Efficacy of unilateral hemilaminectomy for intraspinal tumor resection: a systematic review and meta-analysis

Objectives To systematically review the incidence and factors associated with recurrences or new tumors after apparent complete resection of pheochromocytoma or thoraco–abdomino–pelvic paraganglioma. Design A systematic review and meta-analysis of published literature was performed. Methods Pubmed and Embase from 1980 to 2012 were searched for studies published in English on patients with non-metastatic pheochromocytoma or thoraco–abdomino–pelvic paraganglioma, complete tumor resection, postoperative follow-up exceeding 1 month, and recurrence or new tumor documented by pathology, hormonal dosages, or imaging tests. Incidence rates of new events after curative surgery were calculated for each study that had sufficient information and pooled using random-effect meta-analysis. Results In total, 38 studies were selected from 3518 references, of which 36 reported retrospective cohorts from the USA, Europe, and Asia. Patient follow-up was neither standardized nor exhaustive in the included studies. A clear description of patient retrieval methods was available for nine studies and the follow-up protocol and patient flow for four studies. Only two studies used multivariable methods to assess potential predictors of postoperative events. The overall rate of recurrent disease from 34 studies was 0.98 events/100 person-years (95% confidence interval 0.71, 1.25). Syndromic diseases and paragangliomas were consistently associated with a higher risk of a new event in individual studies and in meta-regression analysis. Conclusions The risk of recurrent disease after complete resection of pheochromocytoma may be lower than that previously estimated, corresponding to five events for 100 patients followed up for 5 years after complete resection. Risk stratification is required to tailor the follow-up protocol after complete resection of a pheochromocytoma or paraganglioma. Large multicenter studies are needed to this end.

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Roles of Surgery in the Treatment of Patients With High-Risk Neuroblastoma in the Children Oncology Group Study: A Systematic Review and Meta-Analysis

Frontiers in Pediatrics ◽

10.3389/fped.2021.706800 ◽

2021 ◽

Vol 9 ◽

Author(s):

Yingyi Qi ◽

Jianghua Zhan

Keyword(s):

Systematic Review ◽

High Risk ◽

Induction Chemotherapy ◽

Meta Analysis ◽

Tumor Resection ◽

Publication Date ◽

Complete Tumor Resection ◽

Full Inclusion ◽

Review Protocol ◽

Complete Tumor

Purpose: Neuroblastoma is the most common extracranial solid tumor in children, and most patients are at high risk when they are initially diagnosed. The roles of surgery and induction chemotherapy in patients with high-risk neuroblastoma have been a subject of much controversy and debate. The objective of the current study was to assess the roles of surgery in high-risk neuroblastoma.Method: The review protocol was prospectively registered (PROSPEROID: CRD42021253961). The PubMed, Embase, Cochrane, and CNKI databases were searched from inception to January 2020 with no restrictions on language or publication date. Clinical studies comparing the outcomes of different surgical ranges for the treatment of high-risk neuroblastoma were analyzed. The Mantel–Haenszel method and a random effects model was utilized to calculate the hazard ratio (95% CI).Results: Fourteen studies that assessed 1,915 subjects met the full inclusion criteria. Compared with the gross tumor resection (GTR) group, complete tumor resection (CTR) did not significantly improve the 5-year EFS [p = 1.0; HR = 0.95 (95% CI, 0.87–1.05); I2 = 0%], and the 5-year OS [p = 0.76; HR = 1.08 (95% CI, 0.80–1.46); I2 = 0%] of patients. GTR or CTR resection had significantly better 5-year OS [p = 0.45; HR = 0.56 (95% CI, 0.43–0.72); I2 = 0%] and 5-year EFS [p = 0.15; HR = 0.80 (95% CI, 0.71–0.90); I2 = 31%] than subtotal tumor resection (STR) or biopsy only; however, both CTR or GTR showed a trend for more intra and post-operative complications compared with the STR or biopsy only [p = 0.37; OR = 1.54 (95% CI, 1.08–2.20); I2 = 0%]. The EFS of the patients who underwent GTR or CTR at the time of diagnosis and after induction chemotherapy were similar [p = 0.24; HR = 1.53 (95% CI, 0.84–2.77); I2 = 29%].Conclusion: For patients with high-risk neuroblastoma, complete tumor resection and gross tumor resection of the primary tumor were related to improved survival, with very limited effects on reducing intraoperative and postoperative complications. It is necessary to design strong chemotherapy regimens to improve the survival rate of advanced patients.Systematic Review Registration:https://www.crd.york.ac.uk/PROSPERO/, PROSPEROID [CRD42021253961].

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Analysis of risk factors for complications of perforator propeller flap used for soft tissue reconstruction after malignant tumor resection: A systematic review and meta-analysis

10.37766/inplasy2021.7.0070 ◽

2021 ◽

Author(s):

Shuai Yue ◽

Mengran Ju ◽

Zhe Su

Keyword(s):

Risk Factors ◽

Systematic Review ◽

Soft Tissue ◽

Malignant Tumor ◽

Meta Analysis ◽

Tumor Resection ◽

Soft Tissue Reconstruction ◽

Propeller Flap ◽

Tissue Reconstruction

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Tumor Resection Margin Definitions in Breast-Conserving Surgery: Systematic Review and Meta-analysis of the Current Literature

Clinical Breast Cancer ◽

10.1016/j.clbc.2018.04.004 ◽

2018 ◽

Vol 18 (4) ◽

pp. e595-e600 ◽

Cited By ~ 14

Author(s):

Susan G. Brouwer de Koning ◽

Marie-Jeanne T.F.D. Vrancken Peeters ◽

Katarzyna Jóźwiak ◽

Patrick A. Bhairosing ◽

Theo J.M. Ruers

Keyword(s):

Systematic Review ◽

Current Literature ◽

Resection Margin ◽

Meta Analysis ◽

Tumor Resection ◽

Breast Conserving Surgery

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Systematic Review and Meta-Analysis on the Impact of Hexaminolevulinate- Versus White-Light Guided Transurethral Bladder Tumor Resection on Progression in Non-Muscle Invasive Bladder Cancer

Bladder Cancer ◽

10.3233/blc-160060 ◽

2016 ◽

Vol 2 (3) ◽

pp. 293-300 ◽

Cited By ~ 27

Author(s):

Georgios Gakis ◽

Omar Fahmy

Keyword(s):

Systematic Review ◽

Bladder Cancer ◽

White Light ◽

Bladder Tumor ◽

Meta Analysis ◽

Tumor Resection ◽

Invasive Bladder Cancer ◽

Muscle Invasive Bladder Cancer ◽

Muscle Invasive ◽

The Impact

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Surgical management for large vestibular schwannomas: a systematic review, meta-analysis, and consensus statement on behalf of the EANS skull base section

Acta Neurochirurgica ◽

10.1007/s00701-020-04491-7 ◽

2020 ◽

Vol 162 (11) ◽

pp. 2595-2617

Author(s):

Daniele Starnoni ◽

Lorenzo Giammattei ◽

Giulia Cossu ◽

Michael J. Link ◽

Pierre-Hugues Roche ◽

...

Keyword(s):

Systematic Review ◽

Facial Nerve ◽

Skull Base ◽

Task Force ◽

Meta Analysis ◽

Tumor Resection ◽

Surgical Strategy ◽

Vestibular Schwannomas ◽

Neural Function ◽

Nerve Preservation

Abstract Background and objective The optimal management of large vestibular schwannomas continues to be debated. We constituted a task force comprising the members of the EANS skull base committee along with international experts to derive recommendations for the management of this problem from a European perspective. Material and methods A systematic review of MEDLINE database, in compliance with the PRISMA guidelines, was performed. A subgroup analysis screening all surgical series published within the last 20 years (January 2000 to March 2020) was performed. Weighted summary rates for tumor resection, oncological control, and facial nerve preservation were determined using meta-analysis models. This data along with contemporary practice patterns were discussed within the task force to generate consensual recommendations regarding preoperative evaluations, optimal surgical strategy, and follow-up management. Results Tumor classification grades should be systematically used in the perioperative management of patients, with large vestibular schwannomas (VS) defined as > 30 mm in the largest extrameatal diameter. Grading scales for pre- and postoperative hearing (AAO-HNS or GR) and facial nerve function (HB) are to be used for reporting functional outcome. There is a lack of consensus to support the superiority of any surgical strategy with respect to extent of resection and use of adjuvant radiosurgery. Intraoperative neuromonitoring needs to be routinely used to preserve neural function. Recommendations for postoperative clinico-radiological evaluations have been elucidated based on the surgical strategy employed. Conclusion The main goal of management of large vestibular schwannomas should focus on maintaining/improving quality of life (QoL), making every attempt at facial/cochlear nerve functional preservation while ensuring optimal oncological control, thereby allowing to meet patient expectations. Despite the fact that this analysis yielded only a few Class B evidences and mostly expert opinions, it will guide practitioners to manage these patients and form the basis for future clinical trials.

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