Efficacy of Neoadjuvant Therapy in Improving Long-Term Survival of Patients with Resectable Rectal Cancer: A Meta-Analysis

2021 ◽  
Vol 21 ◽  
Author(s):  
Xinlong Li ◽  
Xiangyuan Li ◽  
Rongrong Fu ◽  
Derry Ng ◽  
Tong Yang ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Neoadjuvant Therapy ◽  
Meta Analysis ◽  
Low Rectal Cancer ◽  
Cochrane Library ◽  
Term Survival ◽  
Long Term Survival ◽  
Resectable Rectal Cancer ◽  
Long Term Prognosis

Background: The impact of neoadjuvant therapy on long-term prognosis of patients with resectable rectal cancer is currently unknown. Objective: This study aimed to explore the long-term prognosis of patients with resectable rectal cancer following treatment with neoadjuvant therapy. Methods: Four major databases (PubMed, Web of Science, Embase, Cochrane library) were searched to identify relevant articles published between January 2000 and July 2020. The main outcome indicators were the 5-year overall survival (OS) and disease-free survival (DFS). Results: The meta-analysis revealed that 5-year OS (HR: 0.88, 95% Cl: 0.83-0.93) and DFS (HR: 0.95, 95% Cl: 0.91-0.98) were higher in patients with resectable rectal cancer after receiving neoadjuvant therapy than those treated with upfront surgery. Subgroup analysis demonstrated that the long-term survival of patients in Asia and Europe could benefit from neoadjuvant therapy. The neoadjuvant short-course radiotherapy (SCRT) and neoadjuvant chemo-radiotherapy (CRT) improved the 5-year OS and DFS of patients with stage Ⅱ-Ⅲ rectal cancer and mid/low rectal cancer. Further research found that patients with stage Ⅱ only had an increase in OS, while patients with stage Ⅲ have improved 5-year OS and DFS. Conclusion: Neoadjuvant therapy improved the long-term survival of patients with mid/low rectal cancer in stage Ⅱ-Ⅲ (especially stage Ⅲ). Additionally, patients in Asia and Europe seemed to be more likely to benefit from neoadjuvant therapy. For the treatment, we recommend neoadjuvant SCRT and neoadjuvant CRT for resectable rectal cancer.

scholarly journals Efficacy of Neoadjuvant Therapy in Improving Long-Term Survival of Patients With Resectable Rectal Cancer: A Meta-Analysis

2021 ◽  
Author(s):  
Xinlong Li ◽  
Xiangyuan Li ◽  
Rongrong Fu ◽  
Derry Minyao Ng ◽  
Tong Yang ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Neoadjuvant Therapy ◽  
Meta Analysis ◽  
Low Rectal Cancer ◽  
Cochrane Library ◽  
Term Survival ◽  
Resectable Rectal Cancer ◽  
Long Term Prognosis ◽  
The Impact

Abstract Background: The impact of neoadjuvant therapy on the long-term prognosis of patients with resectable rectal cancer is controversial. This study aimed to explore the effect of neoadjuvant therapy on the long-term prognosis of patients with resectable rectal cancer. Methods: Four major databases (PubMed, Web of Science, Embase, Cochrane library) were searched to find relevant articles published between January 2000 and July 2020. The main outcome indicators were the 5-year overall survival (OS) and disease-free survival (DFS). Results: Compared with upfront surgery, our meta-analysis showed that 5-year OS (HR: 0.84, 95% Cl: 0.78-0.91) and DFS (HR: 0.91, 95% Cl: 0.87-0.95) were prolonged for patients with resectable rectal cancer after receiving neoadjuvant therapy. The results of subgroup analysis suggested that both neoadjuvant short-course radiotherapy (SCRT) and neoadjuvant chemo-radiotherapy (CRT) could improve the 5-year OS and DFS. The 5-year OS and DFS of patients with stage Ⅱ-Ⅲ rectal cancer increased significantly and the improvement of 5-year OS and DFS could also be observed in mid/low rectal cancer.Conclusion: Neoadjuvant therapy could improve the long-term survival of patients with mid/low rectal cancer in stage Ⅱ-Ⅲ. For the treatment, neoadjuvant SCRT and neoadjuvant CRT were recommended.

scholarly journals Efficacy of Neoadjuvant Therapy in Improving Long-Term Survival of Patients with Resectable Rectal Cancer: a Meta-Analysis

2021 ◽  
Author(s):  
Xinlong Li ◽  
Xiangyuan Li ◽  
Rongrong Fu ◽  
Derry Minyao Ng ◽  
Tong Yang ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Neoadjuvant Therapy ◽  
Meta Analysis ◽  
Low Rectal Cancer ◽  
Cochrane Library ◽  
Term Survival ◽  
Resectable Rectal Cancer ◽  
Long Term Prognosis ◽  
The Impact

Abstract Background: The impact of neoadjuvant therapy on the long-term prognosis of patients with resectable rectal cancer is controversial. This study aimed to explore the effect of neoadjuvant therapy on the long-term prognosis of patients with resectable rectal cancer. Methods: Four major databases (PubMed, Web of Science, Embase, Cochrane library) were searched to find relevant articles published between January 2000 and July 2020. The main outcome indicators were the 5-year overall survival (OS) and disease-free survival (DFS). Results: Compared with upfront surgery, our meta-analysis showed that 5-year OS (HR: 0.84, 95% Cl: 0.78-0.91) and DFS (HR: 0.91, 95% Cl: 0.87-0.95) were prolonged for patients with resectable rectal cancer after receiving neoadjuvant therapy. The results of subgroup analysis suggested that both neoadjuvant short-course radiotherapy (SCRT) and neoadjuvant chemo-radiotherapy (CRT) could improve the 5-year OS and DFS. The 5-year OS and DFS of patients with stage Ⅱ-Ⅲ rectal cancer increased significantly and the improvement of 5-year OS and DFS could also be observed in mid/low rectal cancer.Conclusion: Neoadjuvant therapy could improve the long-term survival of patients with mid/low rectal cancer in stage Ⅱ-Ⅲ. For the treatment, neoadjuvant SCRT and neoadjuvant CRT were recommended.

scholarly journals The Oncologic Efficacy and Long-term Survival Outcomes of Total Neoadjuvant Therapy for Locally Advanced Rectal Cancer: A Systemic Review and Meta-Analysis

2021 ◽  
Author(s):  
Gan Bin Li ◽  
Yu Tao ◽  
Zhen Jun Wang ◽  
Zhai Wei Zhai ◽  
Jia-Gang Han
Keyword(s):  
Rectal Cancer ◽  
Neoadjuvant Therapy ◽  
Meta Analysis ◽  
Locally Advanced ◽  
Advanced Rectal Cancer ◽  
Locally Advanced Rectal Cancer ◽  
Term Survival ◽  
Long Term Survival ◽  
Total Neoadjuvant Therapy

Abstract Purpose To evaluate the pooled oncologic efficacy of total neoadjuvant therapy for locally advanced rectal cancer patients using meta-analysis method.Method To evaluate the pooled effects of total neoadjuvant therapy in terms of exact oncologic efficacy and long-term survival outcomes, a systemic literature search of PubMed, Embase, China Biology Medicine and WanFang Database was performed.Results A total of 15 studies including 4091 patients were finally identified. The pooled analysis revealed that total neoadjuvant therapy significantly increased the rates of T-downstaging (OR=2.16, 95% CI:1.63~2.87, P<0.00001), pathologic complete response (OR=1.90, 95% CI:1.60~2.27, P<0.00001) and R0 resection (OR=1.44, 95% CI: 1.07~1.93, P=0.01) with a comparable safety profile. Most importantly, patients received total neoadjuvant therapy had a superior overall survival rate compared to standard neoadjuvant chemoradiotherapy (HR=0.74, 95% CI: 0.62~0.89, P=0.001).Conclusion Patients with locally advanced rectal cancer can be managed with total neoadjuvant therapy with a superior short-term oncologic efficacy and long-term survival benefits.

scholarly journals Effect of volatile and intravenous anesthesia on long-term survival of cancer surgery patients: a systematic review and meta-analysis

2020 ◽  
Author(s):  
Li Gong ◽  
Chao Dong ◽  
Qian Cai ◽  
Wen Ouyang
Keyword(s):  
Cancer Patients ◽  
Meta Analysis ◽  
Cancer Surgery ◽  
Anesthetic Techniques ◽  
Breast Cancer Patients ◽  
Term Survival ◽  
Long Term Survival ◽  
Long Term Prognosis ◽  
The Impact

Abstract Background The impact of volatile anesthesia (INHA) and total intravenous anaesthesia (TIVA) on the long-term survival of patients after oncology surgery is a subject of controversy. The purpose of this study was to make overall evaluation of the association between these two anesthetic techniques and long-term prognosis of oncology patients after surgery. Methods Databases were searched according to the PRISMA guidelines up to September 30, 2018. Hazard ratios (HRs) with its 95% confidence intervals (CIs) were calculated after multivariable analyses and propensity score (PS) adjustments. Eight retrospective cohort articles reporting data on overall survival (OS) and recurrence-free survival (RFS) were included. An inverse variance random effects meta-analysis was conducted. The Newcastle Scale was used to assess methodological quality and bias. Results In total, about 18922 cancer patients observed were included in the meta-analysis, of which 10433 cases were available for analysis in INHA and 8489 in TIVA group. Compared to TIVA, INHA showed a shorter OS (HR =1.27, 95% CI 1.069 to 1.516, p=0.007), with a medium heterogeneity (Q-test p=0.003, I-squared=67.6%). However, no significant differences were identified between INHA and TIVA group (HR =1.10, 95% CI 0.729 to 1.659, p=0.651) concerning RFS albeit from a limited data pool. When a subgroup analysis was performed by race, the association was more likely to be observed in the Asian studies (HR=1.46, 95%CI 1.19–1.8, p =0.00), with a much lower heterogeneity (Q-test p=0.148, I-squared=44%). When comparison was done only in breast cancer patients, no significant differences were found for OS (HR=1.625, 95%CI 0.273-9.67, p=0.594) between INHA and TIVA. Conclusion TIVA for cancer surgery might be associated with better OS compared to INHA. The effect of INHA and TIVA on OS and RFS in the perioperative setting remains uncertain, cancer-specific, and has low-level evidence at present. Randomized controlled trials are required in future work. Registry number The review protocol was registered with PROSPERO (Registration NO.CRD42018109341).

The Role of Vitamin D on the Prognosis and Incidence of Lung Cancer: A Systematic Review and Meta-Analysis

2021 ◽  
Author(s):  
Mingxia Qian ◽  
Dina Guo ◽  
Rongrong Fu ◽  
Shuping Qi ◽  
Xiaojun Fu ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Vitamin D ◽  
Cancer Patients ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Term Survival ◽  
Long Term Survival ◽  
Lung Cancer Patients ◽  
Vitamin D Intake

Abstract Background: The correlation between vitamin D intake and lung cancer development is controversial. This meta-analysis aims to evaluate the relationship between vitamin D and the prognosis and incidence of lung cancer. Methods: A comprehensive database search on Pubmed, Web of Science, EBSCO, and Cochrane Library was carried out from the beginning to November 2020. Long-term survival and the incidence rate of patients with lung cancer were the primary outcomes of the study. Results: Ten eligible studies were selected for the meta-analysis following specific inclusion and exclusion criteria. Four included studies, covering 5007 patients, compared the overall survival (OS) and relapse-free survival (RFS) of lung cancer patients among total vitamin D users with non-users. Significantly, the estimated pooled hazard ratio (HR) revealed that vitamin D could improve OS and RFS of lung cancer patients [HR=0.83, 95% CI (0.72-0.95); HR=0.79, 95% CI (0.61-0.97), respectively]. Vitamin D intake was inversely associated with lung cancer incidence in six studies [OR=0.90, 95% CI (0.83-0.97)]. Conclusions: The present meta-analysis shows vitamin D not only improves the long-term survival of lung cancer patients but has a beneficial effect on the incidence of lung cancer. Notwithstanding, more studies are needed to confirm the study results.

Complete Pathologic Response after Combined Modality Treatment for Rectal Cancer and Long-Term Survival: A Meta-Analysis

2012 ◽  
Vol 19 (9) ◽  
pp. 2822-2832 ◽  
Author(s):  
Luigi Zorcolo ◽  
Alan S. Rosman ◽  
Angelo Restivo ◽  
Michele Pisano ◽  
Giuseppe R. Nigri ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Meta Analysis ◽  
Pathologic Response ◽  
Combined Modality Treatment ◽  
Complete Pathologic Response ◽  
Term Survival ◽  
Long Term Survival ◽  
Combined Modality

scholarly journals Effect of Volatile and Intravenous Anesthesia on Long-Term Survival of Cancer Surgery Patients: A Systematic Review and Meta-Analysis

2018 ◽  
Author(s):  
Li Gong ◽  
Chao Dong ◽  
Qian Cai ◽  
Wen Ouyang
Keyword(s):  
Cancer Patients ◽  
Meta Analysis ◽  
Cancer Surgery ◽  
Anesthetic Techniques ◽  
Breast Cancer Patients ◽  
Term Survival ◽  
Long Term Survival ◽  
Long Term Prognosis ◽  
The Impact

Abstract Background The impact of volatile anesthesia (INHA) and total intravenous anaesthesia (TIVA) on the long-term survival of patients after oncology surgery is a subject of controversy. The purpose of this study was to make overall evaluation of the association between these two anesthetic techniques and long-term prognosis of oncology patients after surgery. Methods Databases were searched according to the PRISMA guidelines up to September 30, 2018. Hazard ratios (HRs) with its 95% confidence intervals (CIs) were calculated after multivariable analyses and propensity score (PS) adjustments. Eight retrospective cohort articles reporting data on overall survival (OS) and recurrence-free survival (RFS) were included. An inverse variance random effects meta-analysis was conducted. The Newcastle Scale was used to assess methodological quality and bias. Results In total, about 18922 cancer patients observed were included in the meta-analysis, of which 10433 cases were available for analysis in INHA and 8489 in TIVA group. Compared to TIVA, INHA showed a shorter OS (HR =1.27, 95% CI 1.069 to 1.516, p=0.007), with a medium heterogeneity (Q-test p=0.003, I-squared=67.6%). However, no significant differences were identified between INHA and TIVA group (HR =1.10, 95% CI 0.729 to 1.659, p=0.651) concerning RFS albeit from a limited data pool. When a subgroup analysis was performed by race, the association was more likely to be observed in the Asian studies (HR=1.46, 95%CI 1.19–1.8, p =0.00), with a much lower heterogeneity (Q-test p=0.148, I-squared=44%). When comparison was done only in breast cancer patients, no significant differences were found for OS (HR=1.625, 95%CI 0.273-9.67, p=0.594) between INHA and TIVA. Conclusion TIVA for cancer surgery might be associated with better OS compared to INHA. The effect of INHA and TIVA on OS and RFS in the perioperative setting remains uncertain, cancer-specific, and has low-level evidence at present. Randomized controlled trials are required in future work.

scholarly journals Comparison of surgical quality and long-term outcome between hybrid trans-anal total meso-rectal excision and laparoscopic total meso-rectal excision: a systematic review and meta-analysis

2020 ◽  
Author(s):  
Yingchi Yang ◽  
Huihui Wang ◽  
Kaixin Zhao ◽  
Xiangyu Chu ◽  
Kai Pang ◽  
...  
Keyword(s):  
Conversion Rate ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Rectal Excision ◽  
Term Survival ◽  
Surgical Quality ◽  
Long Term Outcome ◽  
Long Term Survival ◽  
Significant Difference

BACKGROUND Laparoscopy-assisted trans-anal TME (ta-TME), or hybrid ta-TME, inherited the advantages of both trans-anal surgery and trans-abdominal surgery, and is gaining increasing acceptance from colorectal surgeons worldwide. This research aims to make a comprehensive comparison between hybrid ta-TME surgery and traditional laparoscopic TME (la-TME) surgery regarding surgical quality and long-term survival. METHODS Cochrane Library, EMbase, Web of Science and PubMed were searched for studies comparing hybrid ta-TME with traditional la-TME. Indicators for surgical quality and long-term prognosis were extracted and pooled. Heterogeneity was assessed with I2 index and was significant when p<0.1 and I2>50%. Publication bias was estimated by Egger test, where p<0.1 was considered statistically significant. RESULTS 13 studies with 992 patients were included in meta-analysis, of which 467 were in hybrid ta-TME cohorts, and 525 were in traditional la-TME cohorts. Compared with traditional la-TME, hybrid ta-TME has lower rate of positive circumferential margin (RR=0.454, 95%CI 0.240~0.862, p=0.016) and lower conversion rate (RR=0.336, 95%CI 0.134~0.844, p=0.020). On rate of positive distal resection margin, completeness/near-completeness of meso-rectum, overall complications, anal leakage, ileus, urinary dysfunction, 2-year DFS and 2-year OS, there were no significant difference between the two techniques. CONCLUSIONS Hybrid ta-TME is significantly superior to traditional la-TME in ensuring CRM safety and lowering intra-operative conversion rate, and is meanwhile not inferior on other major outcome indicators concerning surgical quality and long-term survival. To further understand this new surgical technique, we need high-quality RCTs, as well as previous researchers updates with results of prolonged follow-up.

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