scholarly journals Association between TERT promoter mutations and clinical behaviors in differentiated thyroid carcinoma: a systematic review and meta-analysis

Endocrine ◽  
2019 ◽  
Vol 67 (1) ◽  
pp. 44-57 ◽  
Author(s):  
Jing Yang ◽  
Yanping Gong ◽  
Shuping Yan ◽  
Hui Chen ◽  
Siqin Qin ◽  
...  
Keyword(s):  
Systematic Review ◽  
Meta Analysis ◽  
Random Effect ◽  
Distant Metastases ◽  
Tnm Stage ◽  
Thyroid Carcinomas ◽  
Specific Mortality ◽  
Disease Specific Mortality ◽  
Promoter Mutations ◽  
Disease Specific

Abstract Background The association between telomerase reverse transcriptase (TERT) promoter mutations and some clinical behaviors in thyroid cancer remains controversial and requires additional investigation. This study aimed to evaluate the association between TERT promoter mutations and clinical behaviors (including clinicopathological features and prognosis) in differentiated thyroid carcinomas (DTC). Methods We performed an up-to-date systematic review and current comprehensive meta-analysis. We searched three electronic databases for relevant studies. We used fixed- or random-effect models to calculate pooled estimated odds ratios (ORs) or standardized mean differences (SMDs) and corresponding 95% confidence intervals (CIs). Results We included 51 eligible studies incorporating 11,382 cases. Average frequencies of TERT promoter mutations in DTC, papillary (PTC), and follicular (FTC) thyroid carcinomas were 10.9%, 10.6%, and 15.1%, respectively. In DTC and PTC, TERT promoter mutations were significantly associated with sex, age, tumor size, vascular invasion, extrathyroidal extension, lymph node and distant metastases, advanced tumor, nodes, and metastasis (TNM) stage, persistence/recurrence, and disease-specific mortality. In FTC, TERT promoter mutations were significantly associated with age, distant metastases, advanced TNM stage, persistence/recurrence, and disease-specific mortality. Conclusions TERT promoter mutations could be considered as biomarkers assisting in risk stratification, prognostic prediction, and individualizing therapeutic options for DTC (PTC and FTC).

scholarly journals Systematic review and meta-analysis on outcomes of salvage therapy in patients with tumour recurrence during ‘watch and wait’ in rectal cancer

2019 ◽  
Vol 101 (7) ◽  
pp. 441-452 ◽  
Author(s):  
J On ◽  
J Shim ◽  
EH Aly
Keyword(s):  
Rectal Cancer ◽  
Relative Risk ◽  
Salvage Therapy ◽  
Meta Analysis ◽  
Salvage Treatment ◽  
Watch And Wait ◽  
Conventional Surgery ◽  
Specific Mortality ◽  
Disease Specific Mortality ◽  
Disease Specific

Introduction The ‘watch and wait’ approach has recently emerged as an alternative approach for managing patients with complete clinical response in rectal cancer. However, less is understood whether the intervention is associated with a favourable outcome among patients who require salvage therapy following local recurrence. Materials and methods A comprehensive systematic search was performed using EMBASE, PubMed, MEDLINE, Journals@Ovid as well as hand searches; published between 2004 and 2018, to identify studies where outcomes of patients undergoing watch and wait were compared with conventional surgery. Study quality was assessed using the Newcastle–Ottawa assessment scale. The main outcome was relative risks for overall and disease specific mortality in salvage therapy. Results Nine eligible studies were included in the meta-analysis. Of 248 patients who followed the watch and wait strategy, 10.5% had salvage therapy for recurrent disease. No statistical heterogeneity was found in the results. The relative risk of overall mortality in the salvage therapy group was 2.42 (95% confidence interval 0.96–6.13) compared with the group who had conventional surgery, but this was not statistically significant (P > 0.05). The relative risk of disease specific mortality in salvage therapy was 2.63 (95% confidence interval 0.81–8.53). Conclusion Our findings demonstrated that there was no significant difference in overall and disease specific mortality in patients who had salvage treatment following recurrence of disease in the watch and wait group compared with the standard treatment group. However, future research into the oncological safety of salvage treatment is needed.

Associations Between Handgrip Strength and Disease-Specific Mortality Including Cancer, Cardiovascular, and Respiratory Diseases in Older Adults: A Meta-Analysis

2020 ◽  
Vol 28 (2) ◽  
pp. 320-331
Author(s):  
Junga Lee
Keyword(s):  
Older Adults ◽  
Older Women ◽  
Respiratory Diseases ◽  
Handgrip Strength ◽  
Meta Analysis ◽  
Adult Participants ◽  
All Cause Mortality ◽  
Specific Mortality ◽  
Disease Specific Mortality ◽  
Disease Specific

Several controversial studies linking handgrip strength and health have suggested that low handgrip strength in older adults may be related to health problems and have investigated whether there is a minimum handgrip strength level associated with reduced mortality. Thus, by meta-analysis, the authors identified an association between handgrip strength in older adults and disease-specific mortality and all-cause mortality. Thirty studies with a total of 194,767 older adult participants were included in this meta-analysis. Higher handgrip strength was associated with an 18% decrease in all-cause mortality. Lower handgrip strength was associated with increased all-cause mortality. The minimum handgrip strength in older women that did not increase all-cause mortality was 18.21 kg. Increased handgrip strength showed a decreased all-cause mortality, whereas decreased handgrip strength was associated with increased all-cause mortality. Strengthening the handgrip may help improve disease-specific mortality in older adults.

scholarly journals Therapeutic Outcomes of Recurrent Well-Differentiated Thyroid Carcinomas

2019 ◽  
Vol 104 (7-8) ◽  
pp. 304-313
Author(s):  
Chih-Yiu Tsai ◽  
Shu-Fu Lin ◽  
Szu-Tah Chen ◽  
Chuen Hsueh ◽  
Yann Sheng Lin ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Thyroid Carcinoma ◽  
Recurrent Disease ◽  
Differentiated Thyroid Carcinoma ◽  
Thyroid Carcinomas ◽  
Specific Mortality ◽  
Disease Specific Mortality ◽  
Well Differentiated ◽  
Disease Specific

Objective The aim of this study was to evaluate outcomes of the recurrent and non-recurrent groups including disease-specific mortality of patients with well-differentiated thyroid carcinoma after multimodality treatment. In addition, prognostic factors for disease-specific mortality were analyzed. Summary of Background Data Among 2,844, there were 166 patients with recurrent disease. Recurrent disease was defined as the presence of papillary or follicular thyroid cancer 6 months after the initial thyroidectomy, including locoregional or distant metastasis, diagnosed using diagnostic or therapeutic 131I scans or other imaging techniques. Methods The study was a retrospective analysis of prospectively collected data for a long-term follow-up result of well-differentiated thyroid carcinoma patients. Results The mean age of 166 patients was 45.8 ± 1.2 years, 116 (69.9%) were women, 111 (66.9%) had locoregional neck recurrence, and 55 (33.1%) had metastatic recurrence in distant organs. We found that when recurrences were observed, more than half were detected within the first 5 years following the initial therapy. The longest period of time before relapse was 29.8 years. After a mean follow-up period of 12.7 ± 0.5 years, 37 (22.3%) patients experienced disease-specific mortality. Multivariable analysis revealed that older age, male sex, and development of a second primary malignancy were associated with disease-specific mortality. Higher post-operative levels of thyroglobulin predicted a shorter time to relapse. Conclusions These data indicate that among the recurrent cases over 50% of recurrent well-differentiated thyroid carcinomas were diagnosed within 5 years after initial thyroidectomy. Additionally, more than 20% of the patients died of thyroid cancer.

Risk factors associated with disease-specific mortality in papillary thyroid cancer patients with distant metastases

Endocrine ◽  
2021 ◽  
Author(s):  
Kamilla Schmitz Nunes ◽  
Leandro Luongo Matos ◽  
Beatriz Godoi Cavalheiro ◽  
Felipe Ferraz Magnabosco ◽  
Marcos Roberto Tavares ◽  
...  
Keyword(s):  
Risk Factors ◽  
Thyroid Cancer ◽  
Cancer Patients ◽  
Papillary Thyroid Cancer ◽  
Distant Metastases ◽  
Papillary Thyroid ◽  
Factors Associated ◽  
Specific Mortality ◽  
Disease Specific Mortality ◽  
Disease Specific

Association of Serum Leptin with All-Cause and Disease Specific Mortality: A Meta-Analysis of Prospective Observational Studies

2018 ◽  
Vol 50 (07) ◽  
pp. 509-520 ◽  
Author(s):  
Hamed Kord-Varkaneh ◽  
Somaye Fatahi ◽  
Shahab Alizadeh ◽  
Ehsan Ghaedi ◽  
Sakineh Shab-Bidar
Keyword(s):  
Observational Studies ◽  
Meta Analysis ◽  
Healthy People ◽  
Serum Leptin ◽  
Risk Of Death ◽  
All Cause Mortality ◽  
Specific Mortality ◽  
Study Heterogeneity ◽  
Disease Specific Mortality ◽  
Disease Specific

AbstractLeptin levels may affect mortality through its link to inflammation and obesity. However, data are inconclusive. This meta-analysis was performed to investigate the association of leptin with mortality. The PubMed, Scopus, Google scholar, and reference lists of the included studies were searched for all published prospective observational studies that described the associations of serum leptin and mortality up to August 2017. Two reviewers independently assessed all potentially relevant studies for inclusion and methodological quality using standardized abstraction forms. Of 518 studies identified, 19 studies considered the association of leptin with all-cause mortality (16 208 subjects) and 12 studies evaluated the association of leptin with disease-specific mortality (13 680 subjects). In the overall analysis, no significant association was found between leptin and all-cause mortality (HR=1.028; 95% CI: 0.908–1.165; p=0.659), with a high between study heterogeneity (p˂0.001, I2=61). Subgroup analysis found that high leptin is associated with increased all-cause mortality in healthy people (HR=1.159 (95% CI, 1.032, 1.302), p=0.012), in men (HR=1.162; 95% CI: 1.036–1.302; p=0.010), and in subjects with ≥60 years old (HR=1.129; 95% CI: 1.030–1.238; p=0.010); whereas, increased leptin levels was related to the decreased cancer-specific mortality ((HR=0.550; 95% CI: 0.418–0.724), p˂0.001). Higher leptin levels in healthy people, old people, and males were associated with increased all-cause mortality, while increased leptin level was related to the reduced risk of death among patients with cancer.

scholarly journals Complications of Outpatient and Inpatient Renal Biopsy: A Systematic Review and Meta-Analysis

Diagnostics ◽  
2021 ◽  
Vol 11 (4) ◽  
pp. 651
Author(s):  
Shih-Yi Lin ◽  
Cherry Yin-Yi Chang ◽  
Cheng-Chieh Lin ◽  
Wu-Huei Hsu ◽  
I.-Wen Liu ◽  
...  
Keyword(s):  
Systematic Review ◽  
Renal Biopsy ◽  
Meta Analysis ◽  
Random Effect ◽  
Bleeding Risk ◽  
Complication Rates ◽  
Bleeding Events ◽  
Cochrane Database ◽  
Renal Biopsies ◽  
Inpatient Settings

Background: The evidence indicates that the optimal observation period following renal biopsy ranges between 6 and 8 h. This systematic review and meta-analysis explored whether differences exist in the complication rates of renal biopsies performed in outpatient and inpatient settings. Methods: We searched the MEDLINE, EMBASE, and the Cochrane Database of Systematic Reviews from 1985 to February 2020. Two reviewers independently selected studies evaluating the bleeding risk from renal biopsies performed in outpatient and inpatient settings and reviewed their full texts. The primary and secondary outcomes were risks of bleeding and major events (including mortality) following the procedure, respectively. Subgroup analysis was conducted according to the original study design (i.e., prospective or retrospective). Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated using a random effect meta-analysis. Heterogeneity was assessed using the I2 test. Results: Data from all 10 eligible studies, which included a total of 1801 patients and 203 bleeding events, were included for analysis. Renal biopsies in outpatient settings were not associated with a higher bleeding risk than those in inpatient settings (OR = 0.81; 95% CI, 0.59–1.11; I2 = 0%). The risk of major events was also comparable across both groups (OR = 0.45; 95% CI, 0.16–1.29; I2 = 4%). Conclusions: Similar rates of bleeding and major events following renal biopsy in outpatient and inpatient settings were observed.

scholarly journals Medicine storage, wastage, and associated determinants among urban households: a systematic review and meta-analysis of household surveys

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Adineh Jafarzadeh ◽  
Alireza Mahboub-Ahari ◽  
Moslem Najafi ◽  
Mahmood Yousefi ◽  
Koustuv Dalal
Keyword(s):  
Systematic Review ◽  
Meta Analysis ◽  
Supply And Demand ◽  
Random Effect ◽  
Effect Sizes ◽  
Household Surveys ◽  
Affective Factors ◽  
Urban Households ◽  
Medical Needs ◽  
Geographical Regions

Abstract Background Irrational household storage of medicines is a world-wide problem, which triggers medicine wastage as well as its associated harms. This study aimed to include all available evidences from literature to perform a focused examination of the prevalence and factors associated with medicine storage and wastage among urban households. This systematic review and meta-analysis mapped the existing literature on the burden, outcomes, and affective socio-economic factors of medicine storage among urban households. In addition, this study estimated pooled effect sizes for storage and wastage rates. Methods Household surveys evaluating modality, size, costs, and affective factors of medicines storage at home were searched in PubMed, EMBASE, OVID, SCOPUS, ProQuest, and Google scholar databases in 2019. Random effect meta-analysis and subgroup analysis were used to pool effect sizes for medicine storage and wastage prevalence among different geographical regions. Results From the 2604 initial records, 20 studies were selected for systematic review and 16 articles were selected for meta-analysis. An overall pooled-prevalence of medicine storage and real wastage rate was 77 and 15%, respectively. In this regard, some significant differences were observed between geographical regions. Southwest Asia region had the highest storage and wastage rates. The most common classes of medicines found in households belonged to the Infective agents for systemic (17.4%) and the Nervous system (16.4%). Moreover, income, education, age, the presence of chronic illness, female gender, and insurance coverage were found to be associated with higher home storage. The most commonly used method of disposal was throwing them in the garbage. Conclusions Factors beyond medical needs were also found to be associated with medicine storage, which urges effective strategies in the supply and demand side of the medicine consumption chain. The first necessary step to mitigate home storage is establishing an adequate legislation and strict enforcement of regulations on dispensing, prescription, and marketing of medicines. Patient’s pressure on excessive prescription, irrational storage, and use of medicines deserve efficient community-centered programs, in order to increase awareness on these issues. So, hazardous consequences of inappropriate disposal should be mitigated by different take back programs, particularly in low and middle income countries.

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