scholarly journals Neuroendocrine tumors and Survival- a meta-analysis

2021 ◽  
Vol 156 (Supplement_1) ◽  
pp. S57-S57
Author(s):  
A Khayyat ◽  
M Asad ◽  
A Aslam ◽  
R Rabbani ◽  
S Fabara ◽  
...  
Keyword(s):  
Sensitivity Analysis ◽  
Overall Survival ◽  
Neuroendocrine Tumors ◽  
Meta Analysis ◽  
Survival Rates ◽  
Poor Survival ◽  
Endoscopic Screening ◽  
Random Effects Models ◽  
Grade 3

Abstract Introduction/Objective Neuroendocrine tumors (NET) are a rare group of epithelial neoplasm present in gastrointestinal tract (GI) (67.5%), bronchopulmonary tree (25.3-30%) and in 15% cases primary sites cannot be identified. Although endoscopic screening, improvement in pathological techniques and early detection have shown improvement in NET survival rates, the prognosis is very poor. In this study we aimed to evaluate the effect of Gastrointestinal pancreatic NETs (GEP NETs) grade on overall survival. Methods/Case Report We searched observational studies describing the overall survival or prognostic factors of primary GEP NETs from May 2011 -May 2021 following PRISMA guidelines. Studies describing the effect of primary grade 3 GEP NETs on overall survival were included. Meta-analysis was performed and pooled hazard ratio and their 95% confidence interval (95%CI) were obtained. The forest plots were created using random effects models and sensitivity analysis was performed to account for the heterogeneity. Results (if a Case Study enter NA) Seven studies with 7692 confirmed patients were included. In our meta-analysis grade 3 GEP NET were associated with higher odds of poor survival (pooled HR: 2.73; 95% CI: 1.36–5.47; p = 0.005), with 92% heterogeneity between studies (p < 0.0001). To account for heterogeneity, sensitivity analysis was performed by removing two outlying studies (Fathi et al. and Foubert et al.) on funnel plots. The results after sensitivity analysis did not change and still showed significant association of grade 3 with poor survival (pooled HR: 4.53; 95% CI: 3.54–5.78; p < 0.00001), with no heterogeneity between studies (p = 0.72; I2 = 0%). Conclusion Our meta-analysis found that grade 3 GEP NETs is associated with poor survival and additional future studies are needed to identify other risk factors associated with poor survival in GEP NETs to improve the mortality.

Meta-analytic comparison of robotic and transoral laser surgical procedures in supraglottic carcinoma

2019 ◽  
Vol 133 (05) ◽  
pp. 404-412 ◽  
Author(s):  
M B Asik ◽  
B Satar ◽  
M Serdar
Keyword(s):  
Overall Survival ◽  
Robotic Surgery ◽  
Surgical Procedures ◽  
Meta Analysis ◽  
Survival Rates ◽  
Published Data ◽  
Disease Specific Survival ◽  
Success Rates ◽  
Surgery Group ◽  
Disease Specific

AbstractObjectiveTo assess published reports of oncological surgical success rates in patients who underwent transoral laser supraglottic surgery and robotic surgery for supraglottic cancer.MethodsA systematic review of the literature was conducted and a meta-analysis of published data was performed. PubMed, Sage, Medline and Cochrane data sources were investigated. Overall survival rates, disease-specific survival rates, additional treatments and recurrence rates were investigated to determine the success of the surgical procedures.ResultsThe meta-analysis included 24 studies; 1617 studies were excluded. There were no statistically significant differences between the transoral laser supraglottic surgery and transoral robotic supraglottic surgery groups in terms of overall survival (77.0 per cent and 82.4 per cent respectively) and disease-specific survival (75.8 per cent and 87.0 per cent respectively). There was recurrence in 164 out of 832 patients (19.7 per cent) in the transoral laser supraglottic surgery group and in only 6 out of 66 patients (9 per cent) in the transoral robotic supraglottic surgery group.ConclusionTransoral laser surgery and robotic surgery appear to have comparable and acceptable oncological success rates.

scholarly journals Factors Affecting the Survival of Patients with Oligometastatic Non-Small-Cell Lung Cancer: A Meta-Analysis

2019 ◽  
Vol 2019 ◽  
pp. 1-6 ◽  
Author(s):  
Yu Shi ◽  
Jianxin Yang ◽  
Ninghua Yao ◽  
Minghai Shao ◽  
Wenxiu Ding ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Sensitivity Analysis ◽  
Overall Survival ◽  
Survival Rate ◽  
Small Cell Lung Cancer ◽  
Meta Analysis ◽  
Small Cell ◽  
Overall Survival Rate ◽  
Small Cell Lung ◽  
Nsclc Patients

Background. The aim was to investigate the potential factors related with overall survival of oligometastatic non-small-cell lung cancer (NSCLC) patients. Methods. A literature search was conducted in databases including PubMed, Embase, and Cochrane library up to March 2017. The hazard radio (HR) as well as the corresponding 95% confidence interval (CI) were calculated, and all the statistics analysis was performed by the R 3.12. Heterogeneity was analyzed using I-squared and Cochran Q tests. Furthermore, sensitivity analysis was performed to evaluate the stability of results. Results. In total, 6 articles were included in the meta-analysis. Nodal status was significantly correlated with the overall survival rate of NSCLC oligometastatic patients (HR: 1.69, 95% CI: 1.23–2.32, Z=3.20, P=0.001). No significant relationship was found between overall survival rate of NSCLC oligometastatic patients and the indicators including sex, stage, smoker, age, and histology. Notably, sensitivity analysis on data evaluating relationship between patients survival and the stage and histology showed that results were reversed after removing one of the studies. Conclusions. Nodal status might be associated with the overall survival of oligometastatic NSCLC patients.

A Comparison of Single Dose Gemtuzumab Ozogamicin 3mg/m2 and 6mg/m2 Combined with Induction Chemotherapy in Younger Patients with AML: Data from the UK NCRI AML17 Trial

Blood ◽  
2014 ◽  
Vol 124 (21) ◽  
pp. 2308-2308 ◽  
Author(s):  
Alan K Burnett ◽  
Nigel Russell ◽  
Robert K. Hills ◽  
Jamie Cavenagh ◽  
Jonathan Kell ◽  
...  
Keyword(s):  
Overall Survival ◽  
Single Dose ◽  
Induction Chemotherapy ◽  
De Novo ◽  
Meta Analysis ◽  
Randomised Trial ◽  
Gemtuzumab Ozogamicin ◽  
Platelet Recovery ◽  
Grade 3 ◽  
The Uk

Abstract On behalf of the UK NCRI AML Study Group. Gemtuzumab Ozogamicin (GO) was the first antibody directed chemotherapy in cancer, but has had a chequered development in AML. We recently completed an individual patient data meta-analysis (Hills et al Lancet Oncology 15 (9): 986-96, 2014) which confirmed, in an analysis of the 5 randomised trials in adults, that simultaneous administration with induction chemotherapy significantly improved survival by reducing relapse risk in favourable and intermediate risk groups, but not in patients with adverse risk. The analysis further suggested that a single dose of 3mg/m2 was as effective at preventing relapse as a 6mg/m2 dose, while having less toxicity, and therefore may be the optimal dose level. A question posed in the UK NCRI AML17 Trial was to directly compare 3mg/m2 with 6mg/m2 to ascertain whether efficacy or toxicity differences overall or within subgroups could be found. Between 06/2009 and 10/2011 788 patients were randomised: the median age was 50yrs (0-81, 29 <16yrs). 86% had de novo, 9% secondary disease and 5% MDS; 53% were male. 13% were favourable/ 69% intermediate, and 18% adverse cytogenetic risk; median presenting WBC was 9.2 (0.4-386); 18% had a FLT3 ITD and 28% had an NPM1c mutation. The associated chemotherapy was DA (3+10) (n=380) or ADE (10+3+5)(n=403); all children received ADE. GO was administered on day one of the induction chemotherapy. WBCs >30 could be cytoreduced with hydroxyurea or the GO delayed till day 4 of chemotherapy. Liver function biochemistry required to be <2XULN. Toxicity was defined as in NCICTC v.3. Results: Eighty-seven percent of patients entered CR/CRi with no difference between the arms overall or with in any demographic subgroup (3mg 89% vs 6mg 85%; OR 1.34 (0.88-2.04), p=0.17). The 30-day (3% vs 7%; OR 2.04 (1.10-3.80), p=0.02) and 60-day mortality (5% vs 9%; OR 1.99 (1.17-3.39), p=0.01) were both increased in the 6mg arm. There were 18 vs 36 deaths within 60 days: causes were infection (10 vs 11); infection+haemorrhage (0 vs 1); haemorrhage 3 vs 4; resistant disease 2 vs 6; veno-occlusive disease 0 vs 5; cardiac 1 vs 3; pulmonary 2 vs 1; renal 0 vs 3; multiple 0 vs 2.Relapse free survival at 3 years was 44% overall and 45% for 3mg and 42% for 6mg (OR 1.11 (0.91-1.35), p=0.3). Overall survival at 3 years was 52% and 53% for 3mg and 50% for 6mg (OR 1.12 (0.91-1.36), p=0.3). There was no difference in mortality after day 60. Allografts were given to 324 patients, 183 in CR1, but the distribution on numbers and transplant type was not different between the arms. Neither the 3mg or 6mg dose caused excess post- transplant toxicity. No subgroup showed any suggestion of response or survival benefit from the 6mg dose with the exception of a non-significant benefit for both response rate (test for heterogeneity p=0.02) and overall survival (test for heterogeneity p=0.04) in the adverse cytogenetics patients (n=133). When grade 3 or 4 toxicities are compared, ALT, creatinine and haematuria in course 1 (7% vs 17%; 1% vs 2%; 1% vs 2% respectively), were the only significant differences in courses 1 & 2. The requirement for red cell and platelet transfusions and days on antibiotics was increased in the 6mg patients in course 1, with slower platelet recovery in course 1. There were no significant grade 3 or 4 toxicity differences or supportive care required in course 2. Central assessment of VOD was confirmed as definite (n=17) or possible (n=5) in 22 of 395 (5.6%) patients on 6mg compared with 2 definite and 0 possible in 2 of 393 on the 3 mg arm (0.5%) (p<0.0001). Conclusion: Although both the 3mg and 6mg dose have provided benefit when combined with induction chemotherapy, in this large randomised trial we found no benefit in giving a single 6mg/m2 dose of GO when compared with 3mg/m2, with the possible exception of in the adverse risk patients who showed no evidence of benefit in the recent meta-analysis. Although the difference in toxicity was modest and VOD, although increased, uncommon, this experience suggests that future studies should focussing on optimising the schedule for GO at the 3mg/m2 dose, such as the fractionated approach developed by the French ALFA Group. Such studies are underway. (We are grateful to CRUK for research funding for this trials and to Pfizer for the provision of gemtuzumab ozogamicin) Disclosures Off Label Use: Gemtuzumab Ozogamicin for AML.

Is there a role for neoadjuvant radiation dose escalation in esophageal cancer? A meta-analysis.

2016 ◽  
Vol 34 (4_suppl) ◽  
pp. 102-102
Author(s):  
Laila Lobo ◽  
Danny Yakoub ◽  
Caroline Ripat ◽  
Rishika Sharma ◽  
Raphael Yechieli
Keyword(s):  
Overall Survival ◽  
Esophageal Cancer ◽  
Radiation Dose ◽  
Esophageal Carcinoma ◽  
Meta Analysis ◽  
Survival Rates ◽  
Fistula Formation ◽  
Significant Difference ◽  
Patient Reported

102 Background: In treating esophageal cancer chemo-radiation is used in the definitive as well as neo-adjuvant setting. Optimal dosage of radiation for best outcome has been debated. The aim of this study is to evaluate clinical outcomes of lower radiation dosage compared to higher. Methods: Online search for studies comparing radiation dose from 1990 to present was performed. Primary outcome was overall-survival rates for up to 5 years. Secondary outcomes included post-treatment complications and treatment response. A cut point of 51 Gy and less was considered as lower dose and greater than 51 Gy was considered higher dose. Quality of included studies was evaluated by STROBE criteria. Relative Risk (RR) and 95% Confidence Intervals (CI) were calculated from pooled data. Results: The search strategy yielded 142 studies, 12 met our selection criteria and included 1876 patients receiving radiation for resectable esophageal carcinoma. Of these patients, 1057 received lower and 819 were treated with greater than 51 Gy. Median age was 63 and 64 years for lower and higher radiation dose respectively. Meta-analysis showed no statistically significant difference in survival and toxicities between the two groups. 1 year overall survival (RR = 0.97, 95% CI 0.84-1.13, p = 0.69), 2 year overall survival (RR = 1.29, 95% CI 0.76-2.19, p = 0.34), 3 year overall survival (RR = 1.18, 95% CI 0.83-1.68, p = 0.37), 4 year overall survival (RR = 1.37, 95% CI 0.64-2.94, p = 0.41), 5 year overall survival (RR = 1.11, 95% CI 0.72-1.69, p = 0.64), Esophagitis (RR = 0.76, 95% CI 0.39-1.50, p = 0.43), Dermatitis (RR = 0.98, 95% CI 0.12-7.94, p = 0.99), Fistula formation (RR = 0.72, 95% CI 0.32-1.60, p = 0.42), Hematologic complications (RR = 1.10, 95% CI 0.20-6.02, p = 0.91), Stricture formation (RR = 1.39, 95% CI 0.54-3.58, p = 0.5). Conclusions: Lower radiation dose appears to be as effective as higher dose in esophageal carcinoma with similar toxicity profile and survival rates. Larger prospective randomized trials, focusing on patient-reported quality-of-life are required to consolidate these results.

Fry-to-adult survival of natural and hatchery-produced chinook salmon (Oncorhynchus tshawytscha) from a common origin

1997 ◽  
Vol 54 (6) ◽  
pp. 1246-1254 ◽  
Author(s):  
M J Unwin
Keyword(s):  
New Zealand ◽  
Chinook Salmon ◽  
Oncorhynchus Tshawytscha ◽  
Survival Rates ◽  
Adult Survival ◽  
Poor Survival ◽  
Stock Size ◽  
Hatchery Fish ◽  
Stock Recruitment

Fry-to-adult survival rates for chinook salmon (Oncorhynchus tshawytscha) from Glenariffe Stream, a tributary of the Rakaia River, New Zealand, were estimated for fish of both natural and hatchery origin. Survival of naturally produced fry, most of which leave Glenariffe Stream within 24 h of emergence, averaged 0.079% (range 0.013-1.17%). For hatchery fish released at 8-12 months, standardised to a mean weight of 38 g, survival covaried with weight at release consistently across all brood years and averaged 0.34% (range 0.008-3.28%). Survival rates for hatchery fish were four times higher than for naturally produced fry, but were extremely poor relative to their size at release. Survival rates for fish of natural and hatchery origin were positively correlated, suggesting that recruitment of both stocks is primarily controlled by common influences within the marine environment, probably during the first winter at sea. Stock-recruitment analysis for the natural population showed little tendency for recruitment to increase with stock size, suggesting that marine survival rates may be density dependent. Although the reasons for the relatively poor survival of hatchery fish are unclear, the results provide a case study in which hatchery fish appear to have a poorer ``fitness to survive'' than their natural counterparts.

Benefits and Adverse Events in Younger Versus Older Patients Receiving Neoadjuvant Chemotherapy for Osteosarcoma: Findings From a Meta-Analysis

2013 ◽  
Vol 31 (18) ◽  
pp. 2303-2312 ◽  
Author(s):  
Marnie Collins ◽  
Miriam Wilhelm ◽  
Rachel Conyers ◽  
Alan Herschtal ◽  
Jeremy Whelan ◽  
...  
Keyword(s):  
Neoadjuvant Chemotherapy ◽  
Tumor Necrosis ◽  
Meta Analysis ◽  
Survival Rates ◽  
Tumor Location ◽  
Published Data ◽  
Cooperative Groups ◽  
Data Set ◽  
Landmark Analysis ◽  
Grade 3

Purpose The LIVESTRONG Young Adult Alliance has conducted a meta-analysis of individual patient data from prospective neoadjuvant chemotherapy osteosarcoma studies and registries to examine the relationships of sex, age, and toxicity on survival. Patients and Methods Suitable data sets were identified by a survey of published data reported in PubMed. The final pooled data set comprised 4,838 patients from five international cooperative groups. Results After accounting for important variables known at study entry such as tumor location and histology, females experienced higher overall survival rates than males (P = .005) and children fared better than adolescents and adults (P = .002). Multivariate landmark analysis following surgery indicated that a higher rate of chemotherapy-induced tumor necrosis was associated with longer survival (P < .001), as was female sex (P = .004) and the incidence of grade 3 or 4 mucositis (P = .03). Age group was not statistically significant in this landmark analysis (P = .12). Females reported higher rates of grade 3 or 4 thrombocytopenia relative to males (P < .001). Children reported the highest rates of grade 3 or 4 neutropenia (P < .001) and thrombocytopenia (P < .001). The achievement of good tumor necrosis was higher for females than for males (P = .002) and for children than for adults (P < .001). Conclusion These results suggest fundamental differences in the way chemotherapy is handled by females compared with males and by children compared with older populations. These differences may influence survival in a disease in which chemotherapy is critical to overall outcomes.

scholarly journals Effect of Induction Chemotherapy in Nasopharyngeal Carcinoma: An Updated Meta-Analysis

2021 ◽  
Vol 10 ◽  
Author(s):  
Shan-Shan Yang ◽  
Jian-Gui Guo ◽  
Jia-Ni Liu ◽  
Zhi-Qiao Liu ◽  
En-Ni Chen ◽  
...  
Keyword(s):  
Overall Survival ◽  
Nasopharyngeal Carcinoma ◽  
Induction Chemotherapy ◽  
Meta Analysis ◽  
Progression Free Survival ◽  
Pooled Analysis ◽  
Free Survival ◽  
Long Term Result ◽  
Grade 3

BackgroundPrevious meta-analysis had evaluated the effect of induction chemotherapy in nasopharyngeal carcinoma. But two trials with opposite findings were not included and the long-term result of another trial significantly differed from the preliminary report. This updated meta-analysis was thus warranted.MethodsLiterature search was conducted to identify randomized controlled trials focusing on the additional efficacy of induction chemotherapy in nasopharyngeal carcinoma. Trial-level pooled analysis of hazard ratio (HR) for progression free survival and overall survival and risk ratio (RR) for locoregional control rate and distant control rate were performed.ResultsTwelve trials were eligible. The addition of induction chemotherapy significantly prolonged both progression free survival (HR=0.68, 95% confidence interval [CI] 0.60–0.76, p&lt;0.001) and overall survival (HR=0.67, 95% CI 0.54–0.80, p&lt;0.001), with 5-year absolute benefit of 11.31% and 8.95%, respectively. Locoregional (RR=0.80, 95% CI 0.70–0.92, p=0.002) and distant control (RR=0.70, 95% CI 0.62–0.80) rates were significantly improved as well. The incidence of grade 3–4 adverse events during the concurrent chemoradiotherapy was higher in leukopenia (p=0.028), thrombocytopenia (p&lt;0.001), and fatigue (p=0.038) in the induction chemotherapy group.ConclusionsThis meta-analysis supported that induction chemotherapy could benefit patients with nasopharyngeal carcinoma in progression free survival, overall survival, locoregional, and distant control rate.

scholarly journals Intensive chemotherapy in children with acute lymphoblastic leukemia. Interim analysis in a referral center in Colombia.

2016 ◽  
Vol 64 (3) ◽  
pp. 417 ◽  
Author(s):  
Angela Maria Trujillo ◽  
Adriana Linares Ballesteros ◽  
Isabel Cristina Sarmiento
Keyword(s):  
Overall Survival ◽  
Acute Lymphoblastic Leukemia ◽  
Lymphoblastic Leukemia ◽  
Survival Rates ◽  
Developed Countries ◽  
Event Free Survival ◽  
Free Survival ◽  
Grade 3 ◽  
Treatment Abandonment ◽  
Cancer In Children

Background: Acute lymphoblastic leukemia is the most common cancer in children. In developed countries, overall survival rates are around 80%, while in developing countries, survival rate is much lower due to high rates of relapse, and abandonment and complications arising from the disease treatment.Objectives: To assess induction mortality, relapse and treatment abandonment. To describe the most frequent side effects of chemotherapy. To evaluate survival rates of patients and compare the findings found in this study with the existing literature.Material and methods: A retrospective cohort study was conducted on patients aged 1 to 18 with acute lymphoblastic leukemia, who received treatment under the BFM ALL IC 2009 protocol at Fundación Hospital La Misericordia (HOMI), from November 2012 to December 2014.Results: 119 patients were included. Death occurred in two cases during induction (1.67%) and in nine (7.7%) due to treatment, all of them caused by infection/sepsis and in complete remission. Six patients abandoned treatment (5%), while seven relapses occurred (5.9%). All patients experienced some type of side effect related to chemotherapy, the most frequent being febrile neutropenia (41.2%) and grade 3-4 infections (15.8%). Overall survival and event-free survival rates were 79.9% and 73.3%, respectively.Conclusions: Evaluating complications of treatment and death allows adopting measures and strategies to reduce such complications.

Expression of microRNA-210 and the prognosis in glioma patients: a meta-analysis

2020 ◽  
Vol 14 (9) ◽  
pp. 795-805
Author(s):  
Xuezhi Hu ◽  
Pengfei Yan ◽  
Jun Feng ◽  
Fangcheng Zhang
Keyword(s):  
Overall Survival ◽  
Predictive Power ◽  
Meta Analysis ◽  
Fixed Effect Model ◽  
Hazard Ratio ◽  
Fixed Effect ◽  
Poor Survival ◽  
Effect Model ◽  
Subgroup Analyses ◽  
Meta Analyses

Aim: To evaluate the predictive power of tumor microRNA-210 (miR-210) on overall survival (OS) in glioma patients. Materials & methods: Studies were identified through searching PubMed, Embase and China National Knowledge Internet electronic databases. Meta-analyses were performed with a random- or fixed-effect model according to the heterogeneity. Results: Six studies were included. Results showed that increased miR-210 expression in tumor independently predicted poor OS in glioma patients (hazard ratio [HR]: 1.38; p = 0.001). Subgroup analyses showed that the prognostic efficacy of tumor miR-210 levels for OS was stronger in overall patients with glioma (HR: 2.22; p < 0.001) than in those with glioblastoma (HR: 1.13; p = 0.01). Conclusion: Expression of miR-210 may predict poor survival in patients with glioma.

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