An educational tool as an aid for making decisions about the initial treatment of gastric cancer.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. e14684-e14684
Author(s):  
Peter Ravdin ◽  
Lindsay Peterson ◽  
Julie Rowe
Keyword(s):  
Gastric Cancer ◽  
Overall Survival ◽  
Medical Literature ◽  
Meta Analysis ◽  
Neoadjuvant Treatment ◽  
Disease Free Survival ◽  
Hazard Ratio ◽  
Low Grade ◽  
Base Line ◽  
Nccn Guidelines

e14684 Background: Tools for making individualized numerical estimates of outcomes and to provide useful information are revolutionizing medicine. We have produced such a tool for decision making for patients with gastric cancer [GC] for whom neo/adjuvant therapy might be an option to be considered. Methods: We widely reviewed the medical literature and meta-analyses about adjuvant and neoadjuvant treatment for potentially resectable [GC]. We also reviewed the guidelines' statements about what is considered appropriate treatment for patients. In addition we used information about individual prognosis based on information from the SEER registry, the AJCC, and also as supplemented from the medical literature. Results: Examination of the medical literature shows the value of adjuvant chemotherapy and radiation for [GC]. For example, and recent GASTRIC meta-analysis of 31 trials found that a benefit for overall survival (hazard ratio [HR], 0.82; 95% CI, 0.76-0.90) and for disease-free survival (HR, 0.82; 95% CI, 0.75-0.90). There is also a substantial literature supporting the use of these regimens in the neoadjuvant setting (such as the MAGIC study with benefit in overall survival (HR for death, 0.75; 95% CI, 0.60 to 0.93). We found however that these HRs were rarely accompanied with estimates of absolute benefit. A typical quote from the GASTIC analysis is "Five-year overall survival increased from 49.6% to 55.3% with chemotherapy," which reflects the outcomes for an average patient. This information is implied as the basis for treatment recommendations for treatment, but numerical estimates of what is gained are not given in such texts as the NCCN guidelines. Our analysis of the SEER data showed disease specific [GC] mortality at 3 years to range from 4% for patients with low grade stage 1a disease to 49 % for patients with high grade stage IIIa disease. Conclusions: Integrating the information about the base line risks for negative outcome with hazard ratio estimates of the effective therapy we can make individualized estimates of outcome. We have also included in the tool substantial additional information about the nature of the disease, past and ongoing trials, and the safety and efficacy of the treatment opinions.

scholarly journals Partial Versus Total Omentectomy in Patients with Gastric Cancer: A Systemic Review and Meta-Analysis

Cancers ◽  
2021 ◽  
Vol 13 (19) ◽  
pp. 4971
Author(s):  
Shion Wei Chai ◽  
Suo-Hsien Wang ◽  
Chih-Yuan Wang ◽  
Yi-Chan Chen ◽  
Ruey-Shyang Soong ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Overall Survival ◽  
Meta Analysis ◽  
Disease Free Survival ◽  
Systemic Review ◽  
Cochrane Library ◽  
Free Survival ◽  
Significant Difference ◽  
Hospital Stays ◽  
Disease Free

Background: Surgical treatment is the key to cure localized gastric cancer. There is no strong evidence that supports the value of omentectomy. Thus, a meta-analysis was conducted to compare the safety and efficiency of partial and total omentectomy in patients with gastric cancer. Methods: PubMed, Embase, and Cochrane Library databases were searched. All studies that compared total and partial omentectomy as treatments for gastric cancer were included. The primary outcomes were patients’ overall survival and disease-free survival, while the secondary outcomes were perioperative outcome and postoperative complications. Results: A total of nine studies were examined, wherein 1043 patients were included in the partial omentectomy group, and 1995 in the total omentectomy group. The partial omentectomy group was associated with better overall survival (hazard ratio: 0.80, 95% CI: 0.66 to 0.98, p = 0.04, I2 = 0%), shorter operative time, and lesser blood loss than the total omentectomy group. In addition, no statistically significant difference was observed in the number of dissected lymph nodes, length of hospital stays, complication rate, and disease-free survival. Conclusions: Our results show that, compared with total omentectomy in gastric cancer surgery, partial omentectomy had non-inferior oncological outcomes and comparable safety outcomes.

scholarly journals Prognostic significance of circRNAs expression in breast carcinoma patients: A meta-analysis

2021 ◽  
Author(s):  
Zizhen Zhou ◽  
Xiancai Li ◽  
Dewu Liu
Keyword(s):  
Breast Cancer ◽  
Overall Survival ◽  
Cancer Patients ◽  
Meta Analysis ◽  
Disease Free Survival ◽  
Hazard Ratio ◽  
Breast Cancer Patients ◽  
Free Survival ◽  
Regulated Expression ◽  
Disease Free

AbstractObjectiveThe aim of our study was to systematically evaluate the prognostic effects of various circrnas and to explore the prognostic value of circRNAs in breast cancer patients.MethodsA systematical search was conducted on PubMed, Scopus, EMBASE, and the Cochrane Library databases. Eligible studies reporting on the association among circRNAs and prognostic values of breast cancer patients were included. Fixed-effects and random effects models were used to calculate the pooled hazard ratio values of overall survival and disease free survival. In addition, funnel plots were used to qualitatively analyze the publication bias.Results28 studies were included in our meta-analysis. The pooled hazard ratio values of overall survival and disease free survival related to different circRNAs expression in breast cancer patients were 1.68 (1.44-1.97), 2.63 (1.95-3.53).We have identified a total of 28 circRNAs including 19 significantly up-regulated expression circRNAs and 9 significantly down-regulated expression circRNAs in BC(breast cancer) patients. Moreover, all of them revealed mechanisms and have the function of promoting or inhibiting the proliferation, metastasis or invasion of breast cancer cells by acting on the corresponding target.ConclusionOverall, specific circRNAs are significantly associated with the prognosis of BC patients and potentially eligible for the prediction of patients survival. It also provides a potential value for clinical decision-making development and may serve as a promising circRNAs-based target therapy waiting for further elucidation.

scholarly journals Efficacy and Benefit of Postoperative Chemotherapy in Micropapillray or Solid Predominant Pattern in Stage IB Lung Adenocarcinoma: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 8 ◽  
Author(s):  
Congcong Xu ◽  
Kanghao Zhu ◽  
Dong Chen ◽  
Yuhang Ruan ◽  
Zixian Jin ◽  
...  
Keyword(s):  
Overall Survival ◽  
Confidence Interval ◽  
Lung Adenocarcinoma ◽  
Meta Analysis ◽  
Disease Free Survival ◽  
Hazard Ratio ◽  
Postoperative Chemotherapy ◽  
Free Survival ◽  
Stage Ib ◽  
Disease Free

Background: The benefit of postoperative chemotherapy remains controversial for patients with either a micropapillary or solid pattern in stage IB non-small cell lung cancer. This study is designed to explore the significance of postoperative chemotherapy in patients with either a micropapillary or solid pattern in stage IB lung adenocarcinoma.Method: To conduct the meta-analysis, PubMed, Cochrane Library, Embase and Medline were used to collect literature on long-term follow-up studies published before March, 2021, involving postoperative chemotherapy for patients with both a micropapillary or solid pattern in stage IB lung adenocarcinoma as compared to non-postoperative chemotherapy. Survival data was extracted from the literature, including the overall survival and disease-free survival. Based on overall survival and disease-free survival, hazard ratios and their 95% of confidence intervals were applied to assess the prognostic effect of postoperative chemotherapy. Review Manager software was used to merge the effect size for the meta-analysis.Result: In total, 6 papers with 956 patients were included. In terms of the prognosis of patients suffering from lung cancer when receiving postoperative chemotherapy, this study comprehensively reviews and evaluates the available evidence of micropapillary or solid patterns. After excluding the heterogeneity between the studies, we found that the pooled results from 6 studies report that postoperative chemotherapy was associated with a better overall survival rate when compared with non-postoperative chemotherapy (hazard ratio = 0.58, 95% confidence interval, 0.44–0.77; P = 0.0002). Postoperative chemotherapy also significantly improved the disease-free survival in patients with either a micropapillary or a solid pattern in stage IB lung adenocarcinoma (postoperative chemotherapy vs. non-postoperative chemotherapy, hazard ratio = 0.51, 95% confidence interval, 0.40–0.64; P < 0.001). However, a subgroup analysis showed that compared with non-postoperative chemotherapy, tumor size was unrelated to the prognosis of patients in stage IB undergoing postoperative chemotherapy (hazard ratio = 0.98, 95% confidence interval, 0.94–1.02; P = 0.27).Conclusion: Postoperative chemotherapy results in a better long-term survival rate for patients with either a solid or a micropapillary pattern in stage IB lung adenocarcinoma. Multi-center, prospective, clinical trials are needed to validate our findings.

Prognostic role of tumor-inflating lymphocytes in gastric cancer: A systematic review and meta-analysis.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e15578-e15578
Author(s):  
Der Sheng Sun ◽  
Jung Soo Lee ◽  
Soon Auck Hong ◽  
Hye Sung Won ◽  
Yoon Ho Ko
Keyword(s):  
Gastric Cancer ◽  
Overall Survival ◽  
Survival Data ◽  
Meta Analysis ◽  
Disease Free Survival ◽  
Tumor Infiltrating Lymphocytes ◽  
Foxp3 Expression ◽  
Survival Outcome ◽  
Cancer Prognosis ◽  
Infiltrating Lymphocytes

e15578 Background: Tumor-infiltrating lymphocytes(TILs) may act as major determinants of the host immune response to tumor cells. However, the potential prognostic value of TILs in gastric cancer remains controversial. This meta-analysis analyzed the associations between TILs and survival outcomes in gastric cancer. Methods: Eligible 24 published studies were identified by searching the PubMed and Google scholar databases. The primary clinical outcome was defined as overall survival (OS) or disease-free survival (DFS), which were analyzed by subgroups such as TILs subtype. The total of the study sample sizes in eligible 24 published studies was 3,229, which ranged from 52 to 273 (median, 120) patients. All studies were non-randomized and retrospective study. The only multivariate hazard ratio(HR) among patient survival data were pooled, and pooled multivariate HR with 95% confidence intervals (95% CI) were used to calculate the strength of this association between TILs expression and survival outcome. Results: The pooled multivariate hazard ratios suggested that high expression of TILs was associated with better overall survival outcome (pooled HR = 0.69, 95% CI 0.57–0.82), compared to low TILs expression in twenty-three eligible studies, particularly in CD8(+) lymphocytes (pooled HR = 0.63, 95% CI 0.48 –0.83). In contrast, a pooled analysis of the FOXP3 (+) T cells or Treg subgroup showed that high FOXP3 (+) expression was negatively correlated with OS (pooled HR = 1.88, 95% CI 1.34 –2.63). In an analysis of seven studies on DFS, the infiltration by TILs, CD4(+) or CD8(+) lymphocytes (pooled HR = 0.59, 95% CI 0.42 –0.81), not by the infiltration of FOXP3 (+) T lymphocytes (pooled HR = 1.82, 95% CI 1.30 – 2.53), was significantly associated with better survival outcome. Conclusions: The results from this meta-analysis suggest that TILs and TILs subsets expression can be a potential prognostic biomarker in patients with gastric cancer. Key Words: Tumor-infiltrating lymphocytes, gastric cancer, prognosis, meta-analysis

scholarly journals Disease-Free Survival as a Surrogate for Overall Survival in Adjuvant Trials of Gastric Cancer: A Meta-Analysis

2013 ◽  
Vol 105 (21) ◽  
pp. 1600-1607 ◽  
Author(s):  
Koji Oba ◽  
Xavier Paoletti ◽  
Steven Alberts ◽  
Yung-Jue Bang ◽  
Jacqueline Benedetti ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Overall Survival ◽  
Meta Analysis ◽  
Disease Free Survival ◽  
Free Survival ◽  
Disease Free

scholarly journals Clinical and prognostic significances of cancer stem cell markers in gastric cancer patients: a systematic review and meta-analysis

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Mahdieh Razmi ◽  
Roya Ghods ◽  
Somayeh Vafaei ◽  
Maryam Sahlolbei ◽  
Leili Saeednejad Zanjani ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Stem Cell ◽  
Cancer Stem Cell ◽  
Clinical Outcomes ◽  
Cancer Progression ◽  
Poor Prognosis ◽  
Meta Analysis ◽  
Disease Free Survival ◽  
Stem Cell Markers ◽  
Free Survival

Abstract Background Gastric cancer (GC) is considered one of the most lethal malignancies worldwide, which is accompanied by a poor prognosis. Although reports regarding the importance of cancer stem cell (CSC) markers in gastric cancer progression have rapidly developed over the last few decades, their clinicopathological and prognostic values in gastric cancer still remain inconclusive. Therefore, the current meta-analysis aimed to quantitatively re-evaluate the association of CSC markers expression, overall and individually, with GC patients’ clinical and survival outcomes. Methods Literature databases including PubMed, Scopus, ISI Web of Science, and Embase were searched to identify the eligible articles. Hazard ratios (HRs) or odds ratios (ORs) with 95% confidence intervals (CIs) were recorded or calculated to determine the relationships between CSC markers expression positivity and overall survival (OS), disease-free survival (DFS)/relapse-free survival (RFS), disease-specific survival (DSS)/ cancer-specific survival (CSS), and clinicopathological features. Results We initially retrieved 4,425 articles, of which a total of 66 articles with 89 studies were considered as eligible for this meta-analysis, comprising of 11,274 GC patients. Overall data analyses indicated that the overexpression of CSC markers is associated with TNM stage (OR = 2.19, 95% CI 1.84–2.61, P = 0.013), lymph node metastasis (OR = 1.76, 95% CI 1.54–2.02, P < 0.001), worse OS (HR = 1.65, 95% CI 1.54–1.77, P < 0.001), poor CSS/DSS (HR = 1.69, 95% CI 1.33–2.15, P < 0.001), and unfavorable DFS/RFS (HR = 2.35, 95% CI 1.90–2.89, P < 0.001) in GC patients. However, CSC markers expression was found to be slightly linked to tumor differentiation (OR = 1.25, 95% CI 1.01–1.55, P = 0.035). Sub-analysis demonstrated a significant positive relationship between most of the individual markers, specially Gli-1, Oct-4, CD44, CD44V6, and CD133, and clinical outcomes as well as the reduced survival, whereas overexpression of Lgr-5, Nanog, and sonic hedgehog (Shh) was not found to be related to the majority of clinical outcomes in GC patients. Conclusion The expression of CSC markers is mostly associated with worse outcomes in patients with GC, both overall and individual. The detection of a combined panel of CSC markers might be appropriate as a prognostic stratification marker to predict tumor aggressiveness and poor prognosis in patients with GC, which probably results in identifying novel potential targets for therapeutic approaches.

scholarly journals HOTAIR as a Prognostic Predictor for Diverse Human Cancers: A Meta- and Bioinformatics Analysis

Cancers ◽  
2019 ◽  
Vol 11 (6) ◽  
pp. 778 ◽  
Author(s):  
Halil Ibrahim Toy ◽  
Didem Okmen ◽  
Panagiota I. Kontou ◽  
Alexandros G. Georgakilas ◽  
Athanasia Pavlopoulou
Keyword(s):  
Overall Survival ◽  
Cancer Patients ◽  
Bioinformatics Analysis ◽  
Meta Analysis ◽  
Disease Free Survival ◽  
Progression Free Survival ◽  
Predictive Biomarker ◽  
Free Survival ◽  
Human Cancers ◽  
Potential Biomarker

Several studies suggest that upregulated expression of the long non-coding RNA HOX transcript antisense RNA (HOTAIR) is a negative predictive biomarker for numerous cancers. Herein, we performed a meta-analysis to further investigate the prognostic value of HOTAIR expression in diverse human cancers. To this end, a systematic literature review was conducted in order to select scientific studies relevant to the association between HOTAIR expression and clinical outcomes, including overall survival (OS), recurrence-free survival (RFS)/disease-free survival (DFS), and progression-free survival (PFS)/metastasis-free survival (MFS) of cancer patients. Collectively, 53 eligible studies including a total of 4873 patients were enrolled in the current meta-analysis. Pooled hazard ratios (HRs) with their corresponding 95% confidence intervals (CIs) were calculated to assess the relationship between HOTAIR and cancer patients’ survival. Elevated HOTAIR expression was found to be significantly associated with OS, RFS/DFS and PFS/MFS in diverse types of cancers. These findings were also corroborated by the results of bioinformatics analysis on overall survival. Therefore, based on our findings, HOTAIR could serve as a potential biomarker for the prediction of cancer patient survival in many different types of human cancers.

scholarly journals Mortality due to cancer treatment delay: systematic review and meta-analysis

BMJ ◽  
2020 ◽  
pp. m4087 ◽  
Author(s):  
Timothy P Hanna ◽  
Will D King ◽  
Stephane Thibodeau ◽  
Matthew Jalink ◽  
Gregory A Paulin ◽  
...  
Keyword(s):  
Systematic Review ◽  
Overall Survival ◽  
Confidence Interval ◽  
Cancer Treatment ◽  
Head And Neck ◽  
Adjuvant Radiotherapy ◽  
Systemic Treatment ◽  
Meta Analysis ◽  
Treatment Delay ◽  
Hazard Ratio

Abstract Objective To quantify the association of cancer treatment delay and mortality for each four week increase in delay to inform cancer treatment pathways. Design Systematic review and meta-analysis. Data sources Published studies in Medline from 1 January 2000 to 10 April 2020. Eligibility criteria for selecting studies Curative, neoadjuvant, and adjuvant indications for surgery, systemic treatment, or radiotherapy for cancers of the bladder, breast, colon, rectum, lung, cervix, and head and neck were included. The main outcome measure was the hazard ratio for overall survival for each four week delay for each indication. Delay was measured from diagnosis to first treatment, or from the completion of one treatment to the start of the next. The primary analysis only included high validity studies controlling for major prognostic factors. Hazard ratios were assumed to be log linear in relation to overall survival and were converted to an effect for each four week delay. Pooled effects were estimated using DerSimonian and Laird random effect models. Results The review included 34 studies for 17 indications (n=1 272 681 patients). No high validity data were found for five of the radiotherapy indications or for cervical cancer surgery. The association between delay and increased mortality was significant (P<0.05) for 13 of 17 indications. Surgery findings were consistent, with a mortality risk for each four week delay of 1.06-1.08 (eg, colectomy 1.06, 95% confidence interval 1.01 to 1.12; breast surgery 1.08, 1.03 to 1.13). Estimates for systemic treatment varied (hazard ratio range 1.01-1.28). Radiotherapy estimates were for radical radiotherapy for head and neck cancer (hazard ratio 1.09, 95% confidence interval 1.05 to 1.14), adjuvant radiotherapy after breast conserving surgery (0.98, 0.88 to 1.09), and cervix cancer adjuvant radiotherapy (1.23, 1.00 to 1.50). A sensitivity analysis of studies that had been excluded because of lack of information on comorbidities or functional status did not change the findings. Conclusions Cancer treatment delay is a problem in health systems worldwide. The impact of delay on mortality can now be quantified for prioritisation and modelling. Even a four week delay of cancer treatment is associated with increased mortality across surgical, systemic treatment, and radiotherapy indications for seven cancers. Policies focused on minimising system level delays to cancer treatment initiation could improve population level survival outcomes.

Overexpression of NUAK1 is associated with disease-free survival and overall survival in patients with gastric cancer

2014 ◽  
Vol 31 (7) ◽  
Author(s):  
Xiao-tian Ye ◽  
Ai-jun Guo ◽  
Peng-fei Yin ◽  
Xian-dong Cao ◽  
Jia-cong Chang
Keyword(s):  
Gastric Cancer ◽  
Overall Survival ◽  
Disease Free Survival ◽  
Free Survival ◽  
Disease Free

scholarly journals Prognostic Value of Pretreatment Systemic Immune-Inflammation Index in Gastric Cancer: A Meta-Analysis

2021 ◽  
Vol 11 ◽  
Author(s):  
Ye Qiu ◽  
Zongxin Zhang ◽  
Ying Chen
Keyword(s):  
Gastric Cancer ◽  
Prognostic Value ◽  
Meta Analysis ◽  
Disease Free Survival ◽  
Positive Lymph Node ◽  
Node Metastasis ◽  
Advanced Tumor ◽  
Tumor Node Metastasis Stage ◽  
Immune Inflammation

BackgroundPrevious studies have investigated the role of systemic immune-inflammation index (SII) as a prognostic factor for gastric cancer (GC) patients, although with inconsistent results. Thus, the aim of this study was to identify the prognostic value of SII in GC through meta-analysis.MethodsWe systematically searched the PubMed, Embase, and Web of Science databases for relevant studies investigating the prognostic role of SII in GC up to December 2019. The hazard ratios (HRs) and 95% confidence intervals (CIs) related to overall survival (OS) and disease-free survival (DFS) were combined. Odds ratios (ORs) and 95% CIs were pooled to assess the correlation between SII and clinicopathological features of GC.ResultsA total of eight studies, comprising 4,236 patients, were included in this meta-analysis. Pooled analysis indicated that a high pretreatment SII predicted poor OS (HR=1.40, 95% CI=1.08–1.81, p=0.010) but not poor DFS (HR=1.30, 95% CI=0.92–1.83, p=0.140) in GC. In addition, an elevated SII correlated with an advanced tumor–node–metastasis stage (OR=2.34, 95% CI=1.40–3.92, p=0.001), T3–T4 stage (OR=2.25, 95% CI=1.34–3.77, p=0.002), positive lymph node metastasis (OR=1.79, 95% CI=1.12–2.87, p=0.016), and tumor size ≥ 5 cm (OR=2.28, 95% CI=1.62–3.22, p&lt;0.001) in patients with GC.ConclusionsA high pretreatment SII significantly associated with poorer survival outcomes as well as several clinical characteristics in GC. We suggest that SII could be monitored to guide prognostication and provide reliable information on the risk of disease progression in GC.

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