scholarly journals Prognostic Role of EGFR/p-EGFR in Patients With Nasopharyngeal Carcinoma: A Meta-Analysis

2021 ◽  
Vol 11 ◽  
Author(s):  
Xishan Chen ◽  
Renba Liang ◽  
Lin Lai ◽  
Kaihua Chen ◽  
Xiaodong Zhu
Keyword(s):  
Nasopharyngeal Carcinoma ◽  
Subgroup Analysis ◽  
Meta Analysis ◽  
Prognostic Significance ◽  
Group Analysis ◽  
High Expression ◽  
Sensitivity Analyses ◽  
Significant Heterogeneity ◽  
Free Survival ◽  
Egfr Expression

BackgroundThe prognostic value of epidermal growth factor receptor (EGFR)/phosphorylated EGFR (p-EGFR) expression in nasopharyngeal carcinoma remains controversial. A meta-analysis was performed to investigate prognostic significance of EGFR/p-EGFR expression in patients with nasopharyngeal carcinoma.MethodsLiteratures published before November 2020 were systematically searched in relevant databases, including PubMed, Web of Science, Embase, China National Knowledge Infrastructure (CNKI), and Wan fang databases. STATA 13 statistical software was used to analyze the pooled hazard ratio (HR) and 95% confidence interval (CI). Heterogeneity of the studies was examined by I2. Sensitivity and subgroup analysis were performed to explore sources of heterogeneity. The potential publication bias was assessed using both Egger’s and Begg’s tests.ResultsA total of 20 literatures with 1545 patients were included for the meta-analysis. The meta-analysis results suggested that high expression of EGFR was significantly associated with poor overall survival (OS) (HR = 1.70, 95% CI: 1.24–3.15, P = 0.001) and disease-free survival (DFS) (HR = 2.58, 95% CI: 1.87–3.56, P = 0.000). However, it was not significantly associated with progression-free survival (PFS) (HR = 1.85, 95% CI: 0.90–3.82, P = 0.09) and distant metastasis-free survival (DMFS) (HR = 1.39, 95% CI: 0.73–2.67, P = 0.319). The subgroup analysis indicated that patients with EGFR high expression in studies of higher TNM stage (III–IV) ratio had significantly poor OS (HR = 2.27, 95% CI: 1.09–4.73, P = 0.03), but heterogeneity existed in studies (I2  =  95.1%, P = 0.000). Sensitivity analyses revealed that EGFR expression did not significantly affect OS by an individual study solely, indicating there was inherent heterogeneity in OS cohorts. There was no significant heterogeneity among eight studies in the DFS cohorts (I2 = 0%, P = 0.606). There was significant heterogeneity between EGFR expression and DMFS (I2 = 82.8%, P = 0.000). Sub-group analysis in differentiated carcinoma demonstrated a smaller heterogeneity (I2 = 33.2%). In addition, p-EGFR high expression had no significant correlation with OS (HR = 1.00, 95% CI: 0.88–1.14, P = 0.982) and DMFS (HR = 1.21, 95% CI: 0.96–1.52, P = 0.112). The heterogeneity among p-EGFR and OS studies was small (I2 = 21%, P = 0.26). There was no significant heterogeneity in the DMFS cohorts (I2 = 0%, P = 0.497).ConclusionEGFR high-expression was significantly associated with poor OS and DFS, which may serve as a prognostic predictor for nasopharyngeal cancer.Systematic Review Registration[https://www.crd.york.ac.uk/PROSPERO], identifier [number CRD42021258457].

scholarly journals Prognostic Impact of Monocyte to Lymphocyte Ratio in Clinical Outcome for Patients with Hepatocellular Carcinoma: A Systematic Review and Meta-Analysis

2020 ◽  
Vol 9 ◽  
pp. 1948
Author(s):  
Masoud Nouri-Vaskeh ◽  
Mohammad Mirza-Aghazadeh-Attari ◽  
Fariba Pashazadeh ◽  
Saber Azami-Aghdash ◽  
Hadi Alizadeh ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Subgroup Analysis ◽  
Meta Analysis ◽  
Prognostic Significance ◽  
Surrogate Marker ◽  
Disease Free Survival ◽  
Systemic Review ◽  
Significant Heterogeneity ◽  
Prognostic Impact ◽  
Free Survival

Background: Lymphocyte to monocyte ratio (LMR) is a surrogate marker of systemic inflammation which is shown to be related to patient’s survival in multiple malignancies. An important implication of this marker potentially is neoplasms in which there is no correlation between prognosis and histopathological staging, or has no reliable chemical markers associated with prognosis. Herein, this meta-analysis aimed to investigate the prognostic role of LMR in the patients with hepatocellular carcinoma (HCC).Methods: In the current systemic review and meta-analysis, we conducted a systemic search of databases and indexing sources, including Medline (PubMed), EMBASE, Cochrane, Scopus, and ProQuest up to May 2019. We include studies evaluating the prognostic significance of LMR on patients with HCC. Overall survival (OS), disease free survival (DFS) and recurrence free survival (RFS) values were extracted from the studies and analyzed. The pooled hazard ratio with 95% confidence interval explored to identify the prognostic value of LMR in survival of the patients with HCC.Results: A total of 12 studies with a total sample size of 3750 were included. There was significant heterogeneity among the studies, so subgroup analysis was also performed. Overall analysis regarding OS showed an insignificant relationship between LMR and patient’s prognosis, subgroup based on LMR cut-offs did not yield any significant result, subgroup analysis for RFS founded statistically significant results and LMR was significantly related to DFS.Conclusion: High LMR was associated with increased DFS and RFS, in return this correlation was not observed for OS.

scholarly journals Prognostic value of aldo-keto reductase family 1 member B10 in solid tumors: a systematic review and meta-analysis

2020 ◽  
Author(s):  
Rongqiang Liu ◽  
Shiyang Zheng ◽  
Shengjia Peng ◽  
Qianmin Ge ◽  
Qi Lin ◽  
...  
Keyword(s):  
Solid Tumors ◽  
Publication Bias ◽  
Prognostic Value ◽  
Meta Analysis ◽  
Prognostic Significance ◽  
Disease Free Survival ◽  
Pooled Analysis ◽  
High Expression ◽  
Sensitivity Analyses ◽  
Free Survival

Abstract Background: It has been reported that the expression of aldo-keto reductase family 1 member B10 (AKR1B10) is abnormal in various types of cancer, and could be used as a prognostic biomarker. However, the results are controversial. Therefore, the aim of this study was to comprehensively evaluate the prognostic value of AKR1B10 expression in solid tumors by conducting a meta-analysis.Methods: The pooled hazard ratios (HRs) with 95% confidence intervals (CIs) for overall survival and disease-free survival/relapse-free survival were calculated to estimate the prognostic significance of AKR1B10 using the random effects model. Subgroup, meta-regression, and sensitivity analyses were used to investigate sources of heterogeneity. Begg’s test and Egger’s test were used to evaluate publication bias.Results: Eleven studies involving 1,389 patients were included in this meta-analysis. The pooled analysis displayed that high expression of AKR1B10 was not associated with OS(HR=1.22; 95% CI: 0.73–2.04) and DFS/PFS (HR=1.23, 95% CI 0.75–2.01) in solid tumors. Sensitivity analysis indicated that the results of the meta-analysis were stable. Begg’s test and Egger’s test also confirmed the absence of publication bias.Conclusions: We demonstrated that high expression of AKR1B10 was not associated with survival outcomes in patients with solid tumors. Further large-sample, prospective, multi-centric, and well-designed studies are warranted to investigate the prognostic role of AKR1B10 in various cancers.

scholarly journals Prognostic Role of miR-221 and miR-222 Expression in Cancer Patients: A Systematic Review and Meta-Analysis

Cancers ◽  
2019 ◽  
Vol 11 (7) ◽  
pp. 970 ◽  
Author(s):  
Gloria Ravegnini ◽  
Sarah Cargnin ◽  
Giulia Sammarini ◽  
Federica Zanotti ◽  
Justo Lorenzo Bermejo ◽  
...  
Keyword(s):  
Systematic Review ◽  
Cancer Patients ◽  
Meta Analysis ◽  
Fine Tuning ◽  
High Expression ◽  
Cochrane Library ◽  
Published Data ◽  
Significant Heterogeneity ◽  
Free Survival

Background: A wealth of evidence has shown that microRNAs (miRNAs) can modulate specific genes, increasing our knowledge on the fine-tuning regulation of protein expression. miR-221 and miR-222 have been frequently identified as deregulated across different cancer types; however, their prognostic significance in cancer remains controversial. In view of these considerations, we performed an updated systematic review and meta-analysis of published data investigating the effects of miR-221/222 on overall survival (OS) and other secondary outcomes among cancer patients. A systematic search of PubMed, Web of Knowledge, and Cochrane Library databases was performed. Hazard ratios (HRs) and 95% confidence intervals (95% CIs) were used to assess the strength of association. Results: Fifty studies, analyzing 6086 patients, were included in the systematic review. Twenty-five studies for miR-221 and 17 studies for miR-222 which assessed OS were included in the meta-analysis. High expression of miR-221 and miR-222 significantly predicted poor OS (HR: 1.48, 95% CI: 1.14–1.93, p = 0.003 and HR: 1.90, 95% CI: 1.43–2.54, p < 0.001, respectively). Subgroup analysis revealed that the finding on miR-221 was not as robust as the one on miR-222. Furthermore, high miR-222 expression was also associated with worse progression-free survival and disease-free survival pooled with recurrence-free survival. Conclusions: The meta-analysis demonstrated that high expression of miR-222 is associated with poor prognosis in cancer patients, whereas the significance of miR-221 remains unclear. More work is required to fully elucidate the role of miR-221 and miR-222 in cancer prognosis, particularly in view of the limitations of existing results, including the significant heterogeneity and limited number of studies for some cancers.

scholarly journals The Prognostic Roles and Clinical Features of CD44v9 in Human Solid Cancers—A Meta-Analysis

2020 ◽  
Author(s):  
Yuanxiu Deng ◽  
Jie Wang ◽  
Shenhui Ji ◽  
Lu Huang ◽  
Meijiang Feng
Keyword(s):  
Clinical Features ◽  
Meta Analysis ◽  
Prognostic Significance ◽  
Disease Free Survival ◽  
Progression Free Survival ◽  
High Expression ◽  
Cochrane Library ◽  
Cancer Specific Survival ◽  
Free Survival ◽  
Diagnosis And Prognosis

Abstract Background: CD44 is the primary receptor for hyaluronic acid and serves as a marker for cancer stem cells. CD44v9 is one of CD44’s variants and takes part in cancer’s growth and metastasis. However, the prognostic roles and clinical features of CD44v9 in cancers remain unclear. Therefore, we conducted this meta-analysis to summarize the prognostic significance and clinical features of CD44v9 in human solid cancers.Methods: we systematically searched all of related studies in PubMed, the Web of Science, Embase and Cochrane library up to June 2020. We analyzed the pooled hazard ratios (HRs) and odds ratios (ORs) with corresponding 95% confidence intervals (CIs) to assess the prognostic functions and clinical features of CD44v9 in various human solid cancers.Results: In this meta-analysis, we included 1705 cancer patients among 12 studies. Results indicated that high expression of CD44v9 was significantly related to poorer overall survival (OS) (HR=1.60, 95%CI 1.28-1.99, P<0.0001), recurrence-free survival/progression-free survival/disease-free survival (RFS/PFS/DFS).( HR=1.81, 95%CI 1.16-2.84, P=0.009) and disease-specific survival/cancer-specific survival (DSS/CSS) (HR=2.93, 95%CI 1.69-5.10, P<0.001). At the same time, we also found that high expression of CD44v9 increased the possibility of lymphoid infiltrates (OR=1.59, 95%CI 1.16-2.20, P=0.005), vascular invasion (OR=1.57, 95%CI 1.11-2.22, P=0.010) and higher TNM stage (OR=1.63, 95%CI 1.19-2.23, P=0.002).Conclusion: Our results demonstrate that CD44v9 overexpression is associated with worse OS, RFS/PFS/CFS and DSS/CSS in patients with solid cancers, which might be a biomarker in the diagnosis and prognosis of cancers in the future.

scholarly journals Prognostic Value of Perineural Invasion in Esophageal and Esophagogastric Junction Carcinoma: A Meta-Analysis

2016 ◽  
Vol 2016 ◽  
pp. 1-9 ◽  
Author(s):  
Aiqin Gao ◽  
Linlin Wang ◽  
Juan Li ◽  
Hongyu Li ◽  
Yali Han ◽  
...  
Keyword(s):  
Prognostic Value ◽  
Esophagogastric Junction ◽  
Perineural Invasion ◽  
Meta Analysis ◽  
Prognostic Significance ◽  
Disease Free Survival ◽  
Statistical Correlation ◽  
Significant Heterogeneity ◽  
Free Survival ◽  
N Stage

Objective. Here we aimed to clarify the prognostic significance of perineural invasion (PNI) in esophageal and esophagogastric junction (EGJ) carcinoma.Methods. A comprehensive literature search for relevant reports published up to July 2015 was performed using Pubmed and Embase databases. The pooled HR and 95% CI for overall survival (OS) and disease-free survival (DFS) were used to assess the prognostic value. The association of PNI with pathological characteristics was evaluated by OR and 95% CI.Results. A total of 13 cohorts were retrieved, covering 2770 patients treated by surgery. The cumulative analysis revealed a statistical correlation between PNI and poor OS (HR = 1.76, 95% CI: 1.54–2.20, andP<0.00001), as well as poor DFS (HR = 1.96, 95% CI: 1.42–2.71, andP<0.001). Moreover, analysis of 1475 patients showed improved PNI in T3 + T4 (OR = 0.39, 95% CI: 0.21–0.70, andP=0.002), N+ (OR = 0.52, 95% CI: 0.40–0.69, andP<0.00001), and G3 + G4 (OR = 0.66, 95% CI: 0.48–0.90, andP=0.008) patients compared with T1 + T2, N−, and G1 + G2 ones, respectively. No significant heterogeneity was found between the studies.Conclusions. PNI is an adverse prognostic biomarker in esophageal and EGJ carcinoma. Moreover, PNI implies advanced T, N stage and poor cell differentiation.

scholarly journals Prognostic and clinicopathological significance of GPRC5A in various cancers: A systematic review and meta-analysis

PLoS ONE ◽  
2021 ◽  
Vol 16 (3) ◽  
pp. e0249040
Author(s):  
Lu Dai ◽  
Xiao Jin ◽  
Zheng Liu
Keyword(s):  
Subgroup Analysis ◽  
Meta Analysis ◽  
Disease Free Survival ◽  
Cancer Prognosis ◽  
Significant Heterogeneity ◽  
Cancer Type ◽  
Advanced Tumor Stage ◽  
Tumor Type ◽  
Free Survival ◽  
Advanced Tumor

Background GPRC5A is associated with various cancer initiation and progression. Controversial findings have been reported about GPRC5A prognostic characteristics, and no meta-analysis has been conducted to assess the relationship between GPRC5A and cancer prognosis. Therefore, the objective of this meta-analysis is to evaluate the overall prognostic effectiveness of GPRC5A. Methods We first conducted a systematic search in the PubMed, Embase, Web of Science, CNKI, Cochrane, and WangFang databases. The hazard ratio (HR) and odds ratios (OR) with 95% CI were then pooled to assess the associations between GPRC5A expression and overall survival (OS), disease-free survival (DFS), event-free survival (EFS), and clinicopathological characteristics. Chi-squared test and I2 statistics were completed to evaluate the heterogeneity in our study. A random‐effects model was used when significant heterogeneity existed (I2>50% and p<0.05); otherwise, we chose the fixed-effect model. Subgroup analysis was stratified by tumor type, region, HR obtained measurements, and sample capacity to explore the source of heterogeneity. Results In total, 15 studies with 624 patients met inclusion criteria of this study. Our results showed that higher expression of GPRC5A is associated with worse OS (HR:1.69 95%CI: 1.20–2.38 I2 = 75.6% p = 0.000), as well as worse EFS (HR:1.45 95%CI: 1.02–1.95 I2 = 0.0% p = 0.354). Subgroup analysis indicated that tumor type might be the source of high heterogeneity. Additionally, cancer patients with enhanced GPRC5A expression were more likely to lymph node metastasis (OR:1.95, 95%CI 1.33–2.86, I2 = 43.9%, p = 0.129) and advanced tumor stage (OR: 1.83, 95%CI 1.15–2.92, I2 = 61.3%, p = 0.035), but not associated with age, sex, differentiation, and distant metastasis. Conclusion GPRC5A can be a promising candidate for predicting medical outcomes and used for accurate diagnosis, prognosis prediction for patients with cancer; however, the predictive value of GPRC5A varies significantly according to cancer type. Further studies for this mechanism will be necessary to reveal novel insights into application of GPRC5A in cancers.

Prognostic significance of platelet-to-lymphocyte ratio in patients with nasopharyngeal carcinoma: a meta-analysis

2020 ◽  
Vol 16 (5) ◽  
pp. 117-127 ◽  
Author(s):  
Junkai Zhang ◽  
Weineng Feng ◽  
Zhihua Ye ◽  
Ying Wei ◽  
Lamei Li ◽  
...  
Keyword(s):  
Nasopharyngeal Carcinoma ◽  
Meta Analysis ◽  
Prognostic Significance ◽  
Intensity Modulated Radiotherapy ◽  
Progression Free Survival ◽  
Platelet To Lymphocyte Ratio ◽  
Poor Overall Survival ◽  
Free Survival ◽  
Lymphocyte Ratio ◽  
N Stage

Aim: Several studies reported the association of platelet-to-lymphocyte ratio (PLR) and prognosis in nasopharyngeal carcinoma (NPC), but the results remain controversial. Therefore, we investigated the prognostic value of PLR in NPC through meta-analysis. Materials & methods: A comprehensive literature search of PubMed, Embase and Web of Science was performed. Results: A total of 9 studies comprising of 3459 patients with NPC were included. The data demonstrated that an increased PLR predicted poor overall survival, progression-free survival and distant metastasis-free survival. There was no significant association between PLR and sex, age, T stage, N stage, tumor node metastasis (TNM) stage or intensity-modulated radiotherapy. Conclusion: This meta-analysis revealed that PLR might be a potential predicative biomarker of poor prognosis in patients with NPC.

scholarly journals Prognostic significance of mean platelet volume in lung cancer patients: A meta-analysis

2021 ◽  
Author(s):  
Sanjeev Kharel ◽  
Suraj Shrestha ◽  
Prafulla Shakya ◽  
Rohit Rawat ◽  
Ramila Shilpakar
Keyword(s):  
Lung Cancer ◽  
Cancer Patients ◽  
Subgroup Analysis ◽  
Mean Platelet Volume ◽  
Meta Analysis ◽  
Prognostic Significance ◽  
Platelet Volume ◽  
Free Survival ◽  
Lung Cancer Patients ◽  
Platelet Size

Abstract Background Lung cancer is the most prevalent cancer globally with a grim prognosis alongside a very high number of cancer-related deaths. Mean platelet volume (MPV) is the measure of platelet size and is considered a surrogate marker of platelet activation. Low MPV indicates exhausted platelets causing worse outcomes in cancer patients. As the correlation between platelet count/platelet size and lung cancer prognosis still remains a topic of debate, this meta-analysis was done to comprehensively evaluate the prognostic significance of MPV among lung cancer patients.Methods A systematic search of electronic databases PubMed, Embase, and Google scholar and additional sources for relevant studies were done with no language restrictions from inception to 7th May 2021. Overall Survival (OS) and Disease-Free Survival (DFS)/Progression-Free Survival (PFS) and hazard ratio (HR) with 95% Confidence Interval (CI) were pooled to evaluate the relation of MPV with OS/DFS. Subgroup analysis based on cancer type, clinical stage, sample size, median age, cut-off value, and study region was done to identify the cause of significant heterogeneity.Results Eleven studies with 2421 lung cancer patients were included in our analysis. Our analysis showed no significant association between MPV levels with OS (H.R.:1.07, 95%C.I.:0.84–1.35, p = 0.60) and DFS/PFS (HR:1.04, 95%C.I.:0.68–1.60, p = 0.84). Under subgroup analysis, studies conducted in countries other than China (HR:1.53, 95% C.I.=1.14–2.03, p < 0.001, I2 = 42.11%) and studies with advanced-stage lung cancer patients (HR: 1.84, 95% C.I.=1.19–2.82, p-value = 0.01, I2 = 0%) showed significant association between MPV levels and worse DFS/PFS.Conclusion Pretreatment MPV levels did not show prognostic significance except in advanced lung cancer cases. Large multicentric studies with large samples and long follow-up times are necessary.

scholarly journals The Prognostic Significance of Combined Pretreatment Fibrinogen and Neutrophil-Lymphocyte Ratio in Various Cancers: A Systematic Review and Meta-Analysis

2020 ◽  
Vol 2020 ◽  
pp. 1-10
Author(s):  
Rongqiang Liu ◽  
Shiyang Zheng ◽  
Qing Yuan ◽  
Peiwen Zhu ◽  
Biao Li ◽  
...  
Keyword(s):  
Prognostic Value ◽  
Meta Analysis ◽  
Prognostic Significance ◽  
Disease Free Survival ◽  
Progression Free Survival ◽  
Regression Analyses ◽  
Free Survival ◽  
Neutrophil Lymphocyte Ratio ◽  
Lymphocyte Ratio ◽  
Meta Regression

Purpose. The prognostic value of a new scoring system, termed F-NLR, that combines pretreatment fibrinogen level with neutrophil-lymphocyte ratio has been evaluated in various cancers. However, the results are controversial. The purpose of this study was to comprehensively analyze the prognostic value of F-NLR score in patients with cancers. Methods. An integrated search of relevant studies was conducted by screening the PubMed and Embase databases. Pooled hazard ratios, with 95% confidence intervals (CIs), for overall survival (OS) and disease-free survival (DFS)/progression-free survival (PFS) were calculated to estimate the prognostic significance of F-NLR score in patients with various tumors. A random effects model was used for comprehensive analysis, and subgroup and meta-regression analyses were used to explore sources of heterogeneity. Results. Thirteen articles reporting data from of 4747 patients were included in the study. Pooled analysis revealed that high F-NLR score was significantly associated with poor OS ( HR = 1.77 ; 95% CI, 1.51–2.08) and poor DFS/PFS ( HR = 1.63 ; 95% CI, 1.30–2.05). Subgroup and meta-regression analyses did not alter the prognostic role of F-NLR score in OS and DFS/PFS. Conclusions. Increased F-NLR score is significantly associated with poor prognosis in patients with cancers and can serve as an effective prognostic indicator.

scholarly journals The high risk of malarial recurrence in patients with Plasmodium-mixed infection after treatment with antimalarial drugs: a systematic review and meta-analysis

2021 ◽  
Vol 14 (1) ◽  
Author(s):  
Aongart Mahittikorn ◽  
Frederick Ramirez Masangkay ◽  
Kwuntida Uthaisar Kotepui ◽  
Giovanni De Jesus Milanez ◽  
Manas Kotepui
Keyword(s):  
Systematic Review ◽  
Mixed Infection ◽  
Subgroup Analysis ◽  
Initial Treatment ◽  
Meta Analysis ◽  
Antimalarial Drugs ◽  
Secondary Outcome ◽  
Significant Heterogeneity ◽  
Pooled Prevalence ◽  
Significant Difference

Abstract Background Malaria mixed infections are often unrecognized by microscopists in the hospitals, and a delay or failure to treat Plasmodium-mixed infection may lead to aggravated morbidity and increased mortality. The present study aimed to quantify the pooled proportion and risk of malarial recurrences after the treatment of Plasmodium-mixed infection. The results of the study may provide benefits in the management of Plasmodium-mixed infection in co-endemic regions. Methods This systematic review and meta-analysis searched the international Prospective Register of Systematic Reviews (PROSPERO; ID = CRD42020199709), MEDLINE, Web of Science, and Scopus for potentially relevant studies in any language published between January 1, 1936, and July 20, 2020, assessing drug efficacy in patients with Plasmodium-mixed infection. The primary outcome was the pooled prevalence of Plasmodium parasitemia after initiating antimalarial treatment for Plasmodium-mixed infection. The secondary outcome was the pooled risk ratio (RR) of malarial recurrence in Plasmodium-mixed infection compared with those in Plasmodium falciparum and Plasmodium vivax mono-infection. The pooled analyses were calculated by random-effects meta-analysis. After the initial treatment in different days of recurrences (≤ 28 days or > 28 days), the risk of Plasmodium parasitemia was compared in subgroup analysis. Results Out of 5217 screened studies, 11 were included in the meta-analysis, including 4390 patients from six countries. The pooled prevalence of all recurrences of Plasmodium-mixed parasitemia was 30% (95% confidence interval (CI) 16–43; I2: 99.2%; 11 studies). The RR of malarial recurrence within 28 days after the initial treatment (clinical treatment failure) of Plasmodium-mixed parasitemia compared with the treatment of P. falciparum was 1.22 (p: 0.029; 95% CI 1.02–1.47; Cochran Q: 0.93; I2: 0%; six studies), while there was no significant difference in the risk of recurrence 28 days after initial treatment compared with the treatment of P. falciparum (p: 0.696, RR: 1.14; 95% CI 0.59–2.18; Cochran Q < 0.05; I2: 98.2%; four studies). The subgroup analysis of antimalarial drugs showed that significant malarial recurrence within 28 days was observed in patients treated with artemisinin-based combination therapies (ACTs) with no significant heterogeneity (p: 0.028, RR: 1.31; 95% CI 1.03–1.66; Cochran Q: 0.834; I2: 0%). Conclusions The present findings showed a high prevalence of malarial recurrence after the initial treatment of Plasmodium-mixed infection. Moreover, significant malaria recurrence of mixed infection occurred within 28 days after treatment with ACTs. Graphic Abstract

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