Adjuvant therapy for retroperitoneal sarcoma: a meta-analysis

Abstract Background Adjuvant therapy is a promising treatment to improve the prognosis of cancer patients, however, the evidence base driving recommendations for adjuvant radiotherapy (ART) or chemotherapy (ACT) in retroperitoneal sarcomas (RPS) primarily hinges on observational data. The aim of this study was to evaluate the effectiveness of adjuvant therapy in the management of RPS patients. Methods We searched PubMed, Web of Science, Embase, ASCO Abstracts, and Cochrane Library for comparative studies (until December 2020) of adjuvant therapy versus surgery alone. Data on the following endpoints were evaluated: overall survival (OS), local recurrence (LR), recurrence-free survival (RFS), and metastasis-free survival (MFS). Data were summarized as hazard ratios (HR) with 95% confidence intervals (CI). Risk of bias of studies was assessed with Begg’s and Egger’s tests. Results A total of 15 trials were eligible, including 9281 adjuvant therapy and 21,583 surgery alone cases (20 studies for OS, six studies for RFS, two studies for LR, and two studies for MFS). Meta-analysis showed that ART was associated with distinct advantages as compared to surgery alone, including a longer OS (HR = 0.80, P < 0.0001), a longer RFS (HR = 0.61, P = 0.0002), and a lower LR (HR = 0.31, P = 0.005). However, this meta-analysis failed to demonstrate a benefit of ACT for RPS patients, including OS (HR = 1.11, P = 0.19), RFS (HR = 1.30, P = 0.09) and MFS (HR = 0.69, P = 0.09). In the sensitivity analysis, ACT was associated with a worse OS (HR = 1.19, P = 0.0002). No evidence of publication bias was observed. Conclusions Overall, the quality of the evidence was moderate for most outcomes. The evidence supports that ART achieved a generally better outcome as compared to surgery alone.

Download Full-text

Adjuvant therapy for retroperitoneal sarcoma: a meta-analysis

10.21203/rs.3.rs-128705/v1 ◽

2020 ◽

Author(s):

Xiangji Li ◽

Tong Wu ◽

Mengmeng Xiao ◽

Shanshan Wu ◽

Li Min ◽

...

Keyword(s):

Adjuvant Therapy ◽

Web Of Science ◽

Meta Analysis ◽

Evidence Base ◽

Cochrane Library ◽

Free Survival ◽

Hazard Ratios ◽

Promising Treatment ◽

Retroperitoneal Sarcomas

Abstract Background Adjuvant therapy is a promising treatment to improve the prognosis of cancer patients, however, the evidence base driving recommendations for adjuvant radiotherapy (ART) or chemotherapy (ACT) in retroperitoneal sarcomas (RPS) primarily hinges on observational data. The aim of this study was to evaluate the effectiveness of adjuvant therapy in the management of RPS by pooling analysis. Methods We searched PubMed, Web of Science, Embase, ASCO Abstracts, and Cochrane Library for comparative studies (until January 2020) comparing adjuvant therapy versus surgery alone. Data on the following endpoints were evaluated: overall survival (OS), local recurrence (LR), recurrence-free survival (RFS), and metastasis-free survival (MFS). Data were summarized as hazard ratios (HR) with 95% confidence intervals (95%CI). Risk of bias of studies was assessed with Begg’s and Egger’s tests. Results A total of 15 trials were eligible, including 9076 adjuvant therapy and 20830 surgery alone cases (20 studies for OS, 6 studies for RFS, 2 studies for LR, and 2 studies for MFS). Meta-analysis showed that ART was associated with distinct advantages as compared to surgery alone, including a longer OS (HR = 0.80, P < 0.0001), a longer RFS (HR = 0.61, P = 0.0002), and a lower LR (HR = 0.31, P = 0.005). However, this meta-analysis failed to demonstrate a benefit of ACT for RPS, including OS (HR = 1.11, P = 0.19), RFS (HR = 1.30, P = 0.09) and MFS (HR = 0.69, P = 0.09). in the sensitivity analysis, ACT was associated with a worse OS (HR = 1.19, P = 0.0002). No evidence of publication bias was observed. Conclusions Overall, the quality of the evidence was moderate for most outcomes. The evidence supports that ART achieved a generally better outcome as compared to surgery alone.

Download Full-text

Prognostic value of PIVKA-II in hepatocellular carcinoma patients receiving curative ablation: A systematic review and meta-analysis

The International Journal of Biological Markers ◽

10.1177/1724600818760234 ◽

2018 ◽

Vol 33 (3) ◽

pp. 266-274 ◽

Cited By ~ 2

Author(s):

Dongjing Zhang ◽

Zhihong Liu ◽

Xueru Yin ◽

Xiaolong Qi ◽

Bingyun Lu ◽

...

Keyword(s):

Hepatocellular Carcinoma ◽

Overall Survival ◽

Prognostic Value ◽

Clinical Utility ◽

Web Of Science ◽

Meta Analysis ◽

Cochrane Library ◽

Recurrence Free Survival ◽

Free Survival ◽

Hazard Ratios

Background: Several studies have been conducted to evaluate the prognostic value of prothrombin induced by vitamin K absence-II (PIVKA-II) overexpression in hepatocellular carcinoma patients treated with curative ablation. However, the results remain controversial. The purpose of this meta-analysis was to explore the correlation between PIVKA-II expression and survival outcomes in these patients. Methods: We performed a systematic literature search in PubMed, EMBASE, Medline, Cochrane Library, and Web of Science to identify the relevant articles investigating the prognostic value of PIVKA-II in patients with hepatocellular carcinoma. Combined hazard ratios (HR) and their 95% confidence intervals (CI) for overall survival and recurrence-free survival were calculated as the analysis endpoints. Results: A total of 15 cohorts encompassing 5647 patients were included. The results indicated that elevated PIVKA-II was significantly associated with poorer overall survival (HR 1.59; 95% CI 1.40, 1.82; P < 0.001) and recurrence-free survival (HR 1.76; 95% CI 1.42, 2.17; P < 0.001). Similar results were observed in the subgroup analysis based on sample size, analytical method, treatment modality, and cut-off value. Conclusions: This meta-analysis suggests that elevated PIVKA-II is a predictor of unfavorable overall survival and recurrence-free survival in hepatocellular carcinoma patients receiving curative ablation. More rigorous studies are warranted to confirm the clinical utility of PIVKA-II in determining hepatocellular carcinoma prognosis.

Download Full-text

Survival of Patients Treated with Antibiotics and Immunotherapy for Cancer: A Systematic Review and Meta-Analysis

Journal of Clinical Medicine ◽

10.3390/jcm9051458 ◽

2020 ◽

Vol 9 (5) ◽

pp. 1458 ◽

Cited By ~ 1

Author(s):

Fausto Petrelli ◽

Alessandro Iaculli ◽

Diego Signorelli ◽

Antonio Ghidini ◽

Lorenzo Dottorini ◽

...

Keyword(s):

Cancer Patients ◽

Checkpoint Inhibitors ◽

Meta Analysis ◽

Progression Free Survival ◽

Cochrane Library ◽

Free Survival ◽

Patients With Cancer ◽

Hazard Ratios ◽

The Cochrane Library ◽

Reporting Data

Antibiotics (ABs) are common medications used for treating infections. In cancer patients treated with immune checkpoint inhibitors (ICIs), concomitant exposure to ABs may impair the efficacy of ICIs and lead to a poorer outcome compared to AB non-users. We report here the results of a meta-analysis evaluating the effects of ABs on the outcome of patients with solid tumours treated with ICIs. PubMed, the Cochrane Library and Embase were searched from inception until September 2019 for observational or prospective studies reporting the prognoses of adult patients with cancer treated with ICIs and with or without ABs. Overall survival (OS) was the primary endpoint, and progression-free survival (PFS) was the secondary endpoint. The effect size was reported as hazard ratios (HRs) with a 95% confidence interval (CI) and an HR > 1 associated with a worse outcome in ABs users compared to AB non-users. Fifteen publications were retrieved for a total of 2363 patients. In the main analysis (n = 15 studies reporting data), OS was reduced in patients exposed to ABs before or during treatment with ICIs (HR = 2.07, 95%CI 1.51–2.84; p < 0.01). Similarly, PFS was inferior in AB users in n = 13 studies with data available (HR = 1.53, 95%CI 1.22–1.93; p < 0.01). In cancer patients treated with ICIs, AB use significantly reduced OS and PFS. Short duration/course of ABs may be considered in clinical situations in which they are strictly needed.

Download Full-text

Survival of Patients Treated with Antibiotics and Immunotherapy for Cancer: A Systematic Review and Meta-Analysis

10.20944/preprints202003.0425.v1 ◽

2020 ◽

Author(s):

Fausto Petrelli ◽

Alessandro Iaculli ◽

Diego Signorelli ◽

Antonio Ghidini ◽

Lorenzo Dottorini ◽

...

Keyword(s):

Cancer Patients ◽

Checkpoint Inhibitors ◽

Meta Analysis ◽

Progression Free Survival ◽

Cochrane Library ◽

Free Survival ◽

Patients With Cancer ◽

Hazard Ratios ◽

The Cochrane Library ◽

Reporting Data

Antibiotics (ABs) are common medications used for treating infections. In cancer patients treated with immune checkpoint inhibitors (ICIs), concomitant exposure to ABs may impair the efficacy of ICIs and lead to a poorer outcome compared to AB non-users. We report here the results of a meta-analysis evaluating the effects of ABs on the outcome of patients with solid tumors treated with ICIs. PubMed, the Cochrane Library, and Embase were searched from inception until September 2019 for observational or prospective studies reporting prognosis of adult patients with cancer treated with ICIs and with or without ABs. Overall survival (OS) was the primary endpoint, and progression-free survival (PFS) was the secondary endpoint. The effect size was reported as hazard ratios (HRs) with a 95% confidence interval (CI), and an HR > 1 associated with a worse outcome in ABs users compared to no-ABs users. Fifteen publications were retrieved for a total of 2363 patients. In the main analysis (n = 15 studies reporting data), OS was reduced in patients exposed to ABs before or during treatment with ICIs (HR = 2.07, 95%CI 1.51–2.84; P<.01). Similarly, PFS was inferior in ABs users in n = 13 studies with data available (HR = 1.53, 95%CI 1.22–1.93; p<.01). In cancer patients treated with ICIs, AB use significantly reduces OS and PFS. Short duration/course of ABs may be considered in clinical situations in which they are strictly needed.

Download Full-text

Adjuvant therapy in pancreatic adenocarcinoma: A systemic review and meta-analysis.

Journal of Clinical Oncology ◽

10.1200/jco.2016.34.4_suppl.330 ◽

2016 ◽

Vol 34 (4_suppl) ◽

pp. 330-330

Author(s):

Kazi Jannatun Nahar ◽

David Chan ◽

Anubhav Mittal ◽

Jaswinder S. Samra ◽

Thomas Hugh ◽

...

Keyword(s):

Pancreatic Adenocarcinoma ◽

Adjuvant Treatment ◽

Meta Analysis ◽

Systemic Review ◽

Free Survival ◽

Hazard Ratios ◽

Cochrane Database ◽

Significant Difference ◽

Grade 3

330 Background: The “optimal” adjuvant treatment in pancreatic cancer remains undetermined. Chemotherapy (chemo) such as gemcitabine (Gem), 5-fluorouracil (5-FU) and chemo-radiotherapy (chemoRT) with either Gem or 5-FU have been investigated in trials. We performed a systematic review and meta-analysis to determine the overall efficacy of adjuvant treatment. Methods: We searched databases (PubMed, Medline, Cochrane database) and major conference proceedings up until August 2015 for randomized trials comparing chemo or chemoRT versus (vs) observation, two different chemo regimens and chemoRT vs chemo. Primary end point was overall survival (OS); secondary end points were relapse free survival (RFS), grade 3/4 toxic effects and quality of life (QoL). We performed meta-analysis as per the PRISMA guidelines; hazard ratios (HR) for OS and RFS were pooled with random-effects modelling. Results: Fifteen trials were identified evaluating 4348 patients. For trials comparing chemo to observation (7 trials, n = 1383) the OS HR was 0.77 (95% CI 0.67-0.89, p = 0.001) and PFS HR 0.73 (95% CI 0.53-1.01, p = 0.06) both favouring chemo. For trials investigating Gem (2 trials, n = 472), OS was improved with HR 0.76 (95% CI 0.63 -0.92, p = 0.006) as was RFS (HR 0.56, 95% CI 0.46-0.68, p < 0.00001). For trials investigating agents other than Gem (5 trials, n = 911), OS was improved with HR 0.79 (95% CI 0.63-0.99, p = 0.04), but RFS was not (2 trials only, HR 1.00, 95% CI 0.73-1.37, p = 0.99). Five trials (n = 1832) compared different chemo regimens to Gem in each case; pooled OS HR was 0.90 (95% CI 0.65-1.25, p = 0.54) and RFS HR 0.88 (95% CI 0.67-1.15, p = 0.35). Insufficient data was available to pool grade 3/4 toxicity for chemo vs observation trials; no significant difference was found in incidence of overall grade 3/4 toxicity for trials comparing two chemo regimens (OR 0.98, 95% CI 0.39-2.47, p = 0.96). QoL data was available in 3 trials (ESPAC-1, ESPAC-3, CapRi) with no significant differences noted. Conclusions: Adjuvant chemo vs no chemo for resected pancreatic adenocarcinoma improves OS and RFS. Adjuvant ChemoRT vs no treatment is not beneficial. Overall, novel chemo regimens have not been shown to be superior to Gem. Reporting of QoL is inadequate to make any conclusion.

Download Full-text

The Prognostic Value of lncRNA SNHG3 in Cancer Patients: A meta-analysis

10.21203/rs.3.rs-91124/v1 ◽

2020 ◽

Author(s):

Jie Wang ◽

Pingyong Zhong ◽

Hao Hua

Keyword(s):

Cancer Patients ◽

Prognostic Value ◽

Meta Analysis ◽

Disease Free Survival ◽

Cochrane Library ◽

Multiple Cancer ◽

Free Survival ◽

Node Metastasis ◽

Hazard Ratios ◽

Clinicopathological Significance

Abstract Background:Small nucleolar RNA host gene 3 (SNHG3) is a promising long non-coding RNA that may possess prognostic value for different types of tumors. The objective of this meta-analysis is to evaluate the prognostic value of lncRNA SNHG3 in cancer patients.Methods:A systematic literature search of the PubMed, Cochrane Library, EMBASE, Medline, Web of Science, CNKI, Weipu, and Wanfang electronic databases was carried out in this meta-anaysis. The synthetic hazard ratios (HRs) or odd ratios (ORs) with 95% confidence intervals (CIs) were obtained to determine the prognostic and clinicopathological significance of SNHG3 expression in tumors. Results:The final meta-anaysis included 17 studies that contained 2072 patients. The pooled results provided evidence that SNHG3 overexpression predicted reduced overall survival (OS) (HR=2.15, 95%CI: 1.76–2.63, P<0.00001), recurrence-free survival (RFS) ( HR=2.22, 95%CI: 1.04–4.76, P=0.04) and disease-free survival (DFS) (HR=2.04, 95%CI: 1.35–3.09, P=0.0007) for various cancers. Additionally, the SNHG3 overexpression was concerned with tumor node metastasis (TNM) stage (III/IV vs. I/II, OR=2.91, 95%CI: 1.60–5.29, P=0.0005), lymph node metastasis (LNM) (positive vs negative, OR=5.00,95%CI:2.82–8.87,P＜0.00001), distant metastasis (DM) (positive vs negative, OR=2.29, 95%CI: 1.52–3.47, P<0.0001) and tumor size (larger vs smaller, OR=1.80, 95%CI: 1.04–3.11, P=0.04).Conclusions:Our results indicated that SNHG3 overexpression was closely correlated with shorter OS in multiple cancer types, suggesting that SNHG3 might function as a promising predictor for clinical outcomes in cancer.

Download Full-text

Impact of Muscle Mass on Survival in Patients with Sepsis: A Systematic Review and Meta-Analysis

Annals of Nutrition and Metabolism ◽

10.1159/000519642 ◽

2021 ◽

pp. 1-7

Author(s):

Jiajie Zhang ◽

Yicheng Huang ◽

Yingsha Chen ◽

Xiaomin Shen ◽

Hongying Pan ◽

...

Keyword(s):

Muscle Mass ◽

Web Of Science ◽

Meta Analysis ◽

Psoas Muscle ◽

Cochrane Library ◽

Conference Abstract ◽

Newcastle Ottawa Scale ◽

Included Article ◽

Ottawa Scale

Introduction: The aim of this study is to investigate the association between loss of muscle mass and prognosis of sepsis. Methods: Six databases, including PubMed, Embase, Cochrane Library, Web of Science, Scopus, and Ovid, were searched by the deadline of August 18, 2020. A meta-analysis was conducted on the collected data by means of a random-effects model. The quality of each included article was assessed according to the Newcastle-Ottawa Scale. Results: Out of 1,819 references, 6 articles and 1 conference abstract were included. Sepsis patients with a loss of muscle mass or sarcopenia had higher mortality (risk ratio [RR]: 1.94, 95% confidence intervals [CI]: 1.59–2.37; I-squared = 18.7%, p < 0.001). The RR of mortality within 30 days (RR: 2.31, 95% CI: 1.78–2.99, p < 0.001) was higher than that of mortality over 30 days. Loss of psoas muscle mass, as evaluated by CT, showed the highest RR of sepsis mortality. In addition, based on data on overall survival retrieved from 4 trials, the pooled hazard ratio (HR) for patients with a loss of muscle mass or sarcopenia was 3.04. Subgroup analysis showed that survival time was the main source of heterogeneity for the overall HR. Furthermore, the scanning areas of muscle mass in survival patients were 0.33 cm2/m2 higher than those measured in deceased patients. Conclusion: A loss of muscle mass, as evaluated by CT scan, was associated with a poor outcome in sepsis.

Download Full-text

Lavender for Sleep Disorder Management in Menopausal Women with or without Hypertension: A Systematic and Meta-analysis

Tabari Biomedical Student Research Journal ◽

10.18502/tbsrj.v3i1.6175 ◽

2021 ◽

Author(s):

Mehdi Mameneh ◽

Ali Rokni ◽

Masumeh Ghazanfarpour ◽

Masoudeh Babakhanian

Keyword(s):

Sleep Disorders ◽

Web Of Science ◽

Sleep Problems ◽

Meta Analysis ◽

Cochrane Library ◽

Quality Of Sleep ◽

Isi Web Of Science ◽

Menopausal Women ◽

Post Menopausal

Introduction: Regarding the prevalence of sexual problems during menopause and the interest of women in the use of aromatherapy in attenuating the sleep disorders, and due to the lack of comprehensive meta-analysis on the effects of aromatherapy on the sleep disorders, the present study was conducted to determine the effect of lavender on the sleep disorders in postmenopausal women.Material and Methods: The following databases were selected to search systematically the effect of lavender on the quality of sleep in post-menopausal women, including PubMed, Cochrane Library, ISI Web of Science and Scopus, regardless time limit since inception to September 29, 2019. The quality of trials was investigated according to Jadad scale.Results: After combination of the result of four trials, our meta-analysis showed that treatment with lavender was more effective than placebo in respect with improvement of quality of sleep in menopausal women (Standardized Mean Difference=1.098; Confidence Interval 95%: 0.33-1.86; P= 0.005).Conclusion: Considering the effects of lavender essential oil on improving the quality of sleep in postmenopausal and middle-aged women, this medication can be prescribed in the clinics of sleep problems, obstetrics and gynecology.

Download Full-text

Prognostic and Clinicopathological Significance of PD-L1 in Patients with Cholangiocarcinoma: A Meta-Analysis

Disease Markers ◽

10.1155/2020/1817931 ◽

2020 ◽

Vol 2020 ◽

pp. 1-12

Author(s):

Qinfen Xie ◽

Lidong Wang ◽

Shusen Zheng

Keyword(s):

Meta Analysis ◽

Prognostic Significance ◽

Disease Free Survival ◽

Cochrane Library ◽

Free Survival ◽

Hazard Ratios ◽

Programmed Death ◽

Poor Differentiation ◽

Clinicopathological Significance ◽

Pn Stage

Background. In recent years, there is growing literature on the prognostic significance of programmed death-ligand 1 (PD-L1) in cholangiocarcinoma (CCA); however, data have been conflicting. Therefore, the objective of this study was to assess the correlation between PD-L1 and prognosis in CCA through meta-analysis. Methods. Published studies were retrieved from the Web of Science, PubMed, Embase, and Cochrane Library up to April 17, 2020. The relationships between PD-L1 expression and survival outcomes were assessed using hazard ratios (HRs) and 95% confidence intervals (CIs). Results. Eighteen studies consisting of 2012 patients were included. Overexpression of PD-L1 was significantly associated with worse overall survival (OS) (HR=1.58, 95%CI=1.30−1.92, p<0.001) but not with poor disease-free survival (DFS) (HR=1.03, 95%CI=0.68−1.55, p=0.895) in CCA. Moreover, PD-L1 was associated with low differentiation (OR=1.43, 95%CI=1.09−1.87, p=0.010) and higher pN stage (OR=1.45, 95%CI=1.10−1.92, p=0.009) but not with sex, TNM stage, vascular invasion, perineural invasion, age, or tumor size. Conclusion. High PD-L1 expression was associated with worse OS, poor differentiation, and higher pN stage in patients with CCA. PD-L1 could be a potential prognostic marker in CCA.

Download Full-text

Prognostic and clinicopathological value of Ki-67 expression in patients with nasopharyngeal carcinoma: a meta-analysis

Therapeutic Advances in Medical Oncology ◽

10.1177/1758835920951346 ◽

2020 ◽

Vol 12 ◽

pp. 175883592095134

Author(s):

Zhaohui Shi ◽

Weihong Jiang ◽

Xiaodong Chen ◽

Min Xu ◽

Xiaocheng Wang ◽

...

Keyword(s):

Nasopharyngeal Carcinoma ◽

Meta Analysis ◽

Progression Free Survival ◽

Cochrane Library ◽

Poor Overall Survival ◽

Ki 67 ◽

Free Survival ◽

Hazard Ratios ◽

N Stage

Background: This meta-analysis aimed to identify the prognostic role of Ki-67 in patients with nasopharyngeal carcinoma (NPC). Methods: Relevant studies were retrieved in the PubMed, Embase, Web of Science, and Cochrane Library databases up to November 2019. The pooled hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated to estimate the association between Ki-67 expression and survival outcomes. Combined odds ratios (ORs) and 95% CIs were measured as effect size on the association between Ki-67 expression and clinical factors. Results: A total of eight studies involving 936 patients with NPC were included in this meta-analysis. The pooled HR indicated that Ki-67 expression was significantly associated with poor overall survival (HR = 2.86, 95% CI = 1.91–4.27, p < 0.001), progression-free survival (HR = 1.78, 95% CI = 1.15–2.74, p = 0.009), and distant metastasis-free survival (HR = 1.65, 95% CI = 1.15–2.36, p = 0.007). However, there was no significant correlation between Ki-67 expression and local recurrence-free survival (HR = 1.07, 95% CI = 0.54–2.14, p = 0.843). Ki-67 overexpression was associated with higher T stage (OR = 1.48, 95% CI = 1.00–2.20, p = 0.052), and the relationship between Ki-67 expression and advanced stage was nearly significant (OR = 2.25, 95% CI = 0.99–5.14, p = 0.054). However, high Ki-67 expression was not significantly correlated with sex, age, N stage, or histological type. Conclusion: This meta-analysis demonstrated that Ki-67 overexpression was a significant marker for poor prognosis in patients with NPC. Ki-67 should be recommended as a useful index for prognostication in patients with NPC.

Download Full-text