scholarly journals Effect of Metformin and Statin Use on Survival in Pancreatic Cancer Patients: a Systematic Literature Review and Meta-analysis

2018 ◽  
Vol 25 (22) ◽  
pp. 2595-2607 ◽  
Author(s):  
E Jian-Yu ◽  
Judith M. Graber ◽  
Shou-En Lu ◽  
Yong Lin ◽  
Grace Lu-Yao ◽  
...  

Background and Objective: Current epidemiological studies report conflicting results for the effect of statin or metformin on pancreatic cancer overall survival. This literature review and meta-analysis summarize the studies reporting an association between statin or metformin use and overall survival of pancreatic cancer patients. Methods: We systematically searched for studies about the association between statin or metformin use and pancreatic cancer overall survival in electronic databases (PubMed, ISI Web of Science, MEDLINE, Cochrane, Scopus, Google Scholar). A meta-analysis based on hazard ratios (HRs) and 95% confidence intervals (CIs) was performed using random effect models. Heterogeneity between the studies was examined using I2 statistics, and sensitivity analyses were conducted to assess the robustness of the findings. Results: Of 116 statin-related articles identified, 6 retrospective cohort studies representing 12,057 patients were included. There was significant heterogeneity between studies. Statin use was associated with improved survival among pancreatic cancer patients (meta-HR = 0.75; 95% CI: 0.59, 0.90; P < 0.001). Of 311 metformin-related articles, 8 retrospective cohort studies and 2 randomized clinical trials, representing 3,042 patients were identified. Metformin use was associated with better overall survival among pancreatic cancer patients (meta-HR = 0.79; 95% CI: 0.70, 0.92, P < 0.001), and significant heterogeneity was observed between studies. Conclusion: Our findings suggest that the improved survival time of pancreatic cancer patients are associated with statin or metformin use. Due to the multiple sources of heterogeneity of the original studies, these findings should be considered cautiously, and confirmed with larger prospective individual-level studies.

Author(s):  
Antonio Raffone ◽  
Renato Seracchioli ◽  
Diego Raimondo ◽  
Manuela Maletta ◽  
Antonio Travaglino ◽  
...  

Abstract Introduction Several studies have assessed the histological co-existence of endometrial carcinoma (EC) and adenomyosis. However, the significance of this association is still unclear. Objective To assess the prevalence of adenomyosis in women with EC for a better understanding of the association between the two diseases. Materials and methods A systematic review and meta-analysis was performed by searching electronics databases from their inception to March 2020, for all studies that allowed extraction of data about prevalence of adenomyosis in EC patients. Adenomyosis prevalence was calculated for each included study and as pooled estimate, with 95% confidence interval (CI). Results Eight retrospective cohort studies assessing 5573 EC patients were included in our analysis. Of total, 1322 were patients with adenomyosis, and 4251 were patients without adenomyosis. Pooled prevalence of adenomyosis in EC patients was 22.6% (95% CI 12.7–37.1%). Conclusion Adenomyosis prevalence in EC patients was not different from that reported for other gynecological conditions. The supposed association between the two diseases appears unsupported.


Author(s):  
Priscilla Perez da Silva Pereira ◽  
Fabiana Araújo Figueiredo Da Mata ◽  
Ana Claudia Morais Godoy Figueiredo ◽  
Roberta Borges Silva ◽  
Maurício Gomes Pereira

Objective To investigate the relationship between maternal exposure to alcohol and low birthweight (LBW). Methods The literature search was performed in January 2017 using the following electronic databases: Medline, Embase, LILACS, SciELO, Web of Science, Scopus, CINHAL, Proquest, and PsychInfo. The search strategy used the following terms: alcohol drinking, binge drinking, alcohol-related disorders, alcoholism, alcohol addiction/use/abuse/consumption, light/moderate/social/low drinking, low birthweight, case-control studies, retrospective studies, and cohort studies. No restrictions regarding language or publication date were considered. The literature search yielded 2,383 articles, and after screening and eligibility assessment, 39 articles were included in the systematic review, and 38 studies were included in the meta-analysis. Results Maternal alcohol consumption was associated with LBW among retrospective cohort studies (relative risk [RR] = 1.37; 95%CI [confidence interval]:1.10–1.77; I2 = 98.4%; p < 0.01). Prospective cohort studies (RR = 1.11; 95%CI: 0.98–1.25; I2 = 81.5%; p < 0.01), and case-control studies (odds ration [OR] = 1.16; 95%CI: 0.68–1.97; I2 = 61.2%; p = 0.05) showed no association between alcohol and LBW. No publication bias was identified, and the meta-regression showed that the sample size influenced the high heterogeneity among retrospective cohort studies. The subgroup analysis showed differences in association between groups when compared by sample size, type of adjustment, or crude measures and publication year. Conclusions We have not found an association between alcohol consumption during gestation and LBW in the analysis in all of the subgroups. In addition, we have found a high heterogeneity between the primary studies, which is related to methodological differences in the conduction of these studies.


2017 ◽  
Vol 44 (3) ◽  
pp. 603-619 ◽  
Author(s):  
Taishiro Kishimoto ◽  
Katsuhiko Hagi ◽  
Masahiro Nitta ◽  
Stefan Leucht ◽  
Mark Olfson ◽  
...  

BMJ Open ◽  
2021 ◽  
Vol 11 (10) ◽  
pp. e052274
Author(s):  
Xue Xue ◽  
Chun-Li Lu ◽  
Xin-Yan Jin ◽  
Xue-Han Liu ◽  
Min Yang ◽  
...  

ObjectivesTo analyse the relationship between serum uric acid (SUA), all-cause and cardiovascular (CV) mortality in peritoneal dialysis (PD) patients to inform clinical practice and future research.DesignA systematic review of observational studies.Data sourcesPubMed, Embase, Web of Science, the Cochrane Library, China National Knowledge Infrastructure (CNKI), SinoMed, Chinese Science and Technology Journal Database (VIP) and Wan Fang databases were searched from their inception to January 2021 for cohort and case–control studies reporting SUA and mortality in patients with PD.MethodsThe Newcastle-Ottawa Quality Assessment Scale was used to appraise quality of cohort and case–control studies. Effect estimates were presented as HRs with 95% CIs in a meta-analysis using STATA V.16.0. Data not suitable for pooling were synthesised qualitatively.ResultsFourteen cohort studies with 24 022 patients were included. No case–control studies were identified. For prospective cohort studies, pooled results for the highest SUA category were significantly greater than the lowest for all-cause (one study; 1278participants; HR 1.79; 95% CI 1.17 to 2.75) and CV mortality (one study; 1278 participants; HR 2.63; 1.62–4.27). An increase of 1 mg/dL in SUA level was associated with a 16% increased risk of all-cause mortality (one study; 1278 participants; HR 1.16; 1.03–1.32) and 34% increased CV mortality risk (one study; 1278 participants; HR 1.34; 1.16–1.55). For retrospective cohort studies, the highest SUA category did not demonstrate an elevated all-cause (five studies; 4570 participants; HR 1.09; 0.70–1.70) or CV mortality (three studies; 3748 participants; HR 1.00; 0.44–2.31) compared with the lowest SUA category. Additionally, there was no increase in all-cause (eight studies; 11 541 participants; HR 0.94; 0.88–1.02) or CV mortality (three studies; 7427 participants; HR 0.90; 0.76–1.06) for every 1 mg/dL increase in SUA level.ConclusionsResults of prospective and retrospective cohort studies were inconsistent. Consequently, prospective, multicentre, long-term follow-up studies are required to confirm the relationship between SUA and mortality in patients with PD.


Author(s):  
Yanping Yang ◽  
Jianhua Li

IntroductionIntermittent pneumatic compression (IPC) has been used for venous thrombosis (VTE) prevention. It’s necessary to evaluate the effects and safety of intraoperative use of IPC devices in the prevention of VTE in surgical patients.Material and methodsTwo authors independently searched the PubMed, Cochrane Library, MedLine, EMbase, China national knowledge infrastructure (CNKI), Wanfang databases for randomized controlled trials (RCTs) and cohort studies on the use of IPC in surgical patients up to June 10, 2021. The Cochrane Collaborations risk of bias tool and Newcastle-Ottawa Scale (NOS) were used for quality assessment. RevMan 5.3 software were used for statistical analyses.ResultsA total of 13 studies including seven RCTs and six retrospective cohort studies involving 6673 surgical patients were included, 1883 patients underwent IPC intervention. The synthesized RCT results indicated that IPC was beneficial to the reduce the incidence of DVT (RR0.30, 95%CI0.22~0.40, P<0.001) and VTE (RR0.51, 95%CI0.27~0.95, P=0.03). The synthesized results from retrospective cohort studies indicated that IPC is beneficial to the reduce the incidence of DVT (RR0.63, 95%CI0.42~0.96, P=0.03) and PE (RR0.34, 95%CI0.16~0.72, P=0.005). No significant publication biases were found for all synthesized outcomes (all p>0.05).ConclusionsIPC seems to be safe and effective in the prevention and management of intraoperative VTE. Limited by sample size, this conclusion still needs to be further confirmed by large-sample, multi-center, high-quality clinical studies.


2020 ◽  
Vol 114 (5) ◽  
pp. 984-996 ◽  
Author(s):  
Francesco Del Giudice ◽  
Alex M. Kasman ◽  
Ettore De Berardinis ◽  
Gian Maria Busetto ◽  
Federico Belladelli ◽  
...  

2020 ◽  
pp. 036354652096448
Author(s):  
Apostolos D. Prodromidis ◽  
Chrysoula Drosatou ◽  
Georgios C. Thivaios ◽  
Nasri Zreik ◽  
Charalambos P. Charalambous

Background: Anterior cruciate ligament (ACL) ruptures are common, but the ideal timing for ACL reconstruction after injury is unclear with regard to meniscal insult. Purpose: To determine whether there is a relationship between timing from ACL rupture to ACL reconstruction and development of meniscal tears within this period. Study Design: Systematic review and meta-analysis. Methods: A systematic literature search was undertaken independently by 2 reviewers using the Cochrane method for systematic reviews in 5 online databases. The reviewers performed independent data extraction and assessment of risk of bias and study quality. The search included any comparative study, including randomized controlled trials (RCTs), prospective and retrospective cohort studies, and case-control studies of an adult population, that assessed the relationship between timing of ACL reconstruction surgery and rates of meniscal tears. Results: After screening, 12 studies (No. of participants = 3042) out of 3390 records were included for analysis: 3 RCTs (n = 272), 2 prospective cohort studies (n = 307), and 7 retrospective cohort studies (n = 2463). In analysis of these studies, rates of reported meniscal tears were compared for ACL procedures performed at 3 and 6 months after injury. Meta-analysis of 5 studies (n = 2012) showed that ACL reconstruction performed >3 months after injury was associated with a higher rate of medial meniscal tears compared with ACL reconstruction performed within 3 months of injury (estimated OR, 2.235; 95% CI, 1.183-4.223; P = .013) but not with a higher rate of lateral meniscal tears. Similarly, meta-analysis of 4 studies (n = 990) showed that ACL reconstruction performed >6 months after injury was associated with a higher rate of medial meniscal tears compared with ACL reconstruction performed within 6 months of injury (estimated OR, 2.487; 95% CI, 1.241-4.984; P = .01) but not with a higher rate of lateral meniscal tears. Conclusion: Our results suggest that delay of ACL reconstruction surgery >3 months after injury is associated with a higher rate of medial meniscal tears within this prereconstruction time frame. Further high-quality prospective studies may help determine whether this is a causal effect. However, based on current evidence, in those patients for whom ACL reconstruction is indicated, ACL reconstruction within 3 months of injury may be recommended. Registration: CRD42016032846 (PROSPERO)


2016 ◽  
Vol 150 (4) ◽  
pp. S181
Author(s):  
Danlu Wang ◽  
Eduardo A. Rodriguez ◽  
Elie Donath ◽  
Ali Pakravan

2020 ◽  
Vol 26 (26) ◽  
pp. 3161-3170 ◽  
Author(s):  
Yongbo Wang ◽  
Tao Fu ◽  
Yu Liu ◽  
Guifang Yang ◽  
Chuanhua Yu ◽  
...  

Background: Metformin has been associated with improved survival outcomes in various malignancies. However, observational studies in head and neck cancer are inconsistent. Objective: The study aimed to summarize and quantify the relationship between metformin use and the survival of head and neck cancer. Methods: A meta-analysis based on cohort studies was systematically conducted (published up to Jan 18, 2020), identified from PubMed, Embase, Web of Science, Cochrane Library, Google Scholar, and Scopus databases. Summary hazard ratios (HR) and 95% confidence intervals (CI) were calculated using a random-effects model. Results: Seven retrospective cohort studies including 3,285 head and neck cancer patients were included. The association between the use of metformin and cancer survival was not statistically significant: summarized HR of 0.89 (95% CI 0.66-1.18, P=0.413, I2=64.0%) for overall survival, summarized HR of 0.65 (95% CI 0.31-1.35, P=0.246, I2=60.3%) for disease-free survival, and summarized HR of 0.69 (95% CI 0.40-1.20, P=0.191, I2=73.1%) for disease-specific survival. Conclusion: In this meta-analysis of 7 retrospective cohort studies, there was not a statistically significant association between the use of metformin and better survival for head and neck cancer. However, the analysis may have been underpowered. More studies of prospective designs with larger sample sizes are needed to investigate the effect of metformin on the survival of head and neck cancer.


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