Association between Perioperative Blood Transfusions and Clinical Outcomes in Patients Undergoing Bladder Cancer Surgery: A Systematic Review and Meta-Analysis Study

Background. Perioperative blood transfusions are associated with poor survival in patients with solid tumors including bladder cancer. Objective. To investigate the impact of perioperative blood transfusions on oncological outcomes after radical cystectomy. Design. Systematic review and meta-analysis. Setting and Participants. Adult patients who underwent radical cystectomy for bladder cancer. Intervention. Packed red blood cells transfusion during or after radical cystectomy for bladder cancer. Outcome Measurements and Statistical Analysis. Recurrence-free survival (RFS), cancer-specific survival (CSS), and overall survival (OS). We calculated the pooled hazard ratio (HR) estimates and 95% confidence intervals by random and fixed effects models. Results and Limitation. Eight, seven, and five studies were included in the OS, CSS, and RFS analysis, respectively. Blood transfusions were associated with 27%, 29%, and 12% reduction in OS, CSS, and RFS, respectively. A sensitivity analysis supported the association. This study has several limitations; however the main problem is that it included only retrospective studies. Conclusions. Perioperative BT may be associated with reduced RFS, CSS, and OS in patients undergoing RC for BC. A randomized controlled study is needed to determine the causality between the administration of blood transfusions and bladder cancer recurrence.

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Clinicopathological factors in bladder cancer for cancer-specific survival outcomes following radical cystectomy: a systematic review and meta-analysis

BMC Cancer ◽

10.1186/s12885-019-5924-6 ◽

2019 ◽

Vol 19 (1) ◽

Cited By ~ 12

Author(s):

Lijin Zhang ◽

Bin Wu ◽

Zhenlei Zha ◽

Wei Qu ◽

Hu Zhao ◽

...

Keyword(s):

Systematic Review ◽

Bladder Cancer ◽

Radical Cystectomy ◽

Meta Analysis ◽

Survival Outcomes ◽

Clinicopathological Factors ◽

Cancer Specific Survival

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Inhibition of Androgen Signalling Improves the Outcomes of Therapies for Bladder Cancer: Results from a Systematic Review of Preclinical and Clinical Evidence and Meta-Analysis of Clinical Studies

Diagnostics ◽

10.3390/diagnostics11020351 ◽

2021 ◽

Vol 11 (2) ◽

pp. 351

Author(s):

Massimiliano Creta ◽

Giuseppe Celentano ◽

Luigi Napolitano ◽

Roberto La Rocca ◽

Marco Capece ◽

...

Keyword(s):

Systematic Review ◽

Bladder Cancer ◽

Relative Risk ◽

Clinical Studies ◽

Clinical Evidence ◽

Meta Analysis ◽

Bladder Tumour ◽

Signalling Pathways ◽

Reductase Inhibitors ◽

The Impact

Bladder cancer (BCa) is an endocrine-related tumour and the activation of androgen signalling pathways may promote bladder tumorigenesis. We summarized the available preclinical and clinical evidence on the implications of the manipulation of androgen signalling pathways on the outcomes of BCa therapies. A systematic review was performed in December 2020. We included papers that met the following criteria: original preclinical and clinical research; evaluating the impact of androgen signalling modulation on the outcomes of BCa therapies. Six preclinical and eight clinical studies were identified. The preclinical evidence demonstrates that the modulation of androgen receptor-related pathways has the potential to interfere with the activity of the Bacillus Calmette Guerin, doxorubicin, cisplatin, gemcitabine, and radiotherapy. The relative risk of BCa recurrence after transurethral resection of the bladder tumour (TURBT) is significantly lower in patients undergoing therapy with 5 alpha reductase inhibitors (5-ARIs) or androgen deprivation therapy (ADT) (Relative risk: 0.50, 95% CI: 0.30–0.82; p = 0.006). Subgroup analysis in patients receiving 5-ARIs revealed a relative risk of BCa recurrence of 0.46 (95% CI: 0.22–0.95; p = 0.040). A significant negative association between the ratio of T1 BCa patients in treated/control groups and the relative risk of BCa recurrence was observed. Therapy with 5-ARIs may represent a potential strategy aimed at reducing BCa recurrence rate, mainly in patients with low stage disease. Further studies are needed to confirm these preliminary data.

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The impact of myosteatosis on outcomes following surgery for gastro-intestinal malignancy: A systematic review and meta-analysis.

Journal of Clinical Oncology ◽

10.1200/jco.2021.39.15_suppl.e15540 ◽

2021 ◽

Vol 39 (15_suppl) ◽

pp. e15540-e15540

Author(s):

Andrew MacCormick ◽

Mark Puckett ◽

Adam Streeter ◽

Somaiah Aroori

Keyword(s):

Systematic Review ◽

Meta Analysis ◽

Group Analysis ◽

Long Term Outcomes ◽

Cancer Specific Survival ◽

Mesh Terms ◽

Similar Term ◽

Colorectal Cancer Patients ◽

The Impact

e15540 Background: Recent research has demonstrated the impact that body composition parameters can have on the outcomes following cancer surgery. Adipose tissue deposition in muscle, known as myosteatosis, can be detected on pre-operative imaging. This systematic review aims to analyse the impact of pre-operative myosteatosis on long-term outcomes following surgery for gastro-intestinal malignancy. Methods: Using MeSH terms, a systematic search of the databases PubMed MEDLINE, EMBASE, Cochrane, CINAHL and AMED was performed. Studies were included if they reported hazard ratios (HR) analysing the impact of pre-operatively defined myosteatosis, or similar term, on the long-term outcomes following surgery for gastro-intestinal malignancy. A total of 39 full texts articles were reviewed for inclusion, with 19 being included after the inclusion criteria were applied. A sub-group analysis was performed for those studies reporting outcomes for colorectal cancer patients only. Results: The total number of included patients across all studies was 14,481. Patients with myosteatosis had a significantly poorer overall survival, according to univariate (HR 1.82, 95% CI 1.67 – 1.99) and multivariable (HR 1.66, 95% CI 1.49 – 1.86) analysis. This was also demonstrated with regards to cancer-specific survival (univariate HR 1.62, 95% CI 1.18 – 2.22, multivariable HR 1.73, 95% CI 1.48 – 2.03) and recurrence-free survival (univariate HR 1.28, 95% CI 1.10 – 1.48, multivariable HR 1.38, 95% CI 1.07 – 1.77). Conclusions: This review demonstrates that patients with pre-operative myosteatosis have poorer long-term outcomes following surgery for gastro-intestinal malignancy. Therefore, myosteatosis should be used for pre-operative optimisation and as a prognostic tool before surgery. More standardised definitions of myosteatosis and further cohort studies of patients with non-colorectal malignancies are required.

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Molecular Investigation of miRNA Biomarkers as Chemoresistance Regulators in Melanoma: A Protocol for Systematic Review and Meta-Analysis

Genes ◽

10.3390/genes13010115 ◽

2022 ◽

Vol 13 (1) ◽

pp. 115

Author(s):

Peter Shaw ◽

Greg Raymond ◽

Katherine S. Tzou ◽

Siddhartha Baxi ◽

Ravishankar Ram Mani ◽

...

Keyword(s):

Systematic Review ◽

Fixed Effects ◽

Meta Analysis ◽

Cochrane Review ◽

Bibliographic Databases ◽

Analysis Model ◽

Pairwise Correlation ◽

Meta Regression Analysis ◽

Trim And Fill ◽

The Impact

Introduction: Melanoma is a global disease that is predominant in Western countries. However, reliable data resources and comprehensive studies on the theragnostic efficiency of miRNAs in melanoma are scarce. Hence, a decisive study or comprehensive review is required to collate the evidence for profiling miRNAs as a theragnostic marker. This protocol details a comprehensive systematic review and meta-analysis on the impact of miRNAs on chemoresistance and their association with theragnosis in melanoma. Methods and analysis: The articles will be retrieved from online bibliographic databases, including Cochrane Review, EMBASE, MEDLINE, PubMed, Scopus, Science Direct, and Web of Science, with different permutations of ‘keywords’. To obtain full-text papers of relevant research, a stated search method will be used, along with selection criteria. The Preferred Reporting Items for Systematic Reviews and Meta-Analysis for Protocols 2015 (PRISMA-P) standards were used to create this study protocol. The hazard ratio (HR) with a 95% confidence interval will be analyzed using Comprehensive Meta-Analysis (CMA) software 3.0. (CI). The pooled effect size will be calculated using a random or fixed-effects meta-analysis model. Cochran’s Q test and the I2 statistic will be used to determine heterogeneity. Egger’s bias indicator test, Orwin’s and the classic fail-safe N tests, the Begg and Mazumdar rank collection test, and Duval and Tweedie’s trim and fill calculation will all be used to determine publication bias. The overall standard deviation will be evaluated using Z-statistics. Subgroup analyses will be performed according to the melanoma participants’ clinicopathological and biological characteristics and methodological factors if sufficient studies and retrieved data are identified and available. The source of heterogeneity will be assessed using a meta-regression analysis. A pairwise matrix could be developed using either a pairwise correlation or expression associations of miRNA with patients’ survival for the same studies.

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A systematic review and meta-analysis of lymphovascular invasion in patients treated with radical cystectomy for bladder cancer

Urologic Oncology Seminars and Original Investigations ◽

10.1016/j.urolonc.2018.03.018 ◽

2018 ◽

Vol 36 (6) ◽

pp. 293-305 ◽

Cited By ~ 12

Author(s):

Andrea Mari ◽

Shoji Kimura ◽

Beat Foerster ◽

Mohammad Abufaraj ◽

David D'Andrea ◽

...

Keyword(s):

Systematic Review ◽

Bladder Cancer ◽

Radical Cystectomy ◽

Lymphovascular Invasion ◽

Meta Analysis

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The Effect of Celiac Neurolysis and Splanchnicectomy on Survival in Unresectable Pancreatic Cancer: A Systematic Review and Meta-Analysis

Digestive Surgery ◽

10.1159/000520456 ◽

2021 ◽

pp. 1-9

Author(s):

Linhan Ye ◽

Stephan Schorn ◽

Ilaria Pergolini ◽

Okan Safak ◽

Elke Demir ◽

...

Keyword(s):

Systematic Review ◽

Pancreatic Cancer ◽

Fixed Effects ◽

Meta Analysis ◽

Stage Iv ◽

Stage Iii ◽

Cochrane Library ◽

Unresectable Pancreatic Cancer ◽

Relevant Effect ◽

The Impact

Background: Intractable pancreatic pain is one of the most common symptoms of patients with pancreatic ductal adenocarcinoma (PDAC). Celiac neurolysis (CN) and splanchnicectomy were already described as effective methods to manage abdominal pain in unresectable PDAC, but their impact on overall survival (OS) has not yet been established. Objective: We aimed to investigate the impact of CN and splanchnicectomy on the survival of patients with unresectable pancreatic cancer. Methods: A systematic review of PubMed and Cochrane Library according to predefined searching terms was conducted in March 2020. Hazard ratios (HR) of OS data were calculated using the Mantel-Haenszel model for random effects or fixed effects. Result: Four randomized-controlled trials (RCTs) and 2 non-RCTs with a total of 2,507 patients were identified. The overall pooled HR did not reveal any relevant effect of CN and splanchnicectomy on OS (HR: 1.03; 95% CI: 0.81–1.32), which was also underlined by the sensitivity analysis of RCTs (HR: 1.0; 95% CI: 0.72–1.39) and non-RCTs (HR: 1.07; 95% CI: 0.71–1.63). However, subgroup analyses depending on tumor stage revealed that CN or splanchnicectomy was associated with a worsened OS in AJCC (American Joint Committee on Cancer) stage III patients with unresectable PDAC (HR: 1.22; 95% CI: 1.03–1.45), but nor for AJCC stage IV patients (HR: 1.27; 95% CI: 0.9–1.80). Conclusion: Although only few data are currently available, this systematic review with meta-analysis showed that in unresectable PDAC, CN or splanchnicectomy is associated with a worsened survival in stage III PDAC patients, with no effect on stage IV PDAC patients. These data call for caution in the usage of CN or splanchnicectomy in stage III PDAC and for further studies addressing this observation.

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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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