scholarly journals Rh-endostatin Concomitant with Chemotherapy Versus Single Agent Chemotherapy for Treating Soft Tissue and Bone Sarcomas: A Systematic Review and Meta-Analysis

2018 ◽  
Vol 21 ◽  
pp. 386-397 ◽  
Author(s):  
Zhuo Ma ◽  
Lifang Guo ◽  
Xiangli Cui ◽  
He Liu ◽  
Lihong Liu
Keyword(s):  
Systematic Review ◽  
Soft Tissue ◽  
Meta Analysis ◽  
Soft Tissue Sarcomas ◽  
Chemotherapeutic Agents ◽  
Cochrane Library ◽  
Large Sample Size ◽  
Proteolytic Fragment ◽  
Significant Difference ◽  
Bone Sarcomas

Objectives: Endostar (recombinant human endostatin (rh-endostatin)), a 20-kDa proteolytic fragment of collagen XVIII, was approved for the treatment of non–small cell lung cancer (NSCLC). Recently, several studies have evaluated the efficacy of rh-endostatin combined with chemotherapy in the treatment of bone and soft tissue sarcomas. Here, we conducted a systematic review and meta-analysis to assess available evidence. Methods: Pubmed, Embase, Web of Sciences, the Cochrane Library and two Chinese literature databases (CNKI, WanFang) were systematically searched till May 20, 2018. Randomized controlled trials (RCTs) and cohort studies which compared the outcomes of rh-endostatin combined with chemotherapy versus chemotherapy alone for treating bone sarcomas or soft tissue sarcomas were included. The primary outcome was overall survival rate (OSR). Secondary outcomes included objectiveremissionrate(ORR), clinical benefit rate (CBR), disease control rate (DCR), distant metastasis rate (DMR) and adverse effects (AEs). The methodological quality of the included studies was evaluated. Data analysis was performed by Revman 5.3 software. Results: 9 studies comprising 839 patients were included. The pooled results indicated that, compared with chemotherapeutic agents alone, rh-endostatin combined group had a significant benefit in 1-year and 2-year OSR. However, there were no difference between 5-year OSR. OR, CBR and DMR were higher in rh-endostatin combined group. No significant difference was observed in the incidence of AEs. Conclusions: Rh-endostatin combined chemotherapeutic agents significantly improved clinical efficacy compared with chemotherapeutic agents alone in treating bone and soft tissue sarcomas. Moreover, combination of rh-endostatin with chemotherapy didn’t increase the incidence of AEs. But more high quality RCTs with  large  sample  size  should  be  done  in  the  future  to confirm the conclusion.

scholarly journals Is MTHFD1 polymorphisms rs 2236225 (c.1958G>A) associated with the susceptibility of NSCL/P? A systematic review and meta-analysis

F1000Research ◽  
2015 ◽  
Vol 4 ◽  
pp. 142 ◽  
Author(s):  
Huaxiang Zhao ◽  
Jieni Zhang ◽  
Mengqi Zhang ◽  
Feng Deng ◽  
Leilei Zheng ◽  
...  
Keyword(s):  
Systematic Review ◽  
Publication Bias ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Large Sample Size ◽  
Extensive Literature ◽  
Asian Countries ◽  
Advanced Technique ◽  
Significant Difference ◽  
Methylenetetrahydrofolate Dehydrogenase

Aims: To investigate the association between the methylenetetrahydrofolate dehydrogenase 1 (MTHFD1) polymorphism rs 2236225 (c.1958G>A) and susceptibility to non-syndromic cleft of the lip and/or palate (NSCL/P).Methods: An extensive literature review has been conducted using PubMed, Web of Science, Cochrane Library, Google Scholar, the China National Knowledge Infrastructure (CNKI), and Wanfang Database for eligible researches. The terms for searching were “cleft lip OR cleft palate OR CLP OR CL/P OR oral facial cleft OR OFC” AND “methylenetetrahydrofolate dehydrogenase (NADP+ dependent) 1 OR methenyltetrahydrofolate cyclohydrolase formyltetrahydrofolate synthetase OR MTHFD1 OR MTHFD”. Two independent researchers screened, evaluated and extracted the data of included studies. The pooled odds ratios (OR) with 95% confidence intervals (95% CI) were calculated by random effects model under five gene models. Subgroup, sensitivity analysis and publication bias were also assessed.Results: Ten case-control studies have been included in the systematic review and eight studies have been considered for the meta-analysis. Overall, the MTHFD1 polymorphism rs2236225 and the risk of NSCL/P showed pooled OR (95% CI) of 1.02 (0.86-1.21) under allelic model. A higher degree of heterogeneity was observed in Asian countries (I2 = 75.6%) compared to non-Asian countries (I2 = 48.9%). Similar consequence appeared in the subgroup of children (I2 = 78.6%) compared with that of mothers (I2 = 0.0%). There was no significant difference in the publication bias by the Begg’s funnel plot (P = 0.711) and Egger’s regression test (P = 0.746).Conclusion: Our assessment suggested there was no significant association between the MTHFD1 polymorphism rs 2236225 (c.1958G>A) and the susceptibility to NSCL/P. Further investigations using a large sample size and a more advanced technique should be adopted to reach a more precise conclusion in the future.

scholarly journals Is MTHFD1 polymorphism rs 2236225 (c.1958G>A) associated with the susceptibility of NSCL/P? A systematic review and meta-analysis

F1000Research ◽  
2016 ◽  
Vol 4 ◽  
pp. 142
Author(s):  
Huaxiang Zhao ◽  
Jieni Zhang ◽  
Mengqi Zhang ◽  
Feng Deng ◽  
Leilei Zheng ◽  
...  
Keyword(s):  
Systematic Review ◽  
Publication Bias ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Large Sample Size ◽  
Extensive Literature ◽  
Asian Countries ◽  
Advanced Technique ◽  
Significant Difference ◽  
Methylenetetrahydrofolate Dehydrogenase

Aims: To investigate the association between the methylenetetrahydrofolate dehydrogenase 1 (MTHFD1) polymorphism rs 2236225 (c.1958G>A) and susceptibility to non-syndromic cleft of the lip and/or palate (NSCL/P).Methods: An extensive literature review has been conducted using PubMed, Web of Science, Cochrane Library, Google Scholar, the China National Knowledge Infrastructure (CNKI), and Wanfang Database for eligible researches. The terms for searching were “cleft lip OR cleft palate OR CLP OR CL/P OR oral facial cleft OR OFC” AND “methylenetetrahydrofolate dehydrogenase (NADP+ dependent) 1 OR methenyltetrahydrofolate cyclohydrolase formyltetrahydrofolate synthetase OR MTHFD1 OR MTHFD”. Two independent researchers screened, evaluated and extracted the data of included studies. The pooled odds ratios (OR) with 95% confidence intervals (95% CI) were calculated by random effects model under five gene models. Subgroup, sensitivity analysis and publication bias were also assessed.Results: Ten case-control studies have been included in the systematic review and eight studies have been considered for the meta-analysis. Overall, the MTHFD1 polymorphism rs2236225 and the risk of NSCL/P showed pooled OR (95% CI) of 1.02 (0.86-1.21) under allelic model. A higher degree of heterogeneity was observed in Asian countries (I2 = 75.6%) compared to non-Asian countries (I2 = 48.9%). Similar consequence appeared in the subgroup of children (I2 = 78.6%) compared with that of mothers (I2 = 0.0%). There was no significant difference in the publication bias by the Begg’s funnel plot (P = 0.711) and Egger’s regression test (P = 0.746).Conclusion: Our assessment suggested there was no significant association between the MTHFD1 polymorphism rs 2236225 (c.1958G>A) and the susceptibility to NSCL/P. Further investigations using a large sample size and a more advanced technique should be adopted to reach a more precise conclusion in the future.

scholarly journals EXPRESS: Stroke risk following traumatic brain injury: systematic review and meta-analysis

2021 ◽  
pp. 174749302110042
Author(s):  
Grace Mary Turner ◽  
Christel McMullan ◽  
Olalekan Lee Aiyegbusi ◽  
Danai Bem ◽  
Tom Marshall ◽  
...  
Keyword(s):  
Systematic Review ◽  
Stroke Risk ◽  
Meta Analysis ◽  
Vitamin K Antagonists ◽  
Cochrane Library ◽  
Control Group ◽  
Large Sample Size ◽  
Hazard Ratios ◽  
Increased Risk ◽  
The Cochrane Library

Aims To investigate the association between TBI and stroke risk. Summary of review We undertook a systematic review of MEDLINE, EMBASE, CINAHL, and The Cochrane Library from inception to 4th December 2020. We used random-effects meta-analysis to pool hazard ratios (HR) for studies which reported stroke risk post-TBI compared to controls. Searches identified 10,501 records; 58 full texts were assessed for eligibility and 18 met the inclusion criteria. The review included a large sample size of 2,606,379 participants from four countries. Six studies included a non-TBI control group, all found TBI patients had significantly increased risk of stroke compared to controls (pooled HR 1.86; 95% CI 1.46-2.37). Findings suggest stroke risk may be highest in the first four months post-TBI, but remains significant up to five years post-TBI. TBI appears to be associated with increased stroke risk regardless of severity or subtype of TBI. There was some evidence to suggest an association between reduced stroke risk post-TBI and Vitamin K antagonists and statins, but increased stroke risk with certain classes of antidepressants. Conclusion TBI is an independent risk factor for stroke, regardless of TBI severity or type. Post-TBI review and management of risk factors for stroke may be warranted.

scholarly journals Kinesio Taping for Balance Function after Stroke: A Systematic Review and Meta-Analysis

2019 ◽  
Vol 2019 ◽  
pp. 1-15 ◽  
Author(s):  
Yijuan Hu ◽  
Dongling Zhong ◽  
Qiwei Xiao ◽  
Qiang Chen ◽  
Juan Li ◽  
...  
Keyword(s):  
Systematic Review ◽  
Treatment Duration ◽  
Meta Analysis ◽  
Current Evidence ◽  
Cochrane Library ◽  
Clinical Effects ◽  
Balance Function ◽  
Balance Impairment ◽  
Kinesio Taping ◽  
Significant Difference

Objective. With the increasing social and economic burdens of balance impairment after stroke, the treatment for balance impairment after stroke becomes a major public health problem worldwide. Kinesio taping (KT) as a part of clinical practice has been used widely in the treatment of balance impairment after stroke. However, the clinical effects of KT for balance function have not been confirmed. The objective of this study is to investigate the effects and safety of KT for balance impairment after stroke. Methods. We conducted a systematic review (SR) and meta-analysis of randomized controlled trials (RCTs) on the effects of KT for balance impairment after stroke. We searched the following databases: (1) English databases: EMBASE (via Ovid), MEDLINE (via Ovid), the Cochrane library, PubMed, and PEDro; (2) Chinese databases: China Biology Medicine (CBM), Wan Fang database, China National Knowledge Infrastructure (CNKI), and VIP. Besides, hand searches of relevant references were also conducted. We systematically searched from the inception to December 2018, using the keywords (Kinesio, Kinesio Tape, tape, or Orthotic Tape) and (stroke, hemiplegia, or hemiplegic paralysis) and (balance or stability). The search strategies were adjusted for each database. The reference lists of included articles were reviewed for relevant trials. For missing data, we contacted the authors to get additional information. Results. 22 RCTs involved 1331 patients, among which 667 patients in the experimental group and 664 patients in the control group were included. Results of meta-analysis showed that, compared with conventional rehabilitation (CR), there was significant difference in Berg Balance Scale (BBS) (MD=4.46, 95%CI 1.72 to 7.19, P=0.001), Time Up and Go Test (TUGT) (MD=-4.62, 95%CI -5.48 to -3.79, P < 0.00001), functional ambulation category scale (FAC) (MD=0.53, 95%CI 0.38 to 0.68, P < 0.00001), Fugl-Meyer assessment (FMA-L) (MD=4.20, 95%CI 3.17 to 5.24, P < 0.00001), and Modified Ashworth Scale (MAS) (MD=-0.38, 95%CI -0.49 to -0.27, P < 0.00001). The results of subgroup analysis showed that there was no significant difference between KT and CR with ≤4 weeks treatment duration (< 4 weeks: MD=5.03, 95%CI -1.80 to 11.85, P=0.15; =4 weeks: MD=4.33, 95%CI -1.50 to 10.15, P=0.15), while there was significant difference with more than 4-week treatment duration (MD=4.77, 95%CI 2.58 to 6.97, P < 0.0001). Conclusions. Based on current evidence, KT was more effective than CR for balance function, lower limb function, and walking function in poststroke patients. Longer treatment duration may be associated with better effects. However, more well-conducted RCTs are required in the future.

scholarly journals Digital models and orthodontic diagnosis: what degree of reliability?

2021 ◽  
Vol 8 ◽  
Author(s):  
ABDOUL Hafizou RABE ◽  
Fatima SALEK ◽  
Intissar El IDRISSI ◽  
Fatima ZAOUI ◽  
Hicham BENYAHIA
Keyword(s):  
Systematic Review ◽  
Numerical Models ◽  
Meta Analysis ◽  
Physical Models ◽  
Cochrane Library ◽  
Digital Models ◽  
Significant Difference ◽  
Clinically Significant ◽  
Conventional Models ◽  
Plaster Models

Abstract  Background: Our study aims to evaluate, through a systematic review, the reliability of numerical models compared to conventional models on the main parameters of orthodontic diagnosis  Method: four databases were consulted: PubMed; Google Scholar, Cochrane Library, and Ebscohost. The research included published studies since 2010, meta-analysis studies, randomized and non-randomized controlled trials, prospective and retrospective studies. Results: Among 3811 selected references, only five studies met our inclusion criteria. In the systematic review, there were statistical differences between the digital models and the plaster models. However, this difference is clinically acceptable. On the other hand, there are some limitations, relative to the types of the severity of the congestion, the elapsed time to digitize, and the numerical means. Conclusion: The results of our systematic review have shown that there is no clinically significant difference between the numerical and physical models for the majority of diagnostic parameters.

scholarly journals Physiotherapy and Pelvic Floor Muscle Exercises for the Prevention and Treatment of Pregnancy-Related Pelvic Floor Dysfunctions: A Systematic Review and Meta-analysis

2019 ◽  
Vol 8 (2) ◽  
pp. 125-132
Author(s):  
Fahime Khorasani ◽  
Fariba Ghaderi ◽  
Parvin Sarbakhsh ◽  
Parisa Ahadi ◽  
Elahe Khorasani ◽  
...  
Keyword(s):  
Systematic Review ◽  
Pelvic Floor ◽  
Pelvic Floor Muscle ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Control Groups ◽  
Pelvic Floor Muscle Exercises ◽  
Significant Difference ◽  
Prevention And Treatment ◽  
Pfm Strength

Objectives: The present systematic review focused on the prevention or treatment of three main types of pelvic floor dysfunctions (PFDs) specifically pelvic organ prolapse (POP), urinary incontinence (UI), and fecal incontinence (FI) using physiotherapy and pelvic floor muscle exercises (PFMEs). With regard to the breadth of the problem, there is not much evidence grounded on the best management. The main purpose of this systematic review was to evaluate the effects of physiotherapy and PFMEs on the prevention and treatment of pregnancy-related PFDs; namely, POP, FI, and UI. Therefore, this review incorporated studies comparing the use of physiotherapy and PFMEs with every other existing interventions. Methods: This systematic review and meta-analysis was conducted on randomized-controlled-trial (RCT) articles and quasi-RCT designs through a search in the studies published with no time limits until December 2017 in the databases of PubMed (Medline), Web of Science, Scopus, Embase, Cochrane Library, and ProQuest. The meta-analysis was also applied for data synthesis. Moreover, heterogeneity was assessed using Cochran’s Q test and I2 index. Results: A total number of 26 RCTs were examined in this review in which the outcome variables were related to POP, UI, and FI prevalence; POP, UI, and FI severity, as well as pelvic floor muscle (PFM) strength and endurance. In most articles, UI prevalence or severity in intervention groups had significantly improved compared with those in controls. The number of studies examining POP and FI was also relatively low. In two studies, FI severity or prevalence in intervention groups had significantly enhanced in comparison with those in control groups; however, FI prevalence in two articles had been reported lower in intervention groups than that in control groups although no significant difference had been observed. There was also no significant improvement in intervention groups in two other studies in this respect. Besides, three articles had not reported traces of improvement in POP, as well as a significant difference between intervention and control groups. Nevertheless, two studies had found a significant improvement in POP in this regard. Based on meta-analysis results for the variable of PFM strength, Cochran’s Q test (P<0.001) and I2 index (90.02) indicated heterogeneity between studies; so, a random-effect meta-analysis was applied to estimate overall effect sizes. The overall mean differences following intervention between the study groups were also equal to 6.94, with a 95% CI (1.36 to 12.52). Conclusions: It was concluded that physiotherapy and PFMEs might have effects on pregnancy-related UI, but they had not consistently reduced FI severity or prevalence and failed to constantly improve POP.

scholarly journals The association of fracture risk in atrial fibrillation patients and long-term anticoagulant therapy category: a systematic review and meta-analysis

PeerJ ◽  
2021 ◽  
Vol 9 ◽  
pp. e10683
Author(s):  
Jun Chen ◽  
Lingchun Lyu ◽  
Jiayi Shen ◽  
Chunlai Zeng ◽  
Cheng Chen ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Systematic Review ◽  
Hip Fracture ◽  
Fracture Risk ◽  
Hip Fractures ◽  
Observational Studies ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Hip Fracture Risk ◽  
Significant Difference

Objective Our study aimed to assess the risk of all fractures and hip fractures in patients with atrial fibrillation (AF) who took non-vitamin K antagonist oral anticoagulants (NOACs) compared to warfarin. Methods We searched PubMed, Embase, and Cochrane Library and Clinical Trials.gov Website. Reviewed related researches up to January 31, 2020, to identify studies with more than 12 months of follow-up data. The protocol for this systematic review and meta-analysis has been registered in the International Prospective Register of Systematic Reviews (PROSPERO Number: CRD42020156893). Results We included five RCT studies, and five observational studies that contained a total of 326,846 patients in our meta-analysis. Our meta-analysis showed that patients taken NOACs had no significant all fracture risk (RR = 0.91, 95% CI [0.81–1.01]) and hip fracture risk (RR = 0.92, 95% CI [0.82–1.03]) compared with those taken warfarin. Subanalysis showed that the risk of all fractures and hip fractures treated by NOACs were significant lower compared with warfarin in observational studies compared with RCT studies. Also, a subanalysis across the duration of anticoagulation showed the NOACs users have lower all fracture risk than warfarin users when the duration of anticoagulation ≤2 years (RR = 0.89, 95% CI [0.80–0.99]). Further analysis, significant lower all fracture risk in the rivaroxaban therapy (RR = 0.81; 95% CI [0.76–0.86]) compared with warfarin but no statistical significance in hip fracture. There were no significant difference of all fracture risk and hip fracture risk in dabigatran, apixaban, and edoxaban therapy compared with warfarin. Conclusion The meta-analysis demonstrated that NOACs associated with a significantly lower all fracture risk compared with warfarin when the duration of anticoagulation more than 2 years. Rivaroxaban users had lower risk of all fracture than warfarin users in AF patients. But there was no evidence to verify apixaban, edoxaban, and dabigatranin could decrease all fracture and hip fracture risk compared with warfarin.

Survival outcomes in primary head and neck adult sarcoma: A systematic review and meta-analysis.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. 6055-6055
Author(s):  
Sondos Zayed ◽  
Cindy Lin ◽  
Gabriel Boldt ◽  
Pencilla Lang ◽  
Nancy Read ◽  
...  
Keyword(s):  
Systematic Review ◽  
Head And Neck ◽  
Soft Tissues ◽  
Treatment Approach ◽  
Meta Analysis ◽  
Multimodality Treatment ◽  
Cochrane Library ◽  
Size Analysis ◽  
Survival Outcomes ◽  
Significant Difference

6055 Background: Head and neck sarcomas (HNS) are rare entities and confer substantial morbidity and mortality. Yet, the optimal management of HNS remains unclear. This study aimed to describe the epidemiology of HNS and to identify the most favorable treatment approach. Methods: We performed a systematic review and meta-analysis based on the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines, using the PubMed (Medline), EMBASE, and Cochrane Library databases, queried from 1990 until present. Articles in the English language reporting on survival outcomes of adult primary HNS patients treated with curative-intent were included. All estimates were weighted based on sample size. Analysis of variance (ANOVA) and two-sample t-tests were used as appropriate. Meta-analyses were performed using random effects models. This study was registered with PROSPERO, CRD42021220970. Results: A total of 3652 articles were identified, with 42 articles reporting on 21228 patients, meeting inclusion criteria. Mean ± SD age was 56.7 ± 14.6 years with 14170 (67.0%) men and 6991 (33.0%) women. The most common locations included skin and soft tissues (n = 12749, 63.3%), bones of skull and face (n = 2256, 11.2%), and oral cavity (n = 1775, 8.8%). The most common histologies included undifferentiated pleomorphic sarcoma (n = 5065, 24.8%), osteosarcoma (n = 2578, 12.6%), Kaposi sarcoma (n = 2316, 11.3%), chondrosarcoma (n = 2141, 10.5%), and hemangiosarcoma (n = 2072, 10.1%). 5459 patients had early stage I-II disease (76.9%) whereas 1643 had late stage III-IV disease (23.1%). Most received surgery alone (n = 10968, 61.0%), 3917 (21.8%) received surgery and radiotherapy (RT), 2173 (12.1%) received definitive RT/chemoradiotherapy (CRT), 811 (4.5%) received surgery and CRT, and 98 (0.5%) received surgery and chemotherapy. Negative margins were achieved in 6081 (76.5%). Mean ± SD follow-up was 55.3 ± 42.8 months. Weighted mean, 2-, 5-, and 10-year overall survival (OS) were 78.5 months, 75.9%, 63.2%, and 54.9% respectively. There was no significant difference in mean OS (P = 0.674) or 5-year OS (P = 0.965) between patients who received surgery alone, multimodality treatment with surgery and RT/CRT, or definitive RT/CRT. Mean ± SD 5-year OS was significantly higher with negative margins (62.7 ± 20.8%) compared with positive margins (22.7 ± 19.1%; P = 0.001). Mean ± SD local recurrence rate (LRR) was 32.0 ± 13.0%. LRRs were 41.8% for definitive RT/CRT, 39.3% for surgery and CRT, 33.6% for surgery alone, 24.7% for surgery and chemotherapy, and 20.1% for surgery and RT (P = 0.126). Conclusions: In the largest HNS study to date, negative margins were associated with an improvement in OS. Multimodality treatment did not confer an OS benefit. Definitive RT/CRT may be associated with a higher LRR. Randomized trials are needed to establish the optimal treatment approach for HNS.

Survival outcomes in primary angiosarcoma of the head and neck: A systematic review and meta-analysis.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e18039-e18039
Author(s):  
Sondos Zayed ◽  
Cindy Lin ◽  
Gabriel Boldt ◽  
Pencilla Lang ◽  
Nancy Read ◽  
...  
Keyword(s):  
Systematic Review ◽  
Head And Neck ◽  
Treatment Approach ◽  
Early Stage ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Size Analysis ◽  
Survival Outcomes ◽  
Curative Intent ◽  
Significant Difference

e18039 Background: Angiosarcoma of the head and neck (ASHN) is a rare entity and confers substantial morbidity and mortality. Yet, the optimal management of ASHN remains unclear. This study aimed to describe the epidemiology of ASHN and to identify the most favorable treatment approach. Methods: We performed a systematic review based on the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines, using the PubMed (Medline), EMBASE, and Cochrane Library databases, queried from 1990 until present. Articles in the English language reporting on survival outcomes of adult primary ASHN treated with curative-intent, were included. All estimates were weighted based on sample size. Analysis of variance (ANOVA) and two-sample t-tests were used as appropriate. This study was registered with PROSPERO, CRD42021220970. Results: A total of 3652 studies were identified, with 14 articles reporting on 2265 ASHN patients, meeting inclusion criteria. Mean ± SD age was 70.6 ± 7.7 years with 1621 (66.6%) men and 812 (33.4%) women. ASHN involved the scalp (n = 176, 57.9%) and the face (n = 128, 42.1%). 249 patients had early stage I-II disease (39.6%) whereas 379 had late stage III-IV disease (60.4%). Most (n = 529, 45.6%) received surgery and radiotherapy (RT), 305 (26.3%) received surgery alone, 210 (18.1%) received definitive RT/chemoradiotherapy (CRT), 75 (6.5%) received surgery and CRT, and 33 (2.8%) received surgery and chemotherapy. Negative margins were achieved in 471 (55.9%) whereas 371 (44.1%) had positive margins. Mean ± SD follow-up was 41.7 ± 15.4 months. Weighted mean, 1-, 5-, and 10-year overall survival (OS) were 26.9 months, 67.3%, 30.6%, and 20.8% respectively. Mean and 5-year disease-specific survival (DSS) were 72.9 months and 50.3% respectively. Mean ± SD local recurrence rate (LRR) was 32.1 ± 11.7%. Median RT dose delivered was 60 Gy (interquartile range: 60-70). Patients who received surgery had a significantly higher mean OS (34.9 vs. 18.7 months, P = 0.04) and 5-year OS (30.1 vs. 14.2%, P = 0.01) compared with those who did not receive surgery. There was no significant difference in mean OS for receiving adjuvant chemotherapy (P = 0.99) or RT (P = 0.51). Conclusions: In the largest ASHN study to date, definitive surgical resection was associated with an improvement in OS. Multimodality treatment did not confer an OS benefit. Randomized trials are needed to establish the optimal treatment approach for ASHN.

Sarcomas of Soft Tissue and Bone

2011 ◽  
Author(s):  
Adam Lerner ◽  
Huihong Xu ◽  
Karen H Antman
Keyword(s):  
Soft Tissue ◽  
Meta Analysis ◽  
Survival Rates ◽  
Fibrous Tissue ◽  
Soft Tissue Sarcomas ◽  
Kaposi Sarcoma ◽  
Uterine Leiomyosarcoma ◽  
Increased Risk ◽  
Bone Sarcomas ◽  
Epidemiologic Features

Sarcomas originate from bone or soft tissue. The most common bone sarcomas are osteosarcomas, Ewing sarcomas, and chondrosarcomas. Soft tissue sarcomas develop in fibrous tissue, fat, muscle, blood vessels, and nerves. Historically, soft tissue sarcomas of the trunk and extremities were reported separately from those of visceral organs (e.g., gastrointestinal and gynecologic sarcomas). This chapter discusses the classification, epidemiology, diagnosis, staging, and treatment of sarcomas of bone and cartilage, and classic soft tissue sarcomas. Management of Kaposi sarcoma, gastrointestinal stromal tumors (GISTs), mesothelioma, and rhabdomyosarcoma is also described. Figures include images of patients with osteosarcoma, liposarcoma, uterine leiomyosarcoma, GIST, and osteosarcoma in a patient with Paget disease of bone. Tables list epidemiologic features of sarcomas, a summary of sarcomas by histology, familial syndromes associated with increased risk of sarcoma, survival rates in sarcoma patients, staging of soft tissue sarcomas, and results of a meta-analysis of doxorubicin-based adjuvant chemotherapy for localized resectable soft tissue sarcoma. This chapter contains 126 references.

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