Is infracolic omentectomy necessary for early-stage (FIGO I–II) borderline ovarian tumors? A protocol for systematic review and meta-analysis

Background: Borderline ovarian tumors (BOTs) are reported to account for 10%–20% of all ovarian tumors. Guidelines for the surgical management of BOTs include hysterectomy with bilateral salpingo-oophorectomy, peritoneal washings, omentectomy, and multiple peritoneal biopsies. However, when omentectomy is recommended, it is unclear whether removal of a normal-appearing omentum has a therapeutic benefit. Methods: We will search the following databases: the Cochrane Central Register of Controlled Trials (CENTRAL), the latest issue in the Cochrane Library, PubMed, EMBASE, LILACS, SCOPUS, Web of Science and Grey literature. Randomized controlled trials (RCTs) and non-randomized studies will be included if the patients are adults (≥18 years) with BOTs in stages I–II according to International Federation of Gynaecology and Obstetrics (FIGO). The methodological assessment will be carried out by two reviewers independently of each other using Cochrane risk-of-bias tool for randomized controlled trials (RoB 2), and the risk of bias in non-randomized studies (ROBINS-I) tool for non-randomized. The search strategy is constructed using the Boolean operators “OR” and “AND,” thorough search, a combination of medical subject heading and free-text terms will be employed. The Review Manager 5.4 will be used for the meta-analysis. For time‐to‐event data, we will use the hazard ratio with a 95% confidence interval (CI). For dichotomous outcomes, we will be used to calculate the risk ratio with a 95% CI. Continuous outcomes will be presented as the weighted mean difference or standardized mean difference with 95% CI. Results: This review will evaluate the effects of non-infracolic omentectomy on overall survival, progression-free survival, quality of life, recurrence index and adverse events in patients with BOTs. Conclusion: Our results will provide clear evidence to determine whether non-infracolic omentectomy is an effective and safe intervention for early stage (FIGO I–II) BOTs, thus benefiting patients, practitioners, and policy makers.