Survival Impact of Ovarian Preservation on Women With Early-Stage Endometrial Cancer: A Systematic Review and Meta-analysis

2016 ◽  
Vol 27 (1) ◽  
pp. 77-84 ◽  
Author(s):  
Haifeng Gu ◽  
Jundong Li ◽  
Yangkui Gu ◽  
Hua Tu ◽  
Yun Zhou ◽  
...  
Keyword(s):  
Endometrial Cancer ◽  
Early Stage ◽  
Meta Analysis ◽  
Grey Literature ◽  
Disease Free Survival ◽  
Premenopausal Women ◽  
Cochrane Library ◽  
Ovarian Preservation ◽  
Significant Difference ◽  
Early Stage Endometrial Cancer

ObjectiveThe aim of this article was to investigate the survival impact of ovarian preservation in surgically treated patients with early-stage endometrial cancer using a meta-analysis.MethodsMajor online databases, including PubMed, EMBASE, Web of Science, the Cochrane Library, as well as Grey Literature database, were searched to collect studies on the effects of ovarian preservation compared with bilateral salpingo-oophorectomy (BSO) for surgical treatment in endometrial cancer patients. The literature search was performed up to April 2016. The results were analyzed using RevMan 5.0 software and Stata/SE 12.0 software.ResultsTotally, 7 retrospective cohort studies including 1419 patients in ovarian preservation group and 15,826 patients in BSO group were enrolled. Meta-analysis showed that there was no significant difference in overall survival between the patients treated with ovarian preservation and BSO (hazards ratio [HR], 1.00; 95% confidence interval [CI], 0.72–1.39; P = 1.00). Similar result was achieved in the young and premenopausal women (HR, 0.99; 95% CI, 0.70–1.39; P = 0.39). Furthermore, the disease-free survival of patients whose ovaries were preserved was slightly compromised but with no statistical significance (HR, 1.49; 95% CI, 0.56–3.93; P = 0.42).ConclusionsOvarian preservation may be safe in patients with early-stage endometrial cancer, and it could be cautiously considered in treating young and premenopausal women because it is not associated with an adverse impact on the patients’ survival. Given the inherent limitations of the included studies, further well-designed randomized controlled trial are needed to confirm and update this analysis.

scholarly journals The Oncology Safety of Diagnostic Hysteroscopy in Early-Stage Endometrial Cancer: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 11 ◽  
Author(s):  
Yi Du ◽  
Yu Xu ◽  
Zhaojuan Qin ◽  
Liang Sun ◽  
Yali Chen ◽  
...  
Keyword(s):  
Systematic Review ◽  
Endometrial Cancer ◽  
Early Stage ◽  
Meta Analysis ◽  
Disease Free Survival ◽  
Developed Countries ◽  
Cochrane Library ◽  
Cancer Disease ◽  
Oncological Safety ◽  
Early Stage Endometrial Cancer

BackgroundHysteroscopy is becoming a common method for the diagnosis of uterine disorders in developed countries. However, hysteroscopy might worsen the prognosis of endometrial cancer because it could cause cancer dissemination into the peritoneal cavity through the fallopian tubes. Objective: The aim of this systematic review and meta-analysis was to explore the oncological safety of hysteroscopy for early-stage endometrial cancer.Search StrategyEligible studies were obtained from PubMed, Embase, and the Cochrane Library up to September 22, 2020.Selection CriteriaStudies which compared the oncological safety of hysteroscopy with other methods were included.Data Collection and AnalysisA total of 3980 patients were included in this study, of whom1357 patients had undergone hysteroscopy and2623 had not.Main ResultsThere was no significant association between hysteroscopy and worse prognosis in early-stage endometrial cancer [disease-free survival: log risk ratio(logRR) -0.22; 95% confidence interval (CI), -0.54 to 0.1; p=0.97; overall survival: logRR 0.03; 95% CI, -0.05 to 0.11; p=0.02; disease-specific survival: logRR 0.03; 95% CI, -0.03 to 0.10; p=0.00].ConclusionThis study suggests that hysteroscopy is a safe diagnostic and treatment method, and has no significant effect on the prognosis of early-stage endometrial cancer.Systematic Review RegistrationPROSPERO registration number: CRD42020193696.

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.

scholarly journals Assessment of the effect of vacuum-formed retainers and Hawley retainers on periodontal health: A systematic review and meta-analysis

PLoS ONE ◽  
2021 ◽  
Vol 16 (7) ◽  
pp. e0253968
Author(s):  
Bowen Li ◽  
Yifeng Xu ◽  
Cailian Lu ◽  
Zhenheng Wei ◽  
Yongyue Li ◽  
...  
Keyword(s):  
Meta Analysis ◽  
Grey Literature ◽  
Mean Difference ◽  
Cochrane Library ◽  
Periodontal Health ◽  
Probing Depth ◽  
Significant Difference ◽  
Orthodontic Patients ◽  
The Cochrane Library ◽  
Sulcus Probing Depth

Background Recently, increasing attention has been paid to the periodontal health of orthodontic patients in the maintenance stage in clinical practice. The focus of this meta-analysis was to compare the effects of vacuum-formed retainers (VFR) and Hawley retainers (HR) on periodontal health, in order to provide a reference for clinical selection. Methods From the establishment of the database until November 2020, a large number of databases were searched to find relevant randomized control trials, including the Cochrane Library databases, Embase, PubMed, Medline via Ovi, Web of Science, Scopus, Grey Literature in Europe, Google Scholar and CNKI. Related literature was manually searched and included in the analysis. Two researchers screened the literature according to relevant criteria. The size of the effect was determined using RevMan5.3 software, and the mean difference and 95% confidence intervals (CI) were used to estimate the results using a random effects model. Results This meta-analysis included six randomized controlled trials involving 304 patients. The results of the meta-analysis showed that there was no statistical difference in sulcus probing depth status between the VFR group and the HR group, including at 1, 3, and 6 months. Compared with the VFR group, the HR group showed a lower gingival index at 1 month (mean difference = 0.12, 95%CI: 0.06 to 0.19) and 3 months (mean difference = 0.11, 95%CI: 0.06 to 0.17), while there was no statistically significant difference at 6 months (mean difference = 0.10, 95%CI: -0.07 to 0.27). The plaque index of the HR group also showed a good state at 1 month (mean difference = 0.06, 95%CI: 0.01 to 0.12), 3 months (mean difference = 0.12, 95%CI: 0.08 to 0.16), and 6 months (mean difference = 0.19, 95%CI: 0.09 to 0.29). Subgroup analysis of PLI showed that when all teeth were measured, PLI status was lower in the HR group at 6 months (mean difference = 0.32, 95%CI: 0.18 to 0.46). PLI status was also low for the other teeth group (mean difference = 0.15, 95%CI: 0.08 to 0.22). Conclusion Our meta-analysis showed that patients using the Hawley retainer had better periodontal health compared with those using vacuum-formed retainers. However, more research is needed to look at the periodontal health of patients using these two retainers.

Survival outcomes in primary angiosarcoma of the head and neck: A systematic review and meta-analysis.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e18039-e18039
Author(s):  
Sondos Zayed ◽  
Cindy Lin ◽  
Gabriel Boldt ◽  
Pencilla Lang ◽  
Nancy Read ◽  
...  
Keyword(s):  
Systematic Review ◽  
Head And Neck ◽  
Treatment Approach ◽  
Early Stage ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Size Analysis ◽  
Survival Outcomes ◽  
Curative Intent ◽  
Significant Difference

e18039 Background: Angiosarcoma of the head and neck (ASHN) is a rare entity and confers substantial morbidity and mortality. Yet, the optimal management of ASHN remains unclear. This study aimed to describe the epidemiology of ASHN and to identify the most favorable treatment approach. Methods: We performed a systematic review based on the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines, using the PubMed (Medline), EMBASE, and Cochrane Library databases, queried from 1990 until present. Articles in the English language reporting on survival outcomes of adult primary ASHN treated with curative-intent, were included. All estimates were weighted based on sample size. Analysis of variance (ANOVA) and two-sample t-tests were used as appropriate. This study was registered with PROSPERO, CRD42021220970. Results: A total of 3652 studies were identified, with 14 articles reporting on 2265 ASHN patients, meeting inclusion criteria. Mean ± SD age was 70.6 ± 7.7 years with 1621 (66.6%) men and 812 (33.4%) women. ASHN involved the scalp (n = 176, 57.9%) and the face (n = 128, 42.1%). 249 patients had early stage I-II disease (39.6%) whereas 379 had late stage III-IV disease (60.4%). Most (n = 529, 45.6%) received surgery and radiotherapy (RT), 305 (26.3%) received surgery alone, 210 (18.1%) received definitive RT/chemoradiotherapy (CRT), 75 (6.5%) received surgery and CRT, and 33 (2.8%) received surgery and chemotherapy. Negative margins were achieved in 471 (55.9%) whereas 371 (44.1%) had positive margins. Mean ± SD follow-up was 41.7 ± 15.4 months. Weighted mean, 1-, 5-, and 10-year overall survival (OS) were 26.9 months, 67.3%, 30.6%, and 20.8% respectively. Mean and 5-year disease-specific survival (DSS) were 72.9 months and 50.3% respectively. Mean ± SD local recurrence rate (LRR) was 32.1 ± 11.7%. Median RT dose delivered was 60 Gy (interquartile range: 60-70). Patients who received surgery had a significantly higher mean OS (34.9 vs. 18.7 months, P = 0.04) and 5-year OS (30.1 vs. 14.2%, P = 0.01) compared with those who did not receive surgery. There was no significant difference in mean OS for receiving adjuvant chemotherapy (P = 0.99) or RT (P = 0.51). Conclusions: In the largest ASHN study to date, definitive surgical resection was associated with an improvement in OS. Multimodality treatment did not confer an OS benefit. Randomized trials are needed to establish the optimal treatment approach for ASHN.

scholarly journals MRI-Based Radiomics Nomogram for Selecting Ovarian Preservation Treatment in Patients With Early-Stage Endometrial Cancer

2021 ◽  
Vol 11 ◽  
Author(s):  
Bi Cong Yan ◽  
Xiao Liang Ma ◽  
Ying Li ◽  
Shao Feng Duan ◽  
Guo Fu Zhang ◽  
...  
Keyword(s):  
Endometrial Cancer ◽  
Early Stage ◽  
Myometrial Invasion ◽  
Roc Curves ◽  
Primary Group ◽  
Endometrioid Adenocarcinoma ◽  
Validation Group ◽  
Cancer Antigen 125 ◽  
Ovarian Preservation ◽  
Early Stage Endometrial Cancer

BackgroundOvarian preservation treatment (OPT) was recommended in young women with early-stage endometrial cancer [superficial myometrial invasion (MI) and grades (G) 1/2-endometrioid adenocarcinoma (EEC)]. A radiomics nomogram was developed to assist radiologists in assessing the depth of MI and in selecting eligible patients for OPT.MethodsFrom February 2014 to May 2021, 209 G 1/2-EEC patients younger than 45 years (mean 39 ± 4.3 years) were included. Of them, 104 retrospective patients were enrolled in the primary group, and 105 prospective patients were enrolled in the validation group. The radiomics features were extracted based on multi-parametric magnetic resonance imaging, and the least absolute shrinkage and selection operator algorithm was applied to reduce the dimensionality of the data and select the radiomics features that correlated with the depth of MI in G 1/2-EEC patients. A radiomics nomogram for evaluating the depth of MI was developed by combing the selected radiomics features with the cancer antigen 125 and tumor size. Receiver operating characteristic (ROC) curves were used to evaluate the diagnostic performance of the radiomics nomogram and of radiologists without and with the aid of the radiomics nomogram. The net reclassification index (NRI) and total integrated discrimination index (IDI) based on the total included patients to assess the clinical benefit of radiologists with the radiomics nomogram were calculated.ResultsIn the primary group, for evaluating the depth of MI, the AUCs were 0.96 for the radiomics nomogram; 0.80 and 0.86 for radiologists 1 and 2 without the aid of the nomogram, respectively; and 0.98 and 0.98 for radiologists 1 and 2 with the aid of the nomogram, respectively. In the validation group, the AUCs were 0.88 for the radiomics nomogram; 0.82 and 0.83 for radiologists 1 and 2 without the aid of the nomogram, respectively; and 0.94 and 0.94 for radiologists 1 and 2 with the aid of the nomogram, respectively. The yielded NRI and IDI values were 0.29 and 0.43 for radiologist 1 and 0.23 and 0.37 for radiologist 2, respectively.ConclusionsThe radiomics nomogram outperformed radiologists and could help radiologists in assessing the depth of MI and selecting eligible OPTs in G 1/2-EEC patients.

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