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A systematic review identified randomized controlled trials evaluating lymphadenectomy’s impact on overall survival and disease-free survival, extracting study and endpoint data and assessing bias with Rob 2. Nine trials (4231 patients) showed no survival improvement across included cancer types. 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\nPara-Aortic Lymphadenectomy in Ovarian, Endometrial, Gastric, and Bladder Cancers: A Systematic Review of Randomized Controlled Trials  \nSouhail Alouini 1,2,* and Younes Bakri 3  \nCitation: Alouini, S.; Bakri, Y.  \nPara-Aortic Lymphadenectomy in Ovarian, Endometrial, Gastric, and Bladder Cancers: A Systematic Review of Randomized Controlled Trials. Cancers 2024, 16, 3394. [https://](https://)  \n[doi.org/10.3390/cancers16193394](doi.org/10.3390/cancers16193394)[ ](doi.org/10.3390/cancers16193394)Academic Editors: Gilles Houvenaeghel and Shinji Miwa  \nReceived: 6 September 2024  \nRevised: 26 September 2024  \nAccepted: 28 September 2024  \nPublished: 4 October 2024  \nCopyright: © 2024 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license ([https://](https://)[ ](https://)[creativecommons.org/licenses/by/](creativecommons.org/licenses/by/)[ ](creativecommons.org/licenses/by/)[4.0/](4.0/)) .  \n1 Department of Gynecological Surgery and Obstetrics, CHU Orleans, 14 Avenue de L’hôpital,  \n45100 Orleans, France  \n2 Département Médecine, Université d’Orléans, Château de la Source Avenue du Parc Floral,  \n45067 Orleans, France  \n3 Department of Surgery Oncology, Ayoub Medical Center, Amman 11931, Jordan; [bakri.balloon@bakrimedical.com](bakri.balloon@bakrimedical.com)  \n* Correspondence: [souhail.alouini@chu-orleans.fr](souhail.alouini@chu-orleans.fr)  \nSimple Summary: Para-aortic lymphadenectomy can be used for both staging and therapeutic purposes in ovarian, endometrial, gastric and bladder cancers. However, Para-aortic lymphadenectomy is associated with high rates of morbidity and mortality and with no evidence of benefits in terms of overall survival and disease-free survival. A systematic review of the literature was performed to look into the published randomized controlled studies (RCTs) that have reported the effectiveness of lymphadenectomy. The total number of patients was 4231 . The studies reported that para-aortic lymphadenectomy did not improve overall survival and disease-free survival in advanced ovarian cancers, early endometrial cancers, advanced gastric, and bladder cancers. All of the studies hada low risk of bias. Conclusions: Para-aortic lymphadenectomy is not advised in advanced ovarian cancers, early endometrial cancers with low risks, advanced gastric cancers, and bladder cancers. Clinicians should inform patients regarding the benefits of para-aortic lymphadenectomy in terms of survival and the potential risks associated with it.  \nAbstract: Background: Para-aortic lymphadenectomy can be used for both diagnostic and therapeutic purposes as it aids in staging, provides prognostic data, and influences the patient’s options for adjuvant therapy. However, there is still contention over its potential in treating cancer. A systematic review of the literature was performed to look into the published randomized controlled studies (RCTs) that have reported the effectiveness of lymphadenectomy. Methods: Five different electronic databases, including PubMed, Cochrane Library, Clinical [trials.gov](trials.gov), ICTRP, and Embase, were used to conduct a comprehensive search. Original RCTs reporting on the impact of lymphadenectomy on the overall survival in various cancers were included. Information related to the study population, intervention, type of cancer, primary endpoints, and key findings of the study were extracted. Quality assessment of the selected studies was conducted using the Revised Cochrane Risk of Bias Tool Rob 2 for randomized trials. Results: A total of 1693 citations, with 1511 from PubMed, 80 from the Cochrane Library, 67 from Embase, 18 from ICTRP, and 17 from Clinicaltrials.gov were retrieved. Preliminary screening was performed, and after applying selection criteria, nine articles were included in the final qualitative analysis. The total num","cbCaikJo2rWIlJBT","https://ap.wps.com/l/cbCaikJo2rWIlJBT","pdf",1033107,13,"English","# Abstract\n# Introduction\n# Methods\n# Results\n# Conclusions","[{\"question\":\"What cancers are covered by this systematic review?\",\"answer\":\"The review evaluates randomized controlled trials in ovarian, endometrial, gastric, and bladder cancers.\"},{\"question\":\"How many randomized controlled trials and total patients were included?\",\"answer\":\"Nine articles were included in the qualitative analysis, totaling 4231 patients across the trials.\"},{\"question\":\"Does para-aortic lymphadenectomy improve overall survival or disease-free survival?\",\"answer\":\"Across advanced ovarian cancers, early endometrial cancers, advanced gastric cancers, and bladder cancers, para-aortic lymphadenectomy did not improve overall survival or disease-free survival.\"},{\"question\":\"What bias assessment tool was used?\",\"answer\":\"Quality assessment of the selected randomized trials used the Revised Cochrane Risk of Bias Tool (Rob 2).\"}]","Para-Aortic Lymphadenectomy in Ovarian, Endometrial, Gastric, and Bladder Cancers - A Systematic Review of Randomized Controlled Trials | PDF",1789998889,33]