scholarly journals The Anti-PD-1/PD-L1 Immunotherapy for Gastric Esophageal Cancer: A Systematic Review and Meta-Analysis and Literature Review

2021 ◽  
Vol 28 ◽  
pp. 107327482199743
Author(s):  
Ke Chen ◽  
Xiao Wang ◽  
Liu Yang ◽  
Zheling Chen
Keyword(s):  
Overall Survival ◽  
Esophageal Cancer ◽  
Survival Rate ◽  
Meta Analysis ◽  
Response Rates ◽  
Control Group ◽  
Term Survival ◽  
Long Term Survival ◽  
And Control

Background: Treatment options for advanced gastric esophageal cancer are quite limited. Chemotherapy is unavoidable at certain stages, and research on targeted therapies has mostly failed. The advent of immunotherapy has brought hope for the treatment of advanced gastric esophageal cancer. The aim of the study was to analyze the safety of anti-PD-1/PD-L1 immunotherapy and the long-term survival of patients who were diagnosed as gastric esophageal cancer and received anti-PD-1/PD-L1 immunotherapy. Method: Studies on anti-PD-1/PD-L1 immunotherapy of advanced gastric esophageal cancer published before February 1, 2020 were searched online. The survival (e.g. 6-month overall survival, 12-month overall survival (OS), progression-free survival (PFS), objective response rates (ORR)) and adverse effects of immunotherapy were compared to that of control therapy (physician’s choice of therapy). Results: After screening 185 studies, 4 comparative cohort studies which reported the long-term survival of patients receiving immunotherapy were included. Compared to control group, the 12-month survival (OR = 1.67, 95% CI: 1.31 to 2.12, P < 0.0001) and 18-month survival (OR = 1.98, 95% CI: 1.39 to 2.81, P = 0.0001) were significantly longer in immunotherapy group. The 3-month survival rate (OR = 1.05, 95% CI: 0.36 to 3.06, P = 0.92) and 18-month survival rate (OR = 1.44, 95% CI: 0.98 to 2.12, P = 0.07) were not significantly different between immunotherapy group and control group. The ORR were not significantly different between immunotherapy group and control group (OR = 1.54, 95% CI: 0.65 to 3.66, P = 0.01). Meta-analysis pointed out that in the PD-L1 CPS ≥10 sub group population, the immunotherapy could obviously benefit the patients in tumor response rates (OR = 3.80, 95% CI: 1.89 to 7.61, P = 0.0002). Conclusion: For the treatment of advanced gastric esophageal cancer, the therapeutic efficacy of anti-PD-1/PD-L1 immunotherapy was superior to that of chemotherapy or palliative care.

665 PROPHYLACTIC THORACIC DUCT OBSTRUCTION DURING ESOPHAGECTOMY: THE IMPACT ON PERIOPERATIVE RISKS AND LONG-TERM SURVIVAL. A SYSTEMATIC REVIEW AND META-ANALYSIS

2021 ◽  
Vol 34 (Supplement_1) ◽  
Author(s):  
Clara Santos ◽  
Laura Santos ◽  
Leticia Datrino ◽  
Guilherme Tavares ◽  
Luca Tristão ◽  
...  
Keyword(s):  
Systematic Review ◽  
Overall Survival ◽  
Postoperative Complications ◽  
Thoracic Duct ◽  
Meta Analysis ◽  
Term Survival ◽  
Long Term Survival ◽  
Thoracic Duct Ligation ◽  
Duct Ligation

Abstract   During esophagectomy for cancer, there is no consensus if prophylactic thoracic duct ligation (TDL), with or without thoracic duct resection (TDR), could influence the perioperative outcomes and long-term survival. This systematic review and meta-analysis compared patients who went through esophagectomy associated or not to ligation or resection of the thoracic duct. Methods A systematic review was conducted in PubMed, Embase, Cochrane Library Central and Lilacs (BVS). The inclusion criteria were: (1) studies that compare thoracic duct ligation, with or without resection, and non-thoracic duct ligation; (2) involve adult patients with esophageal cancer; (3) articles that analyses the outcomes—perioperative complications, perioperative mortality, chylothorax development and overall survival; (4) only clinical trials and cohort were accepted. A 95% confidence interval (CI) was used, and random-effects model was performed. Results Fifteen articles were selected, comprising 6,249 patients. TDL did not reduce the risk for chylothorax (Risk difference [RD]: -0.01; 95%CI: −0.02, 0.00). Also, TDL did not influence the risk for complications (RD: -0.02; 95%CI: −0.11, 0.07); mortality (RD: 0.00; 95%CI: −0.00, 0.00); and reoperation rate (RD: -0.01; 95%CI: −0.02, 0.00). TDR was associated with higher risk for postoperative complications (RD: 0.1; 95%CI 0.00, 0.19); chylothorax (RD: 0.02; 95%CI 0.00, 0.03). Both TDL and TDR did not influence the overall survival rate (TDL: HR: 1.17; 95%CI: 0.86, 1.48; and TDR: HR: 1.16; 95%CI: 0.8, 1.51). Conclusion Thoracic duct obliteration with or without its resection during esophagectomy does not change long term survival. Nonetheless, TDR increased the risk for postoperative complications and chylothorax.

723 TWO- VS. THREE-FIELD LYMPHADENECTOMY FOR ESOPHAGEAL CANCER. A SYSTEMATIC REVIEW AND META-ANALYSIS OF SHORT- AND LONG-TERM OUTCOMES.

2021 ◽  
Vol 34 (Supplement_1) ◽  
Author(s):  
Letícia Nogueira Datrino ◽  
Clara Lucato Santos ◽  
Guilherme Tavares ◽  
Luca Schiliró Tristão ◽  
Maria Carolina Andrade Serafim ◽  
...  
Keyword(s):  
Systematic Review ◽  
Esophageal Cancer ◽  
Meta Analysis ◽  
Operation Time ◽  
Extended Lymphadenectomy ◽  
Long Term Outcomes ◽  
Term Survival ◽  
Long Term Survival ◽  
Short And Long Term

Abstract   Nowadays, there is still no consensus about the benefits of adding neck lymphadenectomy to the traditional two-fields esophagectomy. An extended lymphadenectomy could potentially increase operation time and the risks for postoperative complications. However, extended lymphadenectomy allows resection of cervical nodes at risk for metastases, potentially increasing long-term survival rates. This study aims to estimate whether cervical prophylactic lymphadenectomy for esophageal cancer influences short- and long-term outcomes through a systematic review of literature and meta-analysis. Methods A systematic review was conducted in PubMed, Embase, Cochrane Library Central, and Lilacs (BVS). The inclusion criteria were: (1) studies that compare two-field vs. three-field esophagectomy; (2) adults (&gt;18 years); (3) articles that analyze short- or long-term outcomes; and (4) clinical trials or cohort studies. The results were summarized by forest plots, with effect size (ES) or risk difference (RD) and 95% CI. Results Twenty-five articles were selected, comprising 8,954 patients. Three-field lymphadenectomy was associated to higher operation time (ES: -1.51; 95%CI -1.84, −1.18) and higher blood loss (ES: -0.24; 95%CI: −0.37, −0.11). Also, neck lymphadenectomy inputs additional risk for pulmonary complications (RD: 0.03; 95%CI: 0.01, 0.05). No difference was noted for morbidity (RD: 0.01; 95%CI: −0.01, 0.03); leak (−0.02; 95%CI: −0.07, 0.03); postoperative mortality (RD: 0.00; 95%CI: −0.00, 0.01), and hospital stay (ES: -0.05; 95%CI -0.20, 0.10). Three-field lymphadenectomy allowed higher number of retrieved lymph nodes (MD: -1.51; 95%CI -1.84, −1.18), but did not increase the overall survival (HR: 1.11; 95%CI: 0.96, 1.26). Conclusion Prophylactic neck lymphadenectomy for esophageal cancer should be performed with caution once it is associated with poorer short-term outcomes compared to traditional two-field lymphadenectomy and does not improve long-term survival. Future esophageal cancer studies should determine the subgroup of patients who could benefit from prophylactic neck lymphadenectomy in long-term outcomes.

scholarly journals Ornamental Cherry Tolerance of Flooding and Phytophthora Root Rot

HortScience ◽  
1996 ◽  
Vol 31 (6) ◽  
pp. 988-991 ◽  
Author(s):  
K.A. Jacobs ◽  
G.R. Johnson
Keyword(s):  
Survival Rate ◽  
Root Rot ◽  
Net Photosynthesis ◽  
Severity Index ◽  
Individual Treatment ◽  
Control Group ◽  
Term Survival ◽  
Phytophthora Root Rot ◽  
Long Term Survival

Seedlings of eight Prunus taxa were evaluated for variation in susceptibility to a single, 4- or 5-day flooding period and root rot caused by Phytophthora cryptogea Pethybr. & Lafferty. Survival, plant defoliation, disease severity index, root necrosis, and net photosynthesis indicated that the combination of flooding and pathogen was significantly more severe to all taxa than either individual treatment. Most response variables reflected early plant dysfunction but were not correlated with long-term survival. Long-term survival was 70% in the combination treatment compared to 99% in the control group. Flooding injured seedlings more than the pathogen in most taxa. Taxa differed only slightly in tolerance to the treatments, as measured by survival rate. Prunus takesimensis Nakai had the highest survival rate of 100% and along with P. mahaleb L. and P. yedoensis Matsum. showed some tolerance to flooding and the pathogen. Prunus sargentii Rehd. had the lowest survival rate of 81% and appeared to be least tolerant to the pathogen.

Diabetes mellitus and survival of esophageal cancer patients after esophagectomy: a systematic review and meta-analysis

2020 ◽  
Vol 33 (2) ◽  
Author(s):  
Xi Zheng ◽  
Xingsheng Ma ◽  
Han-Yu Deng ◽  
Panpan Zha ◽  
Jie Zhou ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Esophageal Cancer ◽  
Cancer Patients ◽  
Meta Analysis ◽  
Outcome Data ◽  
Term Survival ◽  
Long Term Survival ◽  
Significant Difference ◽  
The Impact

SUMMARY Diabetes mellitus (DM) is one of the most common comorbidities in esophageal cancer patients who undergo esophagectomy. It is well established that DM has an unfavorable impact on short-term outcomes of patients with surgically treated esophageal cancer; however, whether DM has any impact on long-term survival of these patients remains unclear. We performed the first meta-analysis to investigate the impact of DM on survival of surgically treated esophageal cancer patients. We searched the following databases systematically to retrieve relevant studies on January 2, 2019: PubMed, Embase, and Web of Science. The main outcome data consisting of 3- and 5-year overall survival (OS) rates and hazard ratios (HRs) of OS were extracted to compare survival between patients with and without DM. We finally included for meta-analysis a total of eight cohort studies involving 5,044 esophageal cancer patients who underwent esophagectomy. We found no significant difference between 3-year (risk ratio [RR] = 0.94, 95% CI: 0.73–1.21; P = 0.65) and 5-year (RR = 0.92, 95% CI: 0.80–1.08; P = 0.31) OS rates between patients with and without DM after esophagectomy. Moreover, DM was not found to be an independent predictor of OS for these patients (HR = 1.10, 95% CI: 0.65–1.84; P = 0.72). Our study suggests that DM appears to have no significant impact on long-term survival of esophageal cancer patients who undergo esophagectomy. To improve the prognosis of these patients, it may be more important to control glycemic level in patients with DM who undergo esophagectomy. However, further high-quality studies with appropriate adjustment for confounding factors are needed to verify this conclusion.

scholarly journals Long-Term Survival of Young Stroke Patients: A Population-Based Study of Two Stroke Registries from Tartu, Estonia

2012 ◽  
Vol 2012 ◽  
pp. 1-4 ◽  
Author(s):  
R. Vibo ◽  
S. Schneider ◽  
J. Kõrv
Keyword(s):  
Overall Survival ◽  
Survival Rate ◽  
Survival Rates ◽  
Population Based ◽  
Stroke Patients ◽  
Stroke Subtype ◽  
Term Survival ◽  
Long Term Survival ◽  
Young Stroke

The aim of this paper was to evaluate the long-term survival of young stroke patients in Estonia, analyse time trends of survival, and compare the results with other studies. We have used 2 population-based first-ever stroke registry data (1991–1993 and 2001–2003) to analyse the 1-, 5-, and 7-year outcome of young stroke patients by the Kaplan-Meier method of analysis. From the group of 1206 patients, 129 (11%) were aged under 55 years. The overall survival rate at 1, 5, and 7 years was 0.70 (95% CI 0.62–0.78), 0.63 (95% CI 0.55–0.72), and 0.61 (95% CI 0.53–0.70), respectively. The survival was significantly worse for patients with intracerebral haemorrhage (P<0.01) and for those aged from 45 to 54 years compared to the younger age group from 0 to 44 years (P=0.03). For patients with ischemic stroke, aged from 15 to 44 years, the 1-, 5-, and 7-year survival rate was 0.89 (95% CI 0.79–1.00), 0.75 (95% CI 0.61–0.93), and 0.75 (0.61–0.93), respectively. There was no difference in overall survival between the two studied periods. We report a low long-term survival rate among young stroke patients in Estonia. Increasing age and hemorrhagic stroke subtype were associated with lower survival. We have previously shown a worse outcome for 1-year survival compared to other studies and currently this trend continues for 5- and 7-year survival rates. In fact, these are the lowest survival rates for the combined and separate stroke subtypes reported so far.

scholarly journals P74 Long-term Survival After Minimally Invasive Resection versus Open Pancreaticoduodenectomy for Pancreatic Cancers: A Systematic Review and Meta-analysis

BJS Open ◽  
2021 ◽  
Vol 5 (Supplement_1) ◽  
Author(s):  
Rohan R Gujjuri ◽  
Sivesh K Kamarajah ◽  
James R Bundred ◽  
Long R Jiao ◽  
Mohammed Abu Hilal ◽  
...  
Keyword(s):  
Systematic Review ◽  
Overall Survival ◽  
Meta Analysis ◽  
Term Survival ◽  
Long Term Survival ◽  
Statistical Heterogeneity ◽  
Meta Regression ◽  
Open Pancreaticoduodenectomy ◽  
Egger Test

Abstract Introduction It remains unclear whether minimally invasive pancreaticoduodenectomy (MIPD) and open pancreaticoduodenectomy (OPD) influences long-term survival in periampullary cancers. This review aims evaluate long-term survival between MIPD and OPD for periampullary cancers. Methods A systematic review was performed to identify studies comparing long-term survival after MIPD and OPD. The I2 test was used to test for statistical heterogeneity and publication bias using Egger test. Random-effects meta-analysis was performed for all-cause 5-year (main outcome) and 3-year survival, and disease-specific 5-year and 3-year survival. Meta-regression was performed for the 5- year and 3-year survival outcomes with adjustment for study (region, design, case matching), hospital (centre volume), patient (ASA grade, gender, age), and tumor (stage, neoadjuvant therapy, subtype (i.e. ampullary, distal bile duct, duodenal, pancreatic)). Sensitivity analyses performed on studies including pancreatic ductal adenocarcinoma (PDAC) only. Results The review identified 31 relevant studies. Among all 58,622 patients, 8716 (14.9%) underwent MIPD and 49,875 (85.1%) underwent OPD. Pooled analysis revealed similar 5-year overall survival after MIPD compared with OPD (HR: 0.78, 95% CI 0.50–1.22, p = 0.2). Meta-regression indicated case matching, and ASA Grade II and III as confounding covariates. The statistical heterogeneity was limited (I2 = 12, c2 = 0.26) and the funnel plot was symmetrical both according to visual and statistical testing (Egger test = 0.32). Sensitivity subset analyses for PDAC demonstrated similar 5-year overall survival after MIPD compared with OPD (HR 0.69, 95% CI: 0.32–1.50, p = 0.3). Conclusion Long-term survival after MIPD is similar to OPD. Thus, MIPD can be recommended as a standard surgical approach for periampullary cancers.

scholarly journals LONG-TERM SURVIVAL RATE OF ESOPHAGEAL CANCER

1985 ◽  
Vol 18 (3) ◽  
pp. 567-570
Author(s):  
Mitsuo ERNDO ◽  
Akiyoshi YAMADA ◽  
Hiroko IDE ◽  
Misao YOSHIDA ◽  
Yoko MURATA ◽  
...  
Keyword(s):  
Esophageal Cancer ◽  
Survival Rate ◽  
Term Survival ◽  
Long Term Survival

scholarly journals Effect of Prophylactic Ligation of the Thoracic Duct on Long-Term Survival in Patients Undergoing Esophagectomy: A Meta-Analysis

2021 ◽  
Author(s):  
Mei kun ◽  
Ce Chao ◽  
Long Xuanren ◽  
Ma Chao ◽  
Zhou Rui ◽  
...  
Keyword(s):  
Esophageal Cancer ◽  
Thoracic Duct ◽  
Meta Analysis ◽  
Term Survival ◽  
Free Survival ◽  
Long Term Survival ◽  
Thoracic Duct Ligation ◽  
Duct Ligation ◽  
Statistical Heterogeneity

Abstract Objective: To evaluate the existing literature by comparing long-term survival between patients who underwent prophylactic thoracic duct ligation (PLG) and non-prophylactic thoracic duct ligation (NPLG) during esophagectomy for esophageal cancer, a meta-analysis of relevant studies was conducted.Background: The effect of PLG and NPLG on the long-term survival in patients undergoing esophagectomy for treatment of esophageal cancer has not been established.Methods: All articles searches were performed in PubMed, Cochrane, Embase, and Web of Science, and the deadline is August 31, 2020. The search terms included esophagectomy AND thoracic duct. The selected articles compared the long-term survival of patients undergoing esophagectomy to treat esophageal cancer with prophylactic thoracic duct ligation (PLG) and non-prophylactic thoracic duct ligation (NPLG). The I2 test and X2 test were used to determine statistical heterogeneity. Publication bias was assessed using the Egger test. The results are presented as hazard ratios (HRs) with 95% confidence intervals (CIs). All data analysis was performed using Stata12.0 software.Result: A total of 4418 patients from eight studies were included in this meta-analysis. Pooled analysis revealed that a high overall survival (OS) was significantly associated with NPLG (HR=0.81, 95% CI: 0.74-0.88, P<.001), while the recurrence- free survival (RFS) and disease-free survival (DFS) were not significantly different (HR=1.02, 95% CI: 0.71-1.45, P<.001). There was no statistical difference in long-term survival among patients with different stages of esophageal cancer, while patients who underwent esophagectomy after 2019 had a better long-term prognosis (HR=0.57, 95% CI: 0.57-0.79). In addition, there was no significant difference in prognosis and survival between patients in Japan and China based on regional analysis.Conclusions: Our meta-analysis showed that NPLG was associated with better long-term survival. Thus, we should preserve the thoracic duct during esophageal cancer surgery.

scholarly journals Favourable long-term survival of patients with esophageal cancer treated with extended transhiatal esophagectomy combined with en bloc lymphadenectomy: results from a retrospective observational cohort study

BMC Surgery ◽  
2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Dino Kröll ◽  
Yves Michael Borbély ◽  
Bastian Dislich ◽  
Tobias Haltmeier ◽  
Thomas Malinka ◽  
...  
Keyword(s):  
Overall Survival ◽  
Esophageal Cancer ◽  
Lymph Nodes ◽  
Tertiary Care ◽  
Neoadjuvant Treatment ◽  
R0 Resection ◽  
En Bloc ◽  
Term Survival ◽  
Long Term Survival

Abstract Background Although considered complex and challenging, esophagectomy remains the best potentially curable treatment option for resectable esophageal and esophagogastric junction (AEG) carcinomas. The optimal surgical approach and technique as well as the extent of lymphadenectomy, particularly regarding quality of life and short- and long-term outcomes, are still a matter of debate. To lower perioperative morbidity, we combined the advantages of a one-cavity approach with extended lymph node dissection (usually achieved by only a two-cavity approach) and developed a modified single-cavity transhiatal approach for esophagectomy. Methods The aim of this study was to evaluate the outcome of an extended transhiatal esophageal resection with radical bilateral mediastinal en bloc lymphadenectomy (eTHE). A prospective database of 166 patients with resectable cancers of the esophagus (including adenocarcinomas of the AEG types I and II) were analyzed. Patients were treated between 2001 and 2017 with eTHE at a tertiary care university center. Relevant patient characteristics and outcome parameters were collected and analyzed. The primary endpoint was 5-year overall survival. Secondary outcomes included short-term morbidity, mortality, radicalness of en bloc resection and oncologic efficacy. Results The overall survival rates at 1, 3 and 5 years were 84, 70, and 61.0%, respectively. The in-hospital mortality rate after eTHE was 1.2%. Complications with a Clavien-Dindo score of III/IV occurred in 31 cases (18.6%). A total of 25 patients (15.1%) had a major pulmonary complication. The median hospital stay was 17 days (interquartile range (IQR) 12). Most patients (n = 144; 86.7%) received neoadjuvant treatment. The median number of lymph nodes resected was 25 (IQR 17). The R0 resection rate was 97%. Conclusion In patients with esophageal cancer, eTHE without thoracotomy resulted in excellent long-term survival, an above average number of resected lymph nodes and an acceptable postoperative morbidity and mortality.

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