Survival and Prognostic Factors of Early Childhood Medulloblastoma: An International Meta-Analysis

2010 ◽  
Vol 28 (33) ◽  
pp. 4961-4968 ◽  
Author(s):  
Stefan Rutkowski ◽  
Katja von Hoff ◽  
Angela Emser ◽  
Isabella Zwiener ◽  
Torsten Pietsch ◽  
...  
Keyword(s):  
Early Childhood ◽  
Prognostic Factors ◽  
Meta Analysis ◽  
Large Cell ◽  
Study Groups ◽  
National Study ◽  
Incomplete Resection ◽  
Histologic Subtype ◽  
Prospective Trials ◽  
Childhood Medulloblastoma

Purpose To assess the prognostic role of clinical parameters and histology in early childhood medulloblastoma. Patients and Methods Clinical and histologic data from 270 children younger than age 5 years diagnosed with medulloblastoma between March 1987 and July 2004 and treated within prospective trials of five national study groups were centrally analyzed. Results Two hundred sixty children with medulloblastoma and specified histologic subtype were eligible for analysis (median age, 1.89 years; median follow-up, 8.0 years). Rates for 8-year event-free survival (EFS) and overall survival (OS) were 55% and 76%, respectively, in 108 children with desmoplastic/nodular medulloblastoma (DNMB) or medulloblastoma with extensive nodularity (MBEN); 27% and 42%, respectively, in 145 children with classic medulloblastoma (CMB); and 14% and 14%, respectively, in seven children with large-cell/anaplastic (LC/A) medulloblastoma (P < .001). Histology (DNMB/MBEN: hazard ratio [HR], 0.44; 95% CI, 0.31 to 0.64; LC/A medulloblastoma: HR, 2.27; 95% CI, 0.95 to 5.54; P < .001 compared with CMB), incomplete resection and metastases (M0R1: HR, 1.86; 95% CI, 1.29 to 2.80; M+: HR, 2.28; 95% CI, 1.50 to 3.46; P < .001 compared with M0R0), and national group were independent prognostic factors for EFS, and OS. The HRs for OS ranged from 0.14 for localized M0 and DNMB/MBEN to 13.67 for metastatic LC/A medulloblastoma in different national groups. Conclusion Our results confirm the high frequency of desmoplastic variants of medulloblastomas in early childhood and histopathology as a strong independent prognostic factor. A controlled de-escalation of treatment may be appropriate for young children with DNMB and MBEN in future clinical trials.

scholarly journals Prognostic factors for chronic post-surgical pain after lung or pleural surgery: a protocol for a systematic review and meta-analysis

BMJ Open ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. e051554
Author(s):  
Pascal Richard David Clephas ◽  
Sanne Elisabeth Hoeks ◽  
Marialena Trivella ◽  
Christian S Guay ◽  
Preet Mohinder Singh ◽  
...  
Keyword(s):  
Systematic Review ◽  
Prognostic Factors ◽  
Prognostic Factor ◽  
Meta Analysis ◽  
Case Series ◽  
Related Factors ◽  
Surgical Pain ◽  
Literature Reviews ◽  
Chronic Post Surgical Pain

IntroductionChronic post-surgical pain (CPSP) after lung or pleural surgery is a common complication and associated with a decrease in quality of life, long-term use of pain medication and substantial economic costs. An abundant number of primary prognostic factor studies are published each year, but findings are often inconsistent, methods heterogeneous and the methodological quality questionable. Systematic reviews and meta-analyses are therefore needed to summarise the evidence.Methods and analysisThe reporting of this protocol adheres to the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P) checklist. We will include retrospective and prospective studies with a follow-up of at least 3 months reporting patient-related factors and surgery-related factors for any adult population. Randomised controlled trials will be included if they report on prognostic factors for CPSP after lung or pleural surgery. We will exclude case series, case reports, literature reviews, studies that do not report results for lung or pleural surgery separately and studies that modified the treatment or prognostic factor based on pain during the observation period. MEDLINE, Scopus, Web of Science, Embase, Cochrane, CINAHL, Google Scholar and relevant literature reviews will be searched. Independent pairs of two reviewers will assess studies in two stages based on the PICOTS criteria. We will use the Quality in Prognostic Studies tool for the quality assessment and the CHARMS-PF checklist for the data extraction of the included studies. The analyses will all be conducted separately for each identified prognostic factor. We will analyse adjusted and unadjusted estimated measures separately. When possible, evidence will be summarised with a meta-analysis and otherwise narratively. We will quantify heterogeneity by calculating the Q and I2 statistics. The heterogeneity will be further explored with meta-regression and subgroup analyses based on clinical knowledge. The quality of the evidence obtained will be evaluated according to the Grades of Recommendation Assessment, Development and Evaluation guideline 28.Ethics and disseminationEthical approval will not be necessary, as all data are already in the public domain. Results will be published in a peer-reviewed scientific journal.PROSPERO registration numberCRD42021227888.

Impact of early childhood caries on oral health‐related quality of life: a systematic review and meta‐analysis

2021 ◽  
Author(s):  
Carlos Zaror ◽  
Andrea Matamala‐Santander ◽  
Montse Ferrer ◽  
Fernando Rivera‐Mendoza ◽  
Gerardo Espinoza‐Espinoza ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Systematic Review ◽  
Early Childhood ◽  
Oral Health ◽  
Early Childhood Caries ◽  
Meta Analysis ◽  
Health Related Quality ◽  
Related Quality ◽  
Health Related

scholarly journals Is jumbo biopsy forceps comparable to cold snare for diminutive colorectal polyps? – a meta-analysis

2021 ◽  
Vol 09 (01) ◽  
pp. E9-E13
Author(s):  
Sachin Srinivasan ◽  
Peter D. Siersema ◽  
Madhav Desai
Keyword(s):  
Meta Analysis ◽  
Complete Removal ◽  
Colorectal Polyps ◽  
Comparable Efficacy ◽  
Incomplete Resection ◽  
Complication Rates ◽  
Biopsy Forceps ◽  
Significant Difference ◽  
Leave One Out ◽  
Endoscopic Assessment

Abstract Background and study aims Diminutive colorectal polyps are increasingly being detected and it is not clear whether jumbo biopsy forceps (JBF) has comparable efficacy to that of cold snare polypectomy (CSP) for management of these lesions. Methods An electronic literature search was performed for studies comparing resection rates of JBF and CSP for diminutive polyps (≤ 5 mm). The primary outcome was incomplete resection rate (IRR). Secondary outcomes included failure of tissue retrieval and complication rates (post-polypectomy bleeding, perforation etc.). Leave-one-out analysis was performed to examine the disproportionate role of any of the studies. Meta-analysis outcomes and heterogeneity (I2) were computed using Comprehensive meta-analysis software. Results A total of 4 studies (3 randomized controlled trials and 1 retrospective study) with 407 patients and 569 total polyps (mean size of 3.62 mm) was included for analysis. IRR of JBF was slightly higher than that of CSP (10.2 % vs 7.2 %) but this was not statistically significantly different (Pooled OR 1.76; 95 % CI 0.94–3.28; I2 = 0). Leave-one-out analysis showed no significant difference in the pooled OR comparison either. Two of the 4 studies reported 0 % failure of tissue retrieval for JBF and 1 % and 4.3 % for CSP. There were no complications for either group from the 2 studies that reported this outcome. The quality of the included studies was moderate to high. Conclusions This systematic review with only limited data shows that JBF and CSP are not statistically different in completely removing diminutive polyps, although careful endoscopic assessment is needed to ensure complete removal of all polyp tissue.

A Systematic Review and Meta-Analysis of the Relation Between Engagement and Achievement in Early Childhood Research

2021 ◽  
pp. 027112142110327
Author(s):  
Esther R. Lindström ◽  
Jason C. Chow ◽  
Kathleen N. Zimmerman ◽  
Hongyang Zhao ◽  
Elise Settanni ◽  
...  
Keyword(s):  
Early Childhood ◽  
Academic Engagement ◽  
Literature Search ◽  
Meta Analysis ◽  
Effect Sizes ◽  
Data Sets ◽  
Systematic Literature Search ◽  
Random Effects Models ◽  
Unique Data ◽  
Early Childhood Research

Engagement in early childhood has been linked with later achievement, but the relation between these variables and how they are measured in early childhood requires examination. We estimated the overall association between academic engagement and achievement in children prior to kindergarten entry. Our systematic literature search yielded 13,521 reports for structured eligibility screening; from this pool of studies, we identified 21 unique data sets, with 199 effect sizes for analysis. We coded eligible studies, extracted effect sizes, accounted for effect size dependency, and used random-effects models to synthesize findings. The overall correlation between academic engagement and achievement was r = .24 (range: −.08 to −.71), and moderator analyses did not significantly predict the relation between the two constructs. This study aligns with previous research on this topic and examines issues related to these measures, their constraints, and applications as they pertain to early childhood research.

scholarly journals Efficacy of Surgery for the Treatment of Gastric Cancer Liver Metastases: A Systematic Review of the Literature and Meta-Analysis of Prognostic Factors

2021 ◽  
Vol 10 (5) ◽  
pp. 1141
Author(s):  
Gianpaolo Marte ◽  
Andrea Tufo ◽  
Francesca Steccanella ◽  
Ester Marra ◽  
Piera Federico ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Systematic Review ◽  
Prognostic Factors ◽  
Liver Metastases ◽  
Meta Analysis ◽  
Multidisciplinary Treatment ◽  
Review Of The Literature ◽  
Term Survival ◽  
The Impact

Background: In the last 10 years, the management of patients with gastric cancer liver metastases (GCLM) has changed from chemotherapy alone, towards a multidisciplinary treatment with liver surgery playing a leading role. The aim of this systematic review and meta-analysis is to assess the efficacy of hepatectomy for GCLM and to analyze the impact of related prognostic factors on long-term outcomes. Methods: The databases PubMed (Medline), EMBASE, and Google Scholar were searched for relevant articles from January 2010 to September 2020. We included prospective and retrospective studies that reported the outcomes after hepatectomy for GCLM. A systematic review of the literature and meta-analysis of prognostic factors was performed. Results: We included 40 studies, including 1573 participants who underwent hepatic resection for GCLM. Post-operative morbidity and 30-day mortality rates were 24.7% and 1.6%, respectively. One-year, 3-years, and 5-years overall survival (OS) were 72%, 37%, and 26%, respectively. The 1-year, 3-years, and 5-years disease-free survival (DFS) were 44%, 24%, and 22%, respectively. Well-moderately differentiated tumors, pT1–2 and pN0–1 adenocarcinoma, R0 resection, the presence of solitary metastasis, unilobar metastases, metachronous metastasis, and chemotherapy were all strongly positively associated to better OS and DFS. Conclusion: In the present study, we demonstrated that hepatectomy for GCLM is feasible and provides benefits in terms of long-term survival. Identification of patient subgroups that could benefit from surgical treatment is mandatory in a multidisciplinary setting.

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