scholarly journals Prognostic significance of CTNNB1 mutation in early stage endometrial carcinoma: a systematic review and meta-analysis

2022 ◽  
Author(s):  
Antonio Travaglino ◽  
Antonio Raffone ◽  
Diego Raimondo ◽  
Sabrina Reppuccia ◽  
Alessandro Ruggiero ◽  
...  
Keyword(s):  
Systematic Review ◽  
Endometrial Carcinoma ◽  
Prognostic Value ◽  
Early Stage ◽  
Meta Analysis ◽  
Prognostic Significance ◽  
Disease Free Survival ◽  
Absolute Number ◽  
Molecular Profile ◽  
Endometrioid Endometrial Carcinoma

Abstract Background In the last years, mutations in the exon 3 of CTNNB1 have emerged as a possible prognostic factor for recurrence in early stage endometrioid endometrial carcinoma, especially in cases with no specific molecular profile (NSMP). Objective To define the prognostic value of CTNNB1 mutations in early stage endometrioid endometrial carcinoma, through a systematic review and meta-analysis. Methods Electronic databases were searched from their inception to November 2020 for all studies assessing the prognostic value of CTNNB1 mutation in early stage (FIGO I–II) endometrioid endometrial carcinoma. Odds ratio (OR) for tumor recurrence and hazard ratio (HR) for disease-free survival (DFS) were calculated with a significant p value < 0.05. Results Seven studies with 1031 patients were included. Four studies were suitable for meta-analysis of OR and showed significant association between CTNNB1 mutation and the absolute number of recurrence (OR = 3.000; p = 0.019); the association became stronger after excluding patients with known molecular status other than NSMP (HR = 5.953; p = 0.012). Three studies were suitable for meta-analysis of HR and showed no significant association between CTNNB1 mutation and decreased DFS (HR = 1.847; p = 0.303); the association became significant after excluding patients with known molecular status other than NSMP (HR = 2.831; p = 0.026). Conclusion CTNNB1 mutation is significantly associated with recurrence in early stage endometrioid endometrial carcinomas, especially in the NSMP, appearing potentially useful in directing adjuvant treatment.

scholarly journals The Prognostic Significance of Combined Pretreatment Fibrinogen and Neutrophil-Lymphocyte Ratio in Various Cancers: A Systematic Review and Meta-Analysis

2020 ◽  
Vol 2020 ◽  
pp. 1-10
Author(s):  
Rongqiang Liu ◽  
Shiyang Zheng ◽  
Qing Yuan ◽  
Peiwen Zhu ◽  
Biao Li ◽  
...  
Keyword(s):  
Prognostic Value ◽  
Meta Analysis ◽  
Prognostic Significance ◽  
Disease Free Survival ◽  
Progression Free Survival ◽  
Regression Analyses ◽  
Free Survival ◽  
Neutrophil Lymphocyte Ratio ◽  
Lymphocyte Ratio ◽  
Meta Regression

Purpose. The prognostic value of a new scoring system, termed F-NLR, that combines pretreatment fibrinogen level with neutrophil-lymphocyte ratio has been evaluated in various cancers. However, the results are controversial. The purpose of this study was to comprehensively analyze the prognostic value of F-NLR score in patients with cancers. Methods. An integrated search of relevant studies was conducted by screening the PubMed and Embase databases. Pooled hazard ratios, with 95% confidence intervals (CIs), for overall survival (OS) and disease-free survival (DFS)/progression-free survival (PFS) were calculated to estimate the prognostic significance of F-NLR score in patients with various tumors. A random effects model was used for comprehensive analysis, and subgroup and meta-regression analyses were used to explore sources of heterogeneity. Results. Thirteen articles reporting data from of 4747 patients were included in the study. Pooled analysis revealed that high F-NLR score was significantly associated with poor OS ( HR = 1.77 ; 95% CI, 1.51–2.08) and poor DFS/PFS ( HR = 1.63 ; 95% CI, 1.30–2.05). Subgroup and meta-regression analyses did not alter the prognostic role of F-NLR score in OS and DFS/PFS. Conclusions. Increased F-NLR score is significantly associated with poor prognosis in patients with cancers and can serve as an effective prognostic indicator.

Systematic review of adjuvant therapy for early stage (epithelial) ovarian cancer

2003 ◽  
Vol 13 (4) ◽  
pp. 395-404 ◽  
Author(s):  
B. Winter-Roach ◽  
L. Hooper ◽  
H. Kitchener
Keyword(s):  
Systematic Review ◽  
Ovarian Cancer ◽  
Adjuvant Chemotherapy ◽  
Adjuvant Therapy ◽  
Early Stage ◽  
Meta Analysis ◽  
Disease Free Survival ◽  
Significant Difference ◽  
Well Differentiated ◽  
Platinum Chemotherapy

A systematic review and meta analysis has been undertaken in order to evaluate the effectiveness of adjuvant therapy following surgery for early ovarian cancer. Trials reported since 1990 have been of a higher quality enabling a meta analysis of adjuvant chemotherapy vs adjuvant radiotherapy and a meta analysis of adjuvant chemotherapy vs observation. There was no significant difference between radiotherapy and chemotherapy, though these comprised studies which demonstrated considerable heterogeneity. Chemotherapy did confer significant benefit over observation in terms of both overall and disease free survival. Except for women in whom adequate surgical staging has revealed well differentiated disease confined to one or both ovaries with intact capsule, platinum chemotherapy should be offered to reduce risk of recurrence.

Predictive Prognostic Value of Tissue-Based MicroRNA Expression in Oral Squamous Cell Carcinoma: A Systematic Review and Meta-analysis

2018 ◽  
Vol 97 (7) ◽  
pp. 759-766 ◽  
Author(s):  
G. Troiano ◽  
F. Mastrangelo ◽  
V.C.A. Caponio ◽  
L. Laino ◽  
N. Cirillo ◽  
...  
Keyword(s):  
Systematic Review ◽  
Overall Survival ◽  
Squamous Cell Carcinoma ◽  
Oral Squamous Cell Carcinoma ◽  
Mirna Expression ◽  
Prognostic Value ◽  
Meta Analysis ◽  
Disease Free Survival ◽  
Free Survival ◽  
Disease Free

Oral squamous cell carcinoma (OSCC) is a common type of cancer characterized by a low survival rate, mostly due to local recurrence and metastasis. In view of the importance of predicting tumor behavior in the choice of treatment strategies for OSCC, several studies have attempted to investigate the prognostic value of tissue biomarkers, including microRNA (miRNA). The purpose of this study was to perform a systematic review and meta-analysis to evaluate the relationship between miRNA expression and survival of OSCC patients. Studies were identified by searching on MEDLINE/PubMed, SCOPUS, Web of Science, and Google Scholar. Quality assessment of studies was performed with the Newcastle-Ottawa Scale. Data were collected from cohort studies comparing disease-free survival and overall survival in patients with high miRNA expression compared to those with low expression. A total of 15 studies featuring 1,200 OSCC samples, predominantly from Asia, met the inclusion criteria and were included in the meta-analysis. Poor prognosis correlated with upregulation of 9 miRNAs (miR-21, miR-455-5p, miiR-155-5p, miR-372, miR-373, miR-29b, miR-1246, miR-196a, and miR-181) and downregulation of 7 miRNAs (miR-204, miR-101, miR-32, miR-20a, miR-16, miR-17, and miR-125b). The pooled hazard ratio values (95% confidence interval) related to different miRNA expression for overall survival and disease-free survival were 2.65 (2.07–3.39) and 1.95 (1.28–2.98), respectively. The results of this meta-analysis revealed that the expression levels of specific miRNAs can robustly predict prognosis of OSCC patients.

A Systematic Review Evaluating the Addition of Radiation Therapy to Chemotherapy for Localized Aggressive Non-Hodgkin’s Lymphoma: What Is the Role for Radiotherapy?.

Blood ◽  
2004 ◽  
Vol 104 (11) ◽  
pp. 3155-3155
Author(s):  
Daniel B. Fried ◽  
David E. Morris ◽  
Thomas C. Shea ◽  
Robert Z. Orlowski ◽  
Hendrik W. Van Deventer ◽  
...  
Keyword(s):  
Systematic Review ◽  
Radiation Therapy ◽  
Hodgkin’S Lymphoma ◽  
Randomized Trials ◽  
Early Stage ◽  
Meta Analysis ◽  
Disease Free Survival ◽  
Hodgkin's Lymphoma ◽  
Non Hodgkin’S Lymphoma ◽  
Non Hodgkin's Lymphoma

Abstract Purpose/Objective: We performed a systematic review and meta-analysis of chemotherapy alone compared to chemotherapy plus radiation in the management of adult early stage aggressive non-Hodgkin’s lymphoma (NHL). Overall survival (OS) and disease-free survival (DFS) at 5 years were evaluated. Materials/Methods: Randomized trials published after 1990 comparing chemotherapy alone to chemotherapy plus radiation therapy in the management of adult aggressive NHL were identified through searches of MEDLINE and CANCERLIT databases. In addition, a search of ASTRO, ASCO, and ASH Proceedings from 1999 to the present was performed to identify updates of published articles and abstracts. Studies that were limited to GI sites only were excluded. Only studies employing CHOP or CHOP-like regimens and radiation therapy to a minimum dose of 30 Gy were deemed acceptable. Chemotherapy alone regimens had to consist of a minimum of 4 cycles of therapy. All trials reported OS and DFS at 5 years. A meta-analysis was performed using STATA statistical software, including tests for homogeneity and publication bias. Trials were analyzed by risk ratio (RR) method. Results: Five randomized trials (n = 1933, range for individual studies 215 to 647) were identified that met all inclusion criteria. The 5-yr OS and DFS RRs for the addition of radiation therapy to chemotherapy are presented in Figures 1 and 2, respectively. Three studies suggested an OS and DFS benefit with the addition of radiation to chemotherapy and two suggested an improved OS and DFS among patients treated with chemotherapy alone. Only two of the studies reported patterns of relapse (Aviles et al and Horning et al). These studies showed improved local control with combined modality therapy (16 – 23% vs. 4 – 5%). Risk ratios for OS ranged from 0.90 to 1.56. DFS estimates range from 0.89 to 1.82. A meta-analysis was conducted to estimate the overall treatment effects for this group of studies for both OS and DFS. Due to the high degree of heterogeneity among these trials (p-value for heterogeneity &lt;0.001 for both OS and DFS), summarizing these results with a pooled estimate of effect would be inappropriate. Heterogeneity was decreased only marginally with the exclusion of any individual study from the pooled estimate. Conclusions: It remains unclear whether early stage aggressive NHL patients benefit from the addition of radiation to CHOP-based chemotherapy. However, at this time we are not able to delineate those patients who will benefit from radiotherapy from those who will not. Currently CHOP-based chemotherapy plus radiation remains a standard of care in the US for early stage aggressive NHL. However, controversy remains regarding the role of radiation in light of conflicting results. Our ability to draw firm conclusions based on this review is limited due to the study heterogeneity. Differences among study populations may largely account for this heterogeneity.

The prognostic significance of early stage lymph node positivity in operable invasive breast carcinoma: number or stage

2012 ◽  
Vol 65 (7) ◽  
pp. 624-630 ◽  
Author(s):  
Emad A Rakha ◽  
David Morgan ◽  
Douglas Macmillan
Keyword(s):  
Breast Cancer ◽  
Prognostic Value ◽  
Independent Predictor ◽  
Early Stage ◽  
Histological Grade ◽  
Tumour Size ◽  
Prognostic Significance ◽  
Absolute Number ◽  
Consecutive Series ◽  
Cancer Specific Survival

AimThe earlier detection of breast cancer through mammographic screening has resulted in a shift in stage distribution with patients who are node-positive tending to present with a lower number of positive lymph nodes (LN). This study aims to assess the prognostic value of absolute number of positive nodes in the pN1 TNM stage (1–3 positive LN) and whether the prognostic value of the number of nodes in this clinically important stage justifies its consideration in management decisions.MethodsThis study is based on a large and well-characterised consecutive series of operable breast cancer (3491 cases), treated according to standard protocols in a single institution, with a long-term follow-up.ResultsLN stages and the absolute number of LN are associated with both breast cancer specific survival (BCSS) and distant metastasis free survival (DMFS). In the pN1 stage, patients with three positive LN (14% of pN1) show shorter BCSS (HR=1.9, (95% CI 1.3 to 2.6)) and shorter DMFS (HR=2.2, (95% CI 1.6 to 2.9)) when compared with one and/or two positive nodes. This effect is noted in the whole series as well as in different subgroups based on tumour size (pT1c and pT2), histological grade (grade 2 and 3), vascular invasion and oestrogen receptor status (both positive and negative). Multivariable analyses showed that three positive LN, compared with one and two positive LN, are an independent predictor of shorter BCSS and DMFS.ConclusionThe number of LN in the pN1 stage yielded potentially informative risk assignments with three positive LN providing an independent predictor of poorer outcome.

scholarly journals MCT4 has a potential to be used as a prognostic biomarker - a systematic review and meta-analysis

2019 ◽  
Vol 13 (2) ◽  
Author(s):  
Arslaan Javaeed ◽  
Sanniya Khan Ghauri
Keyword(s):  
Systematic Review ◽  
Cancer Progression ◽  
Meta Analysis ◽  
Prognostic Significance ◽  
Disease Free Survival ◽  
Prognostic Indicators ◽  
Future Research ◽  
Tissue Samples ◽  
Hazard Ratios

The role of several metabolic changes, such as hypoxia and acidosis, in the tumour environment has caught the attention of researchers in cancer progression and invasion. Lactate transport is one of the acidosis-enhancing processes that are mediated via monocarboxylate transporters (MCTs). We conducted a systematic review and meta-analysis to investigate the expression of two cancer-relevant MCTs (MCT1 and MCT4) and their potential prognostic significance in patients with metastasis of different types of cancer. Studies were included if they reported the number of metastatic tissue samples expressing either low or high levels of MCT1 and/or MCT4 or those revealing the hazard ratios (HRs) of the overall survival (OS) or disease-free survival (DFS) as prognostic indicators. During the period between 2010 and 2018, a total of 20 articles including 3831 patients (56.3% males) were identified. There was a significant association between MCT4 expression (high versus low) and lymph node metastasis [odds ratio (OR)=1.87, 95% confidence interval (CI)=1.10-3.17, P=0.02] and distant metastasis (OR=2.18, 95%CI=1.65-2.86, P<0.001) and the correlation remained significant for colorectal and hepatic cancer in subgroup analysis. For survival analysis, patients with shorter OS periods exhibited a higher MCT4 expression [hazard ratio (HR)=1.78, 95%CI=1.49-2.13, P<0.001], while DFS was shorter in patients with high MCT1 (HR=1.48, 95%CI=1.04-2.10, P=0.03) and MCT4 expression (HR=1.70, 95%CI=1.19-2.42, P=0.003) when compared to their counterparts with low expression levels. Future research studies should consider the pharmacologic inhibition of MCT4 to effectively inhibit cancer progression to metastasis.

scholarly journals Prognostic value of lncRNA ROR expression in various cancers: a meta-analysis

2018 ◽  
Vol 38 (5) ◽  
Author(s):  
Renfu Lu ◽  
Junjian Chen ◽  
Lingwen Kong ◽  
Hao Zhu
Keyword(s):  
Prognostic Value ◽  
Meta Analysis ◽  
Clinical Stage ◽  
Prognostic Significance ◽  
Disease Free Survival ◽  
Cochrane Library ◽  
Clinicopathological Parameters ◽  
Advanced Clinical Stage ◽  
Non Coding Rna ◽  
Meta Analyses

Background: There is a dispute on the prognostic value of long non-coding RNA regulator of reprogramming (lncRNA ROR) in cancers. The purpose of the present study was to evaluate the prognostic significance of lncRNA ROR expression in human cancers. Methods: PubMed, Embase, and Cochrane Library were searched to look for relevant studies. The meta-analyses of prognostic and clinicopathological parameters (CPs) were conducted. Results: A total of ten studies were finally included into the meta-analysis. High lncRNA ROR expression was significantly associated with shorter overall survival (hazard ratio [HR] = 2.88, 95% confidence interval [CI] = 2.16–3.84, P<0.01) and disease-free survival (HR = 3.25, 95% CI = 2.30–4.60, P<0.01) compared with low lncRNA ROR expression. Besides, high lncRNA ROR expression was obviously related to more advanced clinical stage (P<0.01), earlier tumor metastasis (P=0.02), lymph node metastasis (P<0.01), and vascular invasion (P<0.01) compared with low lncRNA ROR expression. However, there was no significant correlation between lncRNA ROR expression and other CPs, including age (P=0.18), gender (P=0.33), tumor size (P=0.25), or tumor differentiation (P=0.13). Conclusion: High lncRNA ROR expression was associated with worse prognosis in cancers. LncRNA ROR expression could serve as an unfavorable prognostic factor in various cancers.

scholarly journals Myoinvasive Pattern as a Prognostic Marker in Low-Grade, Early-Stage Endometrioid Endometrial Carcinoma

Cancers ◽  
2019 ◽  
Vol 11 (12) ◽  
pp. 1845 ◽  
Author(s):  
Ignacio Ruz-Caracuel ◽  
Jorge L Ramón-Patino ◽  
Álvaro López-Janeiro ◽  
Laura Yébenes ◽  
Alberto Berjón ◽  
...  
Keyword(s):  
Prognostic Factor ◽  
Microsatellite Instability ◽  
Endometrial Carcinoma ◽  
Early Stage ◽  
Disease Free Survival ◽  
Figo Stage ◽  
Low Grade ◽  
Gynecology And Obstetrics ◽  
Endometrioid Endometrial Carcinoma ◽  
Endometrial Carcinomas

Low-grade and early Federation for Gynecology and Obstetrics (FIGO) stage endometrioid endometrial carcinomas (EEC) have an excellent prognosis. However, approximately 10% of patients develop recurrence, which cannot be correctly predicted at diagnosis. We evaluated myoinvasive patterns as a prognostic factor of relapse in low-grade, early-stage EEC. Two-hundred and fifty-eight cases were selected according to the following inclusion criteria: (i) endometrioid endometrial carcinomas, (ii) grade 1 or 2 with (iii) FIGO stage I or II, and (iv) clinical follow-up. Slides were reviewed to annotate the myoinvasive pattern present in each case (infiltrative glands, microcystic, elongated and fragmented –MELF-, broad front, adenomyosis-like and adenoma malignum). Microsatellite instability was studied by immunoexpression of mismatch repair proteins (MLH1, PMS2, MSH2, and MSH6). There were 29 recurrences (11.2%) among the 258 cases analysed. A predominant broad front myoinvasive pattern was significantly associated with tumour relapse (p = 0.003). The presence of a pattern of infiltrative glands (p = 0.001) and microsatellite instability (p = 0.004) were associated with lower disease-free survival, without having an impact on overall survival. Our observations suggest the potential value of the pattern of myoinvasion as a prognostic factor in low-grade, early-stage endometrioid endometrial carcinoma.

Short versus long duration of adjuvant trastuzumab (T) in HER2+ breast cancer: A systematic review and meta-analysis of randomized controlled trials (RCTs).

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. e12057-e12057 ◽  
Author(s):  
Qurat Ul Ain Riaz Sipra ◽  
Irbaz Bin Riaz ◽  
Muhammad Husnain ◽  
Ammad Raina ◽  
Ahsan Khan ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Systematic Review ◽  
Early Stage ◽  
Meta Analysis ◽  
Unmet Need ◽  
Disease Free Survival ◽  
Significant Heterogeneity ◽  
Cardiac Events ◽  
Her2 Breast Cancer ◽  
Study Heterogeneity

e12057 Background: Several RCTs have evaluated a shorter duration of T ( < 12 months) with hopes of similar efficacy, reduced cardiotoxicity, cost and burden of treatment. Of the 5 major studies, PERSPHONE showed that 6 months was non-inferior compared to 12 months. However, four additional studies of shorter duration failed to demonstrate non-inferiority. Therefore, we performed an updated systematic review and a meta-analysis to assess the optimal duration of adjuvant T. Methods: MEDLINE, EMBASE, Cochrane, Scopus and conference proceedings were searched to identify RCTs comparing one year of adjuvant T with a shorter duration in early-stage HER2+ breast cancer. The DerSimonian-Laird random-effects Meta-Analysis was performed using CMAv3 software to derive pooled Hazard Ratio (HR) estimates for overall survival (OS, Disease-Free Survival (DFS) and Odds Ratio(OR) estimates of cardiac toxicity. Q-test was used to assess between-study heterogeneity; I2 statistic was computed to express the percentage of the total observed variability due to study heterogeneity. The risk for bias was assessed using the Cochrane Collaboration’s tool. Results: We screened 1772 citations and identified 5 studies(n = 11,377) for analysis. 5691 patients were randomized to 12 months of adjuvant T while 5686 were randomized to a shorter duration (3 studies evaluated 6 vs 12 months, 2 studies evaluated 9 weeks vs 12 months). OS (HR, 1.16, 95% CI 1.03-1.31, P= 0.015,I2 0.00, p= 0.837) and DFS (HR, 1.14, 95% CI 1.02-1.26 , P = 0.016,I2 14.90, p= 0.319) were significantly worse in patients receiving shorter duration T as compared to 12 months. Cardiotoxicity was significantly higher in the 12 month group vs shorter duration (OR, 2.10, 95% CI 1.58-2.80, p = 0.000 ,I2 51.182, p= 0.085). Grade 3/4 cardiac events and cardiac events leading to discontinuation of therapy were significantly higher in patients receiving 12 months (HR 2.06, 95% CI 1.60-2.63, P = 0.000, I2 3.967, p= 0.384). There was no significant heterogeneity among studies. Risk of bias was low. Conclusions: Twelve months of adjuvant T is associated with significantly better DFS and OS compared to a shorter duration. As such, 12 months should remain the standard of care for most patients. There is an unmet need to identify lower risk groups which might do well with from shorter duration of HER2-directed therapy.

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