The Effects of Metformin on Ovarian Cancer: A Systematic Review

2013 ◽  
Vol 23 (9) ◽  
pp. 1544-1551 ◽  
Author(s):  
Piyemeth Dilokthornsakul ◽  
Nathorn Chaiyakunapruk ◽  
Wichai Termrungruanglert ◽  
Chayanin Pratoomsoot ◽  
Surasak Saokeaw ◽  
...  
Keyword(s):  
Systematic Review ◽  
Ovarian Cancer ◽  
Cancer Prevention ◽  
Observational Studies ◽  
Cancer Survival ◽  
Meta Analysis ◽  
Progression Free Survival ◽  
Survival Outcomes ◽  
Diabetic Patients ◽  
Therapeutic Effects

ObjectiveThe potential therapeutic effects of metformin on several cancers were reported. However, the evidence of the effects of metformin on ovarian cancer is still limited and inconclusive. This systematic review and meta-analysis study aims to summarize the existing evidence of the therapeutic effects of metformin on ovarian cancer.MethodsWe performed systematic searches using electronic databases including PubMed and EMBASE until December 2012. Key words included “metformin” AND (“ovarian cancer” OR “ovary tumor”). All human studies assessing the effects of metformin on ovarian cancer were eligible for inclusion. All articles were reviewed independently by 2 authors with a standardized approach for the purpose of study, study design, patient characteristics, exposure, and outcomes. The data were pooled using a random-effects model.ResultsOf 190 studies retrieved, only 3 observational studies and 1 report of 2 randomized controlled trials were included. Among those studies, 2 reported the effects of metformin on survival outcomes of ovarian cancer, whereas the other 2 reported the effects of metformin on ovarian cancer prevention. The findings of studies reporting the effects on survival outcomes indicated that metformin may prolong overall, disease-specific, and progression-free survival in ovarian cancer patients. The results of studies reporting the effects of metformin on ovarian cancer prevention were meta-analyzed. It indicated that metformin tended to decrease occurrence of ovarian cancer among diabetic patients with the pooled odds ratio of 0.57 (95% confidence interval, 0.16–1.99).ConclusionsOur findings showed the potential therapeutic effects of metformin on survival outcomes of ovarian cancer and ovarian cancer prevention. However, most of the evidence was observational studies. There is a call for further well-conducted controlled clinical trials to confirm the effects of metformin on ovarian cancer survival and ovarian cancer prevention.

scholarly journals Comparison of the survival outcomes of laparoscopy versus laparotomy in treatment of early-stage ovarian cancer: a systematic review and meta-analysis

2021 ◽  
Vol 14 (1) ◽  
Author(s):  
Qingduo Kong ◽  
Hongyi Wei ◽  
Jing Zhang ◽  
Yilin Li ◽  
Yongjun Wang
Keyword(s):  
Ovarian Cancer ◽  
Overall Survival ◽  
Early Stage ◽  
Meta Analysis ◽  
Progression Free Survival ◽  
Cochrane Library ◽  
Survival Outcomes ◽  
Free Survival ◽  
Review Manager ◽  
Early Stage Ovarian Cancer

Abstract Background Laparoscopy has been widely used for patients with early-stage epithelial ovarian cancer (eEOC). However, there is limited evidence regarding whether survival outcomes of laparoscopy are equivalent to those of laparotomy among patients with eEOC. The result of survival outcomes of laparoscopy is still controversial. The aim of this meta-analysis is to analyze the survival outcomes of laparoscopy versus laparotomy in the treatment of eEOC. Methods According to the keywords, Pubmed, Embase, Cochrane Library and Clinicaltrials.gov were searched for studies from January 1994 to January 2021. Studies comparing the efficacy and safety of laparoscopy versus laparotomy for patients with eEOC were assessed for eligibility. Only studies including outcomes of overall survival (OS) were enrolled. The meta-analysis was performed using Stata software (Version 12.0) and Review Manager (Version 5.2). Results A total of 6 retrospective non-random studies were included in this meta-analysis. The pooled results indicated that there was no difference between two approaches for patients with eEOC in OS (HR = 0.6, P = 0.446), progression-free survival (PFS) (HR = 0.6, P = 0.137) and upstaging rate (OR = 1.18, P = 0.54). But the recurrence rate of laparoscopic surgery was lower than that of laparotomic surgery (OR = 0.48, P = 0.008). Conclusions Laparoscopy and laparotomy appear to provide comparable overall survival and progression-free survival outcomes for patients with eEOC. Further high-quality studies are needed to enhance this statement.

Statin use and kidney cancer survival outcomes: A systematic review and meta-analysis

2017 ◽  
Vol 52 ◽  
pp. 105-116 ◽  
Author(s):  
Madhur Nayan ◽  
Nahid Punjani ◽  
David N. Juurlink ◽  
Antonio Finelli ◽  
Peter C. Austin ◽  
...  
Keyword(s):  
Systematic Review ◽  
Kidney Cancer ◽  
Cancer Survival ◽  
Meta Analysis ◽  
Survival Outcomes ◽  
Statin Use

Dietary Fat Intake and Risk of Ovarian Cancer: A Systematic Review and Dose–Response Meta-Analysis of Observational Studies

2019 ◽  
Vol 71 (6) ◽  
pp. 939-953 ◽  
Author(s):  
Alireza Sadeghi ◽  
Sakineh Shab-Bidar ◽  
Mohammad Parohan ◽  
Kurosh Djafarian
Keyword(s):  
Systematic Review ◽  
Ovarian Cancer ◽  
Dose Response ◽  
Dietary Fat ◽  
Observational Studies ◽  
Meta Analysis ◽  
Fat Intake ◽  
Dietary Fat Intake

scholarly journals Prognostic Significance of the Preoperative Prognostic Nutritional Index in Epithelial Ovarian Cancer Patients: A Systematic Review and Meta-analysis of Cohort Studies

2020 ◽  
Author(s):  
Ting-Ting Gong ◽  
Jia-Yu Zhang ◽  
Hui Sun ◽  
Qi-Jun Wu ◽  
Song Gao
Keyword(s):  
Systematic Review ◽  
Ovarian Cancer ◽  
Cohort Studies ◽  
Publication Bias ◽  
Meta Analysis ◽  
Prognostic Significance ◽  
Prognostic Nutritional Index ◽  
Progression Free Survival ◽  
Poor Overall Survival ◽  
Nutritional Index

Abstract BackgroundThe main aim of this study was to validate the potential association between the preoperative prognostic nutritional index (PNI) and survival of patients with ovarian cancer (OC).MethodsWe systematically searched multiple databases (PubMed, EMBASE, and Web of Science) for publications up to June 30, 2019, to identify observational studies evaluating the PNI in relation to survival. Two reviewers independently extracted data and assessed the quality of each study using the Newcastle-Ottawa Scale (NOS). Summary hazard ratios (HR) and 95% confidence intervals (CI) were calculated with the aid of a random-effects model. The potential for publication bias was explored using Funnel plots as well as Begg’s and Egger’s tests.ResultsAmong the 15,000 studies selected for selection, 5 retrospective cohort studies (4 from China and one from Japan) comprising 1964 OC patients met the inclusion criteria. All studies were graded as ‘low risk of bias’ according to NOS. A low preoperative PNI was associated with poor overall survival (HR = 1.69, 95% CI = 1.16–2.46; I2 = 83.8%) and progression-free survival (HR = 1.86, 95% CI = 1.39–2.51; I2 = 29.7%) of OC patients. No significant publication bias was detected.ConclusionsCollective data from the present systematic review and meta-analysis suggest that a low preoperative PNI is associated with poor survival in OC. Further prospective studies are required to confirm these findings.

scholarly journals Improvements in Fatigue at Higher Achieved Hemoglobin Levels Among Chronic Kidney Disease Patients: A Systematic Review and Meta-Analysis

2020 ◽  
Author(s):  
Murilo Guedes ◽  
Camila R. Guetter ◽  
Lucas HO Erbano ◽  
Andre G. Palone ◽  
Jarcy Zee ◽  
...  
Keyword(s):  
Systematic Review ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Observational Studies ◽  
Meta Analysis ◽  
Diabetic Patients ◽  
Related Quality ◽  
The Impact ◽  
Physical Hrqol ◽  
Anemia Treatment

Abstract Background: The impact anemia treatment with erythropoietin stimulating agents (ESA) on health-related quality of life (HRQOL) in chronic kidney disease (CKD) patients is controversial, particularly regarding optimal hemoglobin (Hb) target ranges.Methods: We conducted a systematic review and meta-analysis of observational studies and randomized controlled trials (RCT) with ESA to estimate the effect of different Hb ranges on physical HRQOL and functionality. We searched PubMed, EMBASE, CENTRAL, PEDro, PsycINFO and Web of Science databases, until May 2019Two authors independently extracted data from studies.We included observational and RCTs that enrolled CKD patients undergoing anemia treatment with ESA with different achieved Hb levels among groups. We excluded studies with achieved Hb < 9 g/dL. For the meta-analysis, we included RCTs with control groups achieving Hb 10-11.5 g/dL and active groups with Hb >11.5 g/dL. We analyzed the standardized mean difference (SMD) between groups for physical HRQOL.Results: Among 8,171 studies, fifteen RCTs and five observational studies were included for the systematic review. We performed the meta-analysis in a subset of eleven eligible RCTs. For physical role and physical function, SMDs were 0.0875 [CI:-0.0025 – 0.178] and 0.08 [CI: -0.03 – 0.19], respectively. For fatigue, SMD was 0.16 [0.09 - 0.24]. Subgroup analysis showed that trials with greater achieved Hb had greater pooled effects sizes — 0.21 [0.07 - 0.36] for Hb > 13 g/dL vs. 0.09 [0.02 - 0.16] for Hb 11.5-13 g/dL. Proportion of older and long-term diabetic patients across studies were associated with lower effect sizes.Conclusion: Achieved hemoglobin higher than currently recommended targets is associated with small but clinically significant improvement in fatigue. Younger and non-diabetic patients may experience more pronounced benefits of higher Hb levels after treatment with ESAs.

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