scholarly journals Systematic review and meta-analysis on outcomes of salvage therapy in patients with tumour recurrence during ‘watch and wait’ in rectal cancer

2019 ◽  
Vol 101 (7) ◽  
pp. 441-452 ◽  
Author(s):  
J On ◽  
J Shim ◽  
EH Aly
Keyword(s):  
Rectal Cancer ◽  
Relative Risk ◽  
Salvage Therapy ◽  
Meta Analysis ◽  
Salvage Treatment ◽  
Watch And Wait ◽  
Conventional Surgery ◽  
Specific Mortality ◽  
Disease Specific Mortality ◽  
Disease Specific

Introduction The ‘watch and wait’ approach has recently emerged as an alternative approach for managing patients with complete clinical response in rectal cancer. However, less is understood whether the intervention is associated with a favourable outcome among patients who require salvage therapy following local recurrence. Materials and methods A comprehensive systematic search was performed using EMBASE, PubMed, MEDLINE, Journals@Ovid as well as hand searches; published between 2004 and 2018, to identify studies where outcomes of patients undergoing watch and wait were compared with conventional surgery. Study quality was assessed using the Newcastle–Ottawa assessment scale. The main outcome was relative risks for overall and disease specific mortality in salvage therapy. Results Nine eligible studies were included in the meta-analysis. Of 248 patients who followed the watch and wait strategy, 10.5% had salvage therapy for recurrent disease. No statistical heterogeneity was found in the results. The relative risk of overall mortality in the salvage therapy group was 2.42 (95% confidence interval 0.96–6.13) compared with the group who had conventional surgery, but this was not statistically significant (P > 0.05). The relative risk of disease specific mortality in salvage therapy was 2.63 (95% confidence interval 0.81–8.53). Conclusion Our findings demonstrated that there was no significant difference in overall and disease specific mortality in patients who had salvage treatment following recurrence of disease in the watch and wait group compared with the standard treatment group. However, future research into the oncological safety of salvage treatment is needed.

Associations Between Handgrip Strength and Disease-Specific Mortality Including Cancer, Cardiovascular, and Respiratory Diseases in Older Adults: A Meta-Analysis

2020 ◽  
Vol 28 (2) ◽  
pp. 320-331
Author(s):  
Junga Lee
Keyword(s):  
Older Adults ◽  
Older Women ◽  
Respiratory Diseases ◽  
Handgrip Strength ◽  
Meta Analysis ◽  
Adult Participants ◽  
All Cause Mortality ◽  
Specific Mortality ◽  
Disease Specific Mortality ◽  
Disease Specific

Several controversial studies linking handgrip strength and health have suggested that low handgrip strength in older adults may be related to health problems and have investigated whether there is a minimum handgrip strength level associated with reduced mortality. Thus, by meta-analysis, the authors identified an association between handgrip strength in older adults and disease-specific mortality and all-cause mortality. Thirty studies with a total of 194,767 older adult participants were included in this meta-analysis. Higher handgrip strength was associated with an 18% decrease in all-cause mortality. Lower handgrip strength was associated with increased all-cause mortality. The minimum handgrip strength in older women that did not increase all-cause mortality was 18.21 kg. Increased handgrip strength showed a decreased all-cause mortality, whereas decreased handgrip strength was associated with increased all-cause mortality. Strengthening the handgrip may help improve disease-specific mortality in older adults.

scholarly journals Association between TERT promoter mutations and clinical behaviors in differentiated thyroid carcinoma: a systematic review and meta-analysis

Endocrine ◽  
2019 ◽  
Vol 67 (1) ◽  
pp. 44-57 ◽  
Author(s):  
Jing Yang ◽  
Yanping Gong ◽  
Shuping Yan ◽  
Hui Chen ◽  
Siqin Qin ◽  
...  
Keyword(s):  
Systematic Review ◽  
Meta Analysis ◽  
Random Effect ◽  
Distant Metastases ◽  
Tnm Stage ◽  
Thyroid Carcinomas ◽  
Specific Mortality ◽  
Disease Specific Mortality ◽  
Promoter Mutations ◽  
Disease Specific

Abstract Background The association between telomerase reverse transcriptase (TERT) promoter mutations and some clinical behaviors in thyroid cancer remains controversial and requires additional investigation. This study aimed to evaluate the association between TERT promoter mutations and clinical behaviors (including clinicopathological features and prognosis) in differentiated thyroid carcinomas (DTC). Methods We performed an up-to-date systematic review and current comprehensive meta-analysis. We searched three electronic databases for relevant studies. We used fixed- or random-effect models to calculate pooled estimated odds ratios (ORs) or standardized mean differences (SMDs) and corresponding 95% confidence intervals (CIs). Results We included 51 eligible studies incorporating 11,382 cases. Average frequencies of TERT promoter mutations in DTC, papillary (PTC), and follicular (FTC) thyroid carcinomas were 10.9%, 10.6%, and 15.1%, respectively. In DTC and PTC, TERT promoter mutations were significantly associated with sex, age, tumor size, vascular invasion, extrathyroidal extension, lymph node and distant metastases, advanced tumor, nodes, and metastasis (TNM) stage, persistence/recurrence, and disease-specific mortality. In FTC, TERT promoter mutations were significantly associated with age, distant metastases, advanced TNM stage, persistence/recurrence, and disease-specific mortality. Conclusions TERT promoter mutations could be considered as biomarkers assisting in risk stratification, prognostic prediction, and individualizing therapeutic options for DTC (PTC and FTC).

Analysis of Disease-Specific Mortality after Local Excision for Stage I Rectal Cancer

2017 ◽  
Vol 225 (4) ◽  
pp. e64-e65
Author(s):  
Carla F. Justiniano ◽  
Adan Z. Becerra ◽  
Zhaomin Xu ◽  
Christopher T. Aquina ◽  
Courntey I. Boodry ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Local Excision ◽  
Stage I ◽  
Specific Mortality ◽  
Disease Specific Mortality ◽  
Disease Specific

Association of Serum Leptin with All-Cause and Disease Specific Mortality: A Meta-Analysis of Prospective Observational Studies

2018 ◽  
Vol 50 (07) ◽  
pp. 509-520 ◽  
Author(s):  
Hamed Kord-Varkaneh ◽  
Somaye Fatahi ◽  
Shahab Alizadeh ◽  
Ehsan Ghaedi ◽  
Sakineh Shab-Bidar
Keyword(s):  
Observational Studies ◽  
Meta Analysis ◽  
Healthy People ◽  
Serum Leptin ◽  
Risk Of Death ◽  
All Cause Mortality ◽  
Specific Mortality ◽  
Study Heterogeneity ◽  
Disease Specific Mortality ◽  
Disease Specific

AbstractLeptin levels may affect mortality through its link to inflammation and obesity. However, data are inconclusive. This meta-analysis was performed to investigate the association of leptin with mortality. The PubMed, Scopus, Google scholar, and reference lists of the included studies were searched for all published prospective observational studies that described the associations of serum leptin and mortality up to August 2017. Two reviewers independently assessed all potentially relevant studies for inclusion and methodological quality using standardized abstraction forms. Of 518 studies identified, 19 studies considered the association of leptin with all-cause mortality (16 208 subjects) and 12 studies evaluated the association of leptin with disease-specific mortality (13 680 subjects). In the overall analysis, no significant association was found between leptin and all-cause mortality (HR=1.028; 95% CI: 0.908–1.165; p=0.659), with a high between study heterogeneity (p˂0.001, I2=61). Subgroup analysis found that high leptin is associated with increased all-cause mortality in healthy people (HR=1.159 (95% CI, 1.032, 1.302), p=0.012), in men (HR=1.162; 95% CI: 1.036–1.302; p=0.010), and in subjects with ≥60 years old (HR=1.129; 95% CI: 1.030–1.238; p=0.010); whereas, increased leptin levels was related to the decreased cancer-specific mortality ((HR=0.550; 95% CI: 0.418–0.724), p˂0.001). Higher leptin levels in healthy people, old people, and males were associated with increased all-cause mortality, while increased leptin level was related to the reduced risk of death among patients with cancer.

Effects of Categorizing Continuous Variables in Decision-Analytic Models

2009 ◽  
Vol 29 (5) ◽  
pp. 549-556 ◽  
Author(s):  
Tanya G. K. Bentley ◽  
Milton C. Weinstein ◽  
Karen M. Kuntz
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Relative Risk ◽  
Markov Models ◽  
Disease Risk ◽  
Disease Incidence ◽  
Specific Mortality ◽  
Risk Of Disease ◽  
Disease Specific Mortality ◽  
Disease Specific

Purpose. When using continuous predictor variables in discrete-state Markov modeling, it is necessary to create categories of risk and assume homogeneous disease risk within categories, which may bias model outcomes. This analysis assessed the tradeoffs between model bias and complexity and/or data limitations when categorizing continuous risk factors in Markov models. Methods. The authors developed a generic Markov cohort model of disease, defining bias as the percentage change in life expectancy gain from a hypothetical intervention when using 2 to 15 risk factor categories as compared with modeling the risk factor as a continuous variable. They evaluated the magnitude and sign of bias as a function of disease incidence, disease-specific mortality, and relative difference in risk among categories. Results. Bias was positive in the base case, indicating that categorization overestimated life expectancy gains. The bias approached zero as the number of risk factor categories increased and did not exceed 4% for any parameter combinations or numbers of categories considered. For any given disease-specific mortality and disease incidence, bias increased with relative risk of disease. For any given relative risk, the relationship between bias and parameters such as disease-specific mortality or disease incidence was not always monotonic. Conclusions. Under the assumption of a normally distributed risk factor and reasonable assumption regarding disease risk and moderate values for the relative risk of disease given risk factor category, categorizing continuously valued risk factors in Markov models is associated with less than 4% absolute bias when at least 2 categories are used.

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