Gender Specific Differences in Disease-Free, Cancer Specific and Overall Survival after Radical Cystectomy for Bladder Cancer: A Systematic Review and Meta-Analysis

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.

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TP1.2.3Oncological Outcomes of Organ Preservation Strategies - Local Excision Procedures and ‘Watchful Waiting’ In Management of Low Rectal Cancers – A Systematic Review And Meta-Analysis

British Journal of Surgery ◽

10.1093/bjs/znab362.002 ◽

2021 ◽

Vol 108 (Supplement_7) ◽

Author(s):

A R Aspari ◽

V Ramesh ◽

G Kumar ◽

S N Narayanasamy ◽

A O Gumber ◽

...

Keyword(s):

Systematic Review ◽

Overall Survival ◽

Local Recurrence ◽

Organ Preservation ◽

Meta Analysis ◽

Disease Free Survival ◽

Distant Metastases ◽

Free Survival ◽

Rectal Cancers ◽

Disease Free

Abstract Objective To evaluate local recurrence, metastases, and survival outcomes of `wait and watch’ (WW) strategy and local excision (LE) of tumours, in comparison to the present standard practice of total mesorectal excision (TME) for locally advanced rectal cancers. Data Sources MEDLINE, EMBASE, PubMed databases, and sources of Grey literature. Study Selection Randomised and non-randomised prospective studies, retrospective studies with propensity-score-matched analyses. Data Extraction and Synthesis These were carried out independently by two reviewers. A random-effects methodology was used for meta-analyses. Data was presented keeping with the 27-item PRISMA checklist. Main Outcomes The primary outcomes of interest were local recurrence, distant metastases, disease-free-survival and overall-survival, which were assessed in comparison to those associated with radical surgeries (TME). Results 7 of the 16 studies in the systematic review were included for the quantitative synthesis and meta-analysis. Local recurrence rates were comparable amongst patients in WW group and LE group to those undergoing TME. [Risk ratio (RR) 3.07/1.41; 95% Confidence Interval (CI) 0.86-10.95/0.66-3.01; P = 0.08/P=0.89 respectively]. Rates of distant metastases in the WW group and LE group were comparable to those undergoing TME [RR = 0.71/0.94; 95% CI 0.22-2.30/0.55-1.61; P = 0.56/ P = 0.83 respectively]. The median 3-year disease-free survival among patients undergoing WW, LE procedure, and TME were 88%, 80%, and 78.2% respectively; and the median 3-year overall survival among the three groups were 96%, 93%, and 89.5% respectively. Conclusions and Relevance Organ-preservation strategies appear to be a viable treatment option in the management of rectal-cancers. Further research is warranted to provide stronger levels of evidence on organ-preservation strategies.

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Meta-analysis of neoadjuvant chemotherapy compared to radical cystectomy alone in improving overall survival of muscle-invasive bladder cancer patients

BMC Urology ◽

10.1186/s12894-020-00733-z ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Agus Rizal A. H. Hamid ◽

Fanny Riana Ridwan ◽

Dyandra Parikesit ◽

Fina Widia ◽

Chaidir Arif Mochtar ◽

...

Keyword(s):

Overall Survival ◽

Bladder Cancer ◽

Neoadjuvant Chemotherapy ◽

Radical Cystectomy ◽

Meta Analysis ◽

Total Sample ◽

Invasive Bladder Cancer ◽

Forest Plot ◽

Muscle Invasive Bladder Cancer ◽

Muscle Invasive

Abstract Background Most patients with muscle-invasive bladder cancer (MIBC) developed metastasis within 2 years, even after radical cystectomy (RC). The recurrence rate of MIBC was more than 50% of the cases. A meta-analysis conducted by Yin et al. showed that neoadjuvant chemotherapy (NAC) + RC improves overall survival in MIBC compared with RC only. However, a new meta-analysis by Li et al. concluded that NAC + RC was not superior to RC only in improving overall survival. The inconsistencies of these studies required further comprehensive analysis to recommend NAC use in bladder cancer treatment. Therefore, this meta-analysis aims to analyze previous studies that compare the efficacy of NAC + RC versus RC only to improve overall survival of MIBC. Methods The articles were searched using Pubmed with keywords “muscle-invasive bladder cancer”, “neoadjuvant chemotherapy”, “cystectomy”, and “overall survival”. The articles that were published until June 2020 were screened. The overall survival outcome was analyzed as hazard ratio (HR) and presented in a forest plot. Result Seventeen studies were included in meta-analysis with a total sample of 13,391 patients, consist of 2890 received NAC followed by RC and 10,418 underwent RC only. Two studies used methotrexate/vinblastine/doxorubicin/cisplatin (MVAC), two studies used gemcitabine/cisplatin (GC), one study used Cisplatin-based regimen, one study used MVAC or GC, one study used gemcitabine/carboplatin (GCarbo) or GC or MVAC, one study used Cisplatin/Gemcitabine or MVAC, one study used Cisplatin only, one study used Cisplatin-based (GC, MVAC) or non-Cisplatin-based (combined paclitaxel/gemcitabine/carboplatin), one study used GC, MVAC, Carboplatin, or Gemcitabine/Nedaplatin (GN), and five studies did not mention the regimen The overall survival in the NAC + RC only group was significantly better than the RC only group (HR 0.82 [0.71–0.95], p = 0.009). Conclusion NAC + RC is recommended to improve overall survival in MIBC patients. A further study assessing side effects and quality of life regarding NAC + RC is needed to establish a strong recommendation regarding this therapy.

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Comparison of perioperative and oncologic outcomes between robot-assisted and laparoscopic radical cystectomy for bladder cancer: a systematic review and updated meta-analysis

International Urology and Nephrology ◽

10.1007/s11255-020-02406-0 ◽

2020 ◽

Vol 52 (7) ◽

pp. 1243-1254 ◽

Cited By ~ 2

Author(s):

Dechao Feng ◽

Shengzhuo Liu ◽

Yin Tang ◽

Yubo Yang ◽

Wuran Wei ◽

...

Keyword(s):

Systematic Review ◽

Bladder Cancer ◽

Radical Cystectomy ◽

Meta Analysis ◽

Oncologic Outcomes ◽

Robot Assisted

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Minimally invasive versus open radical cystectomy for bladder cancer: A systematic review and meta-analysis

Journal of International Medical Research ◽

10.1177/0300060519864806 ◽

2019 ◽

Vol 47 (10) ◽

pp. 4604-4618 ◽

Cited By ~ 2

Author(s):

Hongbin Shi ◽

Jiangsong Li ◽

Kui Li ◽

Xiaobo Yang ◽

Zaisheng Zhu ◽

...

Keyword(s):

Systematic Review ◽

Bladder Cancer ◽

Minimally Invasive ◽

Radical Cystectomy ◽

Meta Analysis ◽

Perioperative Outcomes ◽

Transfusion Rate ◽

Lymph Node Yield ◽

Multicenter Rct ◽

Open Radical Cystectomy

Background We performed a systematic review and meta-analysis to evaluate the efficacy and safety of minimally invasive radical cystectomy (MIRC) versus open radical cystectomy (ORC) for bladder cancer. Methods We searched the EMBASE and MEDLINE databases to identify randomized controlled trials (RCTs) of MIRC versus ORC in the treatment of bladder cancer. Results Eight articles describing nine RCTs (803 patients) were analyzed. No significant differences were found between MIRC and ORC in two oncologic outcomes: the recurrence rate and mortality. Additionally, no significant differences were found in three pathologic outcomes: lymph node yield, positive lymph nodes, and positive surgical margins. With respect to perioperative outcomes, however, MIRC showed a significantly longer operating time, less estimated blood loss, lower blood transfusion rate, shorter time to regular diet, and shorter length of hospital stay than ORC. The incidence of complications was similar between the two techniques. We found no statistically significant differences in the above outcomes between robot-assisted radical cystectomy and ORC or between laparoscopic radical cystectomy and ORC with the exception of the complication rate. Conclusions MIRC is an effective and safe surgical approach in the treatment of bladder cancer. However, a large-scale multicenter RCT is needed to confirm these findings.

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Laparoscopic versus Open Radical Cystectomy in Bladder Cancer: A Systematic Review and Meta-Analysis of Comparative Studies

PLoS ONE ◽

10.1371/journal.pone.0095667 ◽

2014 ◽

Vol 9 (5) ◽

pp. e95667 ◽

Cited By ~ 40

Author(s):

Kun Tang ◽

Heng Li ◽

Ding Xia ◽

Zhiquan Hu ◽

Qianyuan Zhuang ◽

...

Keyword(s):

Systematic Review ◽

Bladder Cancer ◽

Radical Cystectomy ◽

Comparative Studies ◽

Meta Analysis ◽

Open Radical Cystectomy

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Oncologic surveillance in bladder cancer following radical cystectomy: A systematic review and meta-analysis

Urologic Oncology Seminars and Original Investigations ◽

10.1016/j.urolonc.2015.11.025 ◽

2016 ◽

Vol 34 (5) ◽

pp. 236.e13-236.e21 ◽

Cited By ~ 5

Author(s):

Suzanne B. Stewart-Merrill ◽

Fares Alahdab ◽

Khalid Benkhadra ◽

Zhen Wang ◽

Atsushi Sorita ◽

...

Keyword(s):

Systematic Review ◽

Bladder Cancer ◽

Radical Cystectomy ◽

Meta Analysis

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Adjuvant Therapy for Stage II Colon Cancer: A Systematic Review From the Cancer Care Ontario Program in Evidence-Based Care’s Gastrointestinal Cancer Disease Site Group

Journal of Clinical Oncology ◽

10.1200/jco.2004.03.087 ◽

2004 ◽

Vol 22 (16) ◽

pp. 3395-3407 ◽

Cited By ~ 218

Author(s):

Alvaro Figueredo ◽

Manya L. Charette ◽

Jean Maroun ◽

Melissa C. Brouwers ◽

Lisa Zuraw

Keyword(s):

Systematic Review ◽

Colon Cancer ◽

Overall Survival ◽

Adjuvant Therapy ◽

Meta Analysis ◽

Disease Free Survival ◽

Stage Ii ◽

Free Survival ◽

Stage Ii Colon Cancer ◽

Disease Free

Purpose To develop a systematic review that would address the following question: Should patients with stage II colon cancer receive adjuvant therapy? Methods A systematic review was undertaken to locate randomized controlled trials comparing adjuvant therapy to observation. Results Thirty-seven trials and 11 meta-analyses were included. The evidence for stage II colon cancer comes primarily from a trial of fluorouracil plus levamisole and a meta-analysis of 1,016 patients comparing fluorouracil plus folinic acid versus observation. Neither detected an improvement in disease-free or overall survival for adjuvant therapy. A recent pooled analysis of data from seven trials observed a benefit for adjuvant therapy in a multivariate analysis for both disease-free and overall survival. The disease-free survival benefits appeared to extend to stage II patients; however, no P values were provided. A meta-analysis of chemotherapy by portal vein infusion has also shown a benefit in disease-free and overall survival for stage II patients. A meta-analysis was conducted using data on stage II patients where data were available (n = 4,187). The mortality risk ratio was 0.87 (95% CI, 0.75 to 1.01; P = .07). Conclusion There is preliminary evidence indicating that adjuvant therapy is associated with a disease-free survival benefit for patients with stage II colon cancer. These benefits are small and not necessarily associated with improved overall survival. Patients should be made aware of these results and encouraged to participate in active clinical trials. Additional investigation of newer therapies and more mature data from the presently available trials should be pursued.

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