PT - JOURNAL ARTICLE AU - Amy McCarthy AU - Katharine Balfour AU - Iman El Sayed AU - Richard Edmondson AU - Yee-Loi Louise Wan TI - Neoadjuvant therapy or upfront surgery in advanced endometrial cancer: a systematic review protocol AID - 10.1136/bmjopen-2021-054004 DP - 2021 Nov 01 TA - BMJ Open PG - e054004 VI - 11 IP - 11 4099 - http://bmjopen.bmj.com/content/11/11/e054004.short 4100 - http://bmjopen.bmj.com/content/11/11/e054004.full SO - BMJ Open2021 Nov 01; 11 AB - Introduction There is no consensus on the optimal treatment strategy for people with advanced endometrial cancer. Neoadjuvant therapies such as chemotherapy and radiotherapy have been employed to try to reduce the morbidity of surgery, improve its feasibility and/or improve functional performance in people considered unfit for primary surgery. The objective of this review is to assess whether neoadjuvant chemotherapy or radiotherapy improves health outcomes in people with advanced endometrial cancer when compared with upfront surgery.Methods and analysis This review will consider both randomised and non-randomised studies that compare health outcomes associated with the neoadjuvant therapy and upfront surgery in advanced endometrial cancer. Potential studies for inclusion will be collated from electronic searches of OVID Medline, Embase, international trial registries and conference abstract lists. Data collection and extraction will be performed according to the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses guidelines. The methodological quality of the studies will be assessed using the Risk of Bias 2 and Risk of Bias in Non-randomised Studies of Interventions tools. If appropriate, we will perform a meta-analysis and provide summary statistics for each outcome.Ethics and dissemination Ethics approval was not required for this study. Once complete, we will publish our findings in peer-reviewed publications, via conference presentations and to update relevant practice guidelines.