy changes adverse effects: hot flush compared with chemotherapy alone (very low certainty).

1 finding from 1 review