scholarly journals Does Gastrointestinal Bleeding Affect the Prognosis of Patients With Gastrointestinal Stromal Tumor: A Meta-analysis.

2021 ◽  
Author(s):  
Yue Zhang ◽  
Qi Liu ◽  
Hao Xu
Keyword(s):  
Overall Survival ◽  
Gastrointestinal Bleeding ◽  
Gastrointestinal Stromal Tumor ◽  
Random Effects ◽  
Gastrointestinal Stromal Tumors ◽  
Meta Analysis ◽  
Random Effects Model ◽  
Relapse Free Survival ◽  
Free Survival ◽  
Stromal Tumors

Abstract Background: The effect of gastrointestinal bleeding on the prognosis of gastrointestinal stromal tumors has been widely studied in recent years, but it is still controversial. Therefore, we performed the first comprehensive meta-analysis to evaluate the effect of gastrointestinal bleeding on the prognosis of gastrointestinal stromal tumors.Methods: We searched PubMed, MEDLINE, Web of Science, EMBASE, and Cochrane Library databases to recruit studies on the effect of gastrointestinal bleeding on the prognosis of patients with gastrointestinal stromal tumor. Eight studies containing 2915 patients were involved in this meta-analysis until May 31, 2021. Pooled hazard ratios (HRs) with 95% confidence interval (95% CI) were calculated to estimate the effect using random-effects model. Results: The pooled results revealed that gastrointestinal bleeding was not associated with relapse-free survival (HR = 1.33, 95% CI 0.66-2.68, P < 0.001; random-effects model I2=87.7, P < 0.001) and overall survival (HR = 1.29, 95% CI 0.43-3.87, P < 0.001; random-effects model I2=88.9, P < 0.001) in patients with gastrointestinal stromal tumors. Conclusions: Our present a meta-analysis indicates that gastrointestinal bleeding has no effect on relapse-free survival and overall survival of patients with gastrointestinal stromal tumors, although gastrointestinal bleeding is one of the major clinical symptoms of gastrointestinal stromal tumors.

Meta-analysis for the Association between Overall Survival and Progression-Free Survival in Gastrointestinal Stromal Tumor

2014 ◽  
Vol 21 (2) ◽  
pp. 295-302 ◽  
Author(s):  
Ipek Özer-Stillman ◽  
Lauren Strand ◽  
Jane Chang ◽  
Ateesha F. Mohamed ◽  
Katherine E. Tranbarger-Freier
Keyword(s):  
Overall Survival ◽  
Gastrointestinal Stromal Tumor ◽  
Meta Analysis ◽  
Progression Free Survival ◽  
Stromal Tumor ◽  
Free Survival

Meta-Analysis on the Efficacy and Safety of Laparoscopic Surgery for Large Gastric Gastrointestinal Stromal Tumors

2020 ◽  
pp. 000313482095148
Author(s):  
Miao Yu ◽  
Deng-chao Wang ◽  
Jian Wei ◽  
Yue-hua Lei ◽  
Zhao-jun Fu ◽  
...  
Keyword(s):  
Gastrointestinal Stromal Tumors ◽  
Laparoscopic Resection ◽  
Meta Analysis ◽  
Disease Free Survival ◽  
Operation Time ◽  
Intraoperative Blood Loss ◽  
Open Resection ◽  
Free Survival ◽  
Stromal Tumors ◽  
Disease Free

Background The aim of this study was to conduct a meta-analysis comparing the safety and feasibility of laparoscopic versus open resection for gastric gastrointestinal stromal tumors (GISTs) larger than 5 cm. Method We searched the Cochrane Library, PubMed, and Embase for relevant articles. Randomized and nonrandomized clinical trials were identified and included in this study. Searching for related articles on large GIST (>5 cm) for laparoscopic resection (laparoscopic group [LAPG]) and open resection (open group [OG]), RevMan 5.3 was used for data analysis, comparing 2 groups of operation time, intraoperative blood loss, complications, length of hospital stay, recurrence rate, disease-free survival, and overall survival. Results Seven studies including 440 patients were identified for the meta-analysis. Meta-analysis revealed that LAPG had less bleeding, shorter postoperative hospital stay, and a better 5-year disease-free survival. There was no significant difference between LAPG and OG in operation time, postoperative complications, recurrence rate, and overall survival. Conclusion Laparoscopic resection of large (>5 cm) GIST is safe and feasible and has the advantages of less intraoperative blood loss and fast postoperative recovery, with a good outcome in the recent oncology.

Treatment of nonresectable and metastatic gastrointestinal stromal tumors: Experience with the use of tyrosine kinase inhibitors in a third-level hospital in Mexico city.

2015 ◽  
Vol 33 (3_suppl) ◽  
pp. 224-224
Author(s):  
Abdel Karim Dip Borunda ◽  
Alejandro J. Silva
Keyword(s):  
Overall Survival ◽  
Tyrosine Kinase ◽  
Tyrosine Kinase Inhibitors ◽  
Gastrointestinal Stromal Tumors ◽  
Poor Prognosis ◽  
Kinase Inhibitors ◽  
Systemic Treatment ◽  
Progression Free Survival ◽  
Free Survival ◽  
Stromal Tumors

224 Background: Stromal tumors of the digestive tract are uncommon malignant diseases, and are subclassified as leiomyosarcomas and gastrointestinal stromal tumors (GIST) depending on the molecular expression of CD117 (KIT). GISTs represent 1% of malignant tumors affecting this anatomical site. Located diseases are reasonably well controlled by surgical resection and several criteria define the need for adjuvant therapy. In the case of metastatic disease a poor prognosis has been reported with systemic treatment based on chemotherapy. Recently, significant advances have been shown since Tyrosine – kinase inhibitors were introduced, with median overall survival close to 5 years. Unfortunately in Mexico, even though the therapy has been long used there are no published data of the experience in the treatment of these tumors. Methods: We used an electronic data base to obtain clinical, radiological and histological data of patients diagnosed with GIST and treated in the oncological center of the Mexican Institute of Social Security, patients were subclassified by stage, symptoms at diagnosis as well as the initial and subsequent systemic treatment. Finally we made an analysis for progression free survival and overall survival identifying prognostic factors. Results: We obtained information of 71 patients with metastatic, nonresectable or recurrent GIST, treated with a TKI, we observed a predominant relation for women (60.4%), with median age of 58 years. Stage at diagnosis was predominantly metastatic (46.5%) most frequently affected sites were lung, liver and retroperitoneum. Median progression free survival was 23.6m and overall survival was 81.3 months. All patients were initially treated with imatinib at a dose of 400mg per day. Treatment was well tolerated in most cases. Conclusions: Metastatic GIST evaluated in our center shows a different affection in gender and age, our population shows a different response to TKI’s, than reported in other series with superior overall survival, Poor prognosis is associated with lung affection. Biological studies will be started for the molecular evaluation of these tumors.

scholarly journals Radiotherapy protocol deviations and clinical outcomes: A meta-analysis of cooperative group clinical trials.

2012 ◽  
Vol 30 (34_suppl) ◽  
pp. 181-181 ◽  
Author(s):  
Nitin Ohri ◽  
Xinglei Shen ◽  
Adam Dicker ◽  
Laura Doyle ◽  
Amy Harrison ◽  
...  
Keyword(s):  
Overall Survival ◽  
Clinical Trials ◽  
Quality Assurance ◽  
Clinical Outcomes ◽  
Random Effects ◽  
Meta Analysis ◽  
Random Effects Model ◽  
Cooperative Group ◽  
Secondary Endpoints ◽  
The Impact

181 Background: Several reports have linked noncompliance with radiotherapy (RT) protocol guidelines with inferior clinical outcomes. Here we perform a meta-analysis of prospective cooperative group trials to determine the impact of RT quality assurance (QA) deviations on disease control and overall survival (OS). Methods: We searched MEDLINE and the Cochrane Central Register of Controlled Trials for multi-institutional trials that reported clinical outcomes in relation to RT quality assurance (QA) results. Hazard ratios (HRs) describing the impact of RT protocol noncompliance on outcomes were extracted directly from the original studies or calculated from survival curves. Analyses were performed to assess the impact of RT QA deviations on OS and secondary outcomes (local/locoregional control, event-free survival, relapse), which were grouped together. Pooled estimates were obtained using the inverse variance method. A random effects model was used in cases of significant effect heterogeneity (p<0.10 using Q test). Results: Eight studies met all inclusion criteria and were incorporated into this analysis. Four were pediatric trials (POG 8346, SFOP.TC 94, POG 9031, SIOP/UKCC PNET-3), and four studied adult patients (RTOG 73-01, SWOG 7628, TROG 02.02, RTOG 97-04). Six of these trials reported the impact of RT QA deviations on overall survival, and six described the effects of RT QA deviations on secondary endpoints. The frequency of RT QA deviations ranged from 8% to 71% (median: 40%). Using a random effects model, RT deviations were associated with a significant decrease in OS (HR = 1.74, 95% CI: 1.28 to 2.35, p<0.001). A similar effect was seen for secondary endpoints (HR = 1.79, 95% CI: 1.15 to 2.78, p=0.009). No evidence of publication bias was detected using the Egger test (p=0.361 for OS, p=0.468 for secondary endpoints). Conclusions: In clinical trials, RT protocol deviations are associated with increased risk of treatment failure and overall mortality. The magnitude of these effects demonstrates that RT QA results should be considered in the interpretation of clinical trial results. More importantly, the delivery of high-quality RT is critical for the successful treatment of cancer patients.

Association of objective response by mRECIST with better overall survival (OS) in patients with advanced hepatocellular carcinoma (HCC) treated with systemic therapies: A systematic review and meta-analysis of randomized controlled trials.

2020 ◽  
Vol 38 (4_suppl) ◽  
pp. 586-586
Author(s):  
Masatoshi Kudo ◽  
Yasutaka Chiba ◽  
Tim Meyer ◽  
Riccardo Lencioni ◽  
Josep M. Llovet
Keyword(s):  
Overall Survival ◽  
Random Effects ◽  
Meta Analysis ◽  
Objective Response ◽  
Advanced Hepatocellular Carcinoma ◽  
Random Effects Model ◽  
Advanced Hcc ◽  
Pubmed Database ◽  
Asco Meeting ◽  
Systemic Therapies

586 Background: EASL guidelines for management of HCC recommends assessing tumor response according to mRECIST at all stages of the disease (EASL guidelines, J Hep 2018). Several studies have reported that objective response by mRECIST predicted overall survival (OS) but definitive data are still lacking. Methods: The PubMed database and ASCO meeting library were searched for full reports of randomized trials in patients with advanced HCC treated by systemic therapy up to August 31, 2018. We search strategy used the following terms: HCC, mRECIST, OS and objective response rate (ORR). We assess the association between ORR and OS in a meta-analysis of pooled data by using random effects model comparing patients achieving objective response (complete or partial response) versus non responders (stable disease, progressive disease) and displayed the results as per hazard ratio (HR, 95% CI). Results: Among 14 articles assessing response by mRECIST to systemic therapies in randomized studies in advanced HCC, 4 studies (5 trials) including 1,463 patients were considered eligible. Systemic therapies tested included lenvatinib, sorafenib, brivanib and nintedanib. Overall, ORR as per mRECIST ranged from 11.5% to 18.8%, being the median OS for responders of 18.5 to 27.2 mo (as opposed 8.9 to 11.4 for non-responders). As per random effects model, the HR for overall survival (responders versus non responders) was 0.47 (95% confidence interval 0.34–0.66, p<0.001). Conclusions: Objective response by mRECIST to systemic therapies in patients with advanced HCC is significantly and strongly associated to OS. Patients achieving an objective response can expect a significantly longer OS.

Standard versus personalized schedule of regorafenib in metastatic gastrointestinal stromal tumors (GIST): A retrospective, multicenter, real-world study.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e23521-e23521
Author(s):  
Margherita Nannini ◽  
Alessandro Rizzo ◽  
Maria Concetta Nigro ◽  
Bruno Vincenzi ◽  
Alessandro Mazzocca ◽  
...  
Keyword(s):  
Overall Survival ◽  
Clinical Practice ◽  
Real World ◽  
Gastrointestinal Stromal Tumors ◽  
Treatment Plan ◽  
Progression Free Survival ◽  
Term Therapy ◽  
Free Survival ◽  
Stromal Tumors ◽  
The Impact

e23521 Background: Regorafenib (REG) is a multikinase inhibitor approved as third-line treatment in gastrointestinal stromal tumors (GIST). Although its proven activity, REG can present a relevant adverse profile which often leads to treatment modifications and transient or permanent discontinuation; thus, in clinical practice physicians usually adopt various dosing and interval schedules to counteract REG-related adverse events (AEs) and avoid treatment interruption. The aim of this real-world study was to investigate the efficacy and safety of personalized schedules of REG in metastatic GIST patients, in comparison with the standard schedule (160 mg daily, 3-weeks-on, 1-week-off schedule). Methods: Institutional registries across seven Italian reference centers were retrospectively reviewed and data of interest retrieved to identify GIST patients who had received REG from February 2013 to January 2021. The primary endpoint was Progression-Free Survival (PFS), with Overall Survival (OS) also assessed as secondary endpoint. The Kaplan-Meier method was used to estimate survival and the log-rank test to make comparisons. The impact of variables on survival was assessed through univariate and multivariate analysis. Results: A total of 152 GIST patients (82 male and 70 female) were included and split in two groups on the basis of the REG treatment plan received (standard vs personalized). Among the 103 patients for whom the treatment was personalized (38 since the beginning and 65 during the treatment course), the main strategies adopted were the following: 120 mg/day d1-21 e28 (n = 56; 54.4%); 80 mg/day d1-21 e28 (n = 22; 21.4%); 160 mg/day d1-5 e7 (n = 13; 12.6%). At a median follow-up of 36.5 months, median Overall Survival (OS) was 16.6 months (95% CI 14.1-21.8) and 20.5 months (95% CI 15.0-25.4) in the standard-dose and the personalized schedule groups, respectively (HR 0.75; 95% CI 0.49-1.22; p = 0.16). Median Progression-Free Survival (PFS) was 5.6 months (95% CI 3.3-not reached) and 9.7 months (95% CI 7.9-14.5) in the same groups (HR 0.51; 95% CI 0.34-0.75; p = 0.00052). Conclusions: Despite the expected limits of a retrospective analysis, we confirm that REG personalized schedules are commonly adopted in everyday clinical practice of high-volume GIST expert centers and correlate with significant improvement of therapeutic outcomes. Based on these results, REG treatment optimization in GIST patients may represent the best strategy to maximize long-term therapy, preserving tolerability and quality of life.

scholarly journals Prognostic Value of Bleeding in Gastrointestinal Stromal Tumors: A Meta-Analysis

2021 ◽  
Vol 20 ◽  
pp. 153303382110342
Author(s):  
Xin Fan ◽  
He Han ◽  
Zhiyu Sun ◽  
Liwen Zhang ◽  
Gong Chen ◽  
...  
Keyword(s):  
Gastrointestinal Bleeding ◽  
Gastrointestinal Stromal Tumor ◽  
Meta Analysis ◽  
Stromal Tumor ◽  
Tumor Diameter ◽  
Gi Bleeding ◽  
Tumor Rupture ◽  
Related Factors ◽  
Free Survival ◽  
Aging Factor

Background: Gastrointestinal bleeding is the most common clinical manifestation of gastrointestinal stromal tumor. It is of great significance to the prognosis of patients. But the results are controversial. The purpose of this study was to evaluate the relationship between gastrointestinal bleeding and clinical prognosis in patients with GIST. Methods: A systematic literature search was performed in Pumbed, Cochrane Library, EMBASE, ClinicalTrials.gov , CNKI, VIP and wanfang databases with the pattern of unlimited languages. 12 studies with 2781 individuals were included in the final analysis. The overall survival (OS), recurrence-free survival/disease-free survival (RFS/DFS) and related factors affecting bleeding in patients with gastrointestinal stromal tumor (GIST) were extracted. Hazard ratio (HR) and 95% confidence interval (CI) were used for in the meta-analysis. Results: A total of 12 articles were included in the study, including 2781 patients with GIST, including 845 patients with gastrointestinal bleeding. The OS of GIST patients with gastrointestinal bleeding was significantly worse (HR = 2.54, 95% CI = 1.13-5.73, P = 0.025). But there was no significant difference in RFS between gastrointestinal bleeding patients and non-bleeding patients (HR = 1.35, 95% CI = 0.70-2.61, P = 0.371). Further analysis of the related factors of GI bleeding in GIST patients was observed, besides the aging factor (HR = 1.02, 95% CI = 0.69-1.50, P = 0.929), Small intestinal stromal tumor (HR = 0.56, 95% CI = 0.41-0.76, P < 0.001), tumor diameter ≥ 5 cm (HR = 2.09, 95% CI = 1.20-3.63, P = 0.009), Mitotic index ≥ 5/50 HPF (HR = 1.66, 95% CI = 1.11-2.49, P = 0.014) and tumor rupture (HR = 2.04, 95% CI = 1.0-3.82, P = 0.026) all increased the risk of GI bleeding in patients with GIST. Conclusions: The OS of GIST patients with GI bleeding was worse than non-GI bleeding, but had no significant effect on RFS. Nevertheless the aging factor, the location of GIST in the small intestine, tumor diameter ≥ 5 cm, Mitotic index ≥ 5/50 HPF and tumor rupture all increased the risk of GI bleeding in patients with GIST.

scholarly journals The impact of LncRNA dysregulation on clinicopathology and survival of pancreatic cancer: a systematic review and meta-analysis (PRISMA compliant)

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Elahe Seyed Hosseini ◽  
Ali Nikkhah ◽  
Amir Sotudeh ◽  
Marziyeh Alizadeh Zarei ◽  
Fatemeh Izadpanah ◽  
...  
Keyword(s):  
Pancreatic Cancer ◽  
Overall Survival ◽  
Random Effects ◽  
Meta Analysis ◽  
Disease Free Survival ◽  
Progression Free Survival ◽  
Free Survival ◽  
Diagnosis And Prognosis ◽  
The Impact ◽  
Disease Free

Abstract Purpose An increasing number of studies have reported a significant association between long non-coding RNAs (lncRNAs) dysregulation and pancreatic cancers. In the present study, we aimed to gather articles to evaluate the prognostic value of long non coding RNA in pancreatic cancer. Experimental design We systematically searched all eligible articles from databases of PubMed, Web of Science, and Scopus to meta-analysis of published articles and screen association of multiple lncRNAs expression with clinicopathology and/or survival of pancreatic cancer. The pooled hazard ratios (HRs) and their 95% confidence intervals (95% CIs) were used to analysis of overall survival, disease-free survival and progression-free survival were measured with a fixed or random effects model. Results A total of 39 articles were included in the present meta-analysis. Our results showed that dysregulation of lncRNAs were linked to overall survival (39 studies, 4736 patients HR = 0.41, 95% CI 0.25 ± 0.58, random-effects in pancreatic cancer. Moreover, altered lncRNAs were also contributed to progression-free survival (8 studies, 1180 patients HR: 1.88, 95% CI (1.35–2.62) and disease-free survival (2 studies, 285 patients, HR: 6.07, 95% CI 1.28–28.78). In addition, our findings revealed the association between dysregulated RNAs and clinicopathological features in this type of cancer. Conclusions In conclusion, dysregulated lncRNAs could be served as promising biomarkers for diagnosis and prognosis of pancreatic cancer.

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