| Outcomes | Hazard ratio (95% CI) Chemotherapy versus observation |
No of participants (studies) | Quality of the evidence (GRADE) | Comments |
|---|---|---|---|---|
| Overall 5-yr survival | HR 0.71 (0.53 to 0.93) | 1006 women (three studies) |
⊕⊕⊕⊕ high |
Homogeneous data (I2 = 0%); P = 0.01 |
| Overall 10-yr survival | HR 0.74 (0.58 to 0.95) | 925 women (two studies) |
⊕⊕⊕⊕ high |
Homogeneous data (I2 = 0%);. P = 0.02 |
| Progression-free 5-yr survival | HR 0.67 (0.53 to 0.84) | 1170 women (four studies) |
⊕⊕⊕⊕ high |
Homogeneous data (I2 = 0%); P = 0.0005 |
| Progression-free 10-yr survival | HR 0.67 (0.54 to 0.84) | 925 women (two studies) |
⊕⊕⊕⊕ high |
Homogeneous data (I2 = 0%); P = 0.0005 |
| Overall 5-yr survival: sub-optimal staging* | HR 0.63 (0.46 to 0.85) | 772 women (two studies) |
⊕⊕⊕⊕ high |
Homogeneous data (I2 = 0%); P = 0.003 |
| Progression-free 5-yr survival: sub-optimal staging** | RR 0.64 (0.50 to 0.82) | 934 women (three studies) |
⊕⊕⊕⊕ high |
Homogeneous data (I2 = 19%); P = 0.0004 |
| Overall 5-yr survival: optimal staging* | HR 1.22 (0.63 to 2.37) | 234 women (two studies) |
⊕⊕⊕○ moderate |
Quality of the evidence downgraded to ‘moderate’ due to small subgroup size (I2 = 0%; P = 0.56)* |
| Progression-free 5-yr survival: optimal staging** | RR 0.67 (0.36 to 1.22) | 234 women (two studies) |
⊕⊕⊕○ moderate |
Quality of the evidence downgraded to ‘moderate’ due to small subgroup size (I2 = 0%; P = 0.19) |
CI: confidence interval; HR: hazard ratio
GRADE Working Group grades of evidence
High quality: Further research is very unlikely to change our confidence in the estimate of effect.
Moderate quality: Further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate.
Low quality: Further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate.
Very low quality: We are very uncertain about the estimate.
Tests for subgroup differences between optimal and sub-optimal subgroups for the 5-year OS outcome were Chi2 = 3.14, df = 1 (P = 0.08) and I2 = 68.1%. We consider this to be a significant difference.
Tests for subgroup differences between optimal and sub-optimal subgroups for the 5-year PFS outcome showed that the subgroups were not different with respect to this outcome (P = 0.91; I2 = 0%).