Impact of Tumor–Stroma Ratio on the Prognosis of Colorectal Cancer: A Systematic Review

BackgroundIt is critical to develop a reliable and cost-effective prognostic tool for colorectal cancer (CRC) stratification and treatment optimization. Tumor–stroma ratio (TSR) may be a promising indicator of poor prognosis in CRC patients. As a result, we conducted a systematic review on the predictive value of TSR in CRC.MethodsThis study was carried out according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guideline. An electronic search was completed using commonly used databases PubMed, CENTRAL, Cochrane Central Register of Controlled Trials, and Google scholar till the last search up to May 30, 2021. STATA version 13 was used to analyze the data.ResultsA total of 13 studies [(12 for disease-free survival (DFS) and nine studies for overall survival (OS)] involving 4,857 patients met the inclusion criteria for the systematic review in the present study. In individuals with stage II CRC, stage III CRC, or mixed stage CRC, we observed a significantly higher pooled hazard ratio (HR) in those with a low TSR/greater stromal content (HR, 1.54; 95% CI: 1.20 to 1.88), (HR, 1.90; 95% CI: 1.35 to 2.45), and (HR, 1.70; 95% CI: 1.45 to 1.95), respectively, for predicting DFS. We found that a low TSR ratio had a statistically significant predictive relevance for stage II (HR, 1.43; 95% CI: 1.09 to 1.77) and mixed stages of CRC (HR, 1.65; 95% CI: 1.31 to 2.0) for outcome OS.ConclusionIn patients with CRC, low TSR was found to be a prognostic factor for a worse prognosis (DFS and OS).

Download Full-text

Economic evaluation of laparoscopic surgery for colorectal cancer

International Journal of Technology Assessment in Health Care ◽

10.1017/s0266462307070559 ◽

2007 ◽

Vol 23 (4) ◽

pp. 464-472 ◽

Cited By ~ 7

Author(s):

Robyn M. de Verteuil ◽

Rodolfo A. Hernández ◽

Luke Vale ◽

Keyword(s):

Colorectal Cancer ◽

Systematic Review ◽

Laparoscopic Surgery ◽

Cost Effectiveness ◽

Incremental Cost ◽

Open Surgery ◽

Disease Free Survival ◽

Cost Effective ◽

Economic Evaluations ◽

Short Term

Objectives: The aim of this study was to assess the cost-effectiveness of laparoscopic surgery compared with open surgery for the treatment of colorectal cancer.Methods: A Markov model was developed to model cost-effectiveness over 25 years. Data on the clinical effectiveness of laparoscopic and open surgery for colorectal cancer were obtained from a systematic review of the literature. Data on costs came from a systematic review of economic evaluations and from published sources. The outcomes of the model were presented as the incremental cost per life-year gained and using cost-effectiveness acceptability curves to illustrate the likelihood that a treatment was cost-effective at various threshold values for society's willingness to pay for an additional life-year.Results: Laparoscopic surgery was on average £300 more costly and slightly less effective than open surgery and had a 30 percent chance of being cost-effective if society is willing to pay £30,000 for a life-year. One interpretation of the available data suggests equal survival and disease-free survival. Making this assumption, laparoscopic surgery had a greater chance of being considered cost-effective. Presenting the results as incremental cost per quality-adjusted life-year (QALY) made no difference to the results, as utility data were poor. Evidence suggests short-term benefits after laparoscopic repair. This benefit would have to be at least 0.01 of a QALY for laparoscopic surgery to be considered cost-effective.Conclusions: Laparoscopic surgery is likely to be associated with short-term quality of life benefits, similar long-term outcomes, and an additional £300 per patient. A judgment is required as to whether the short-term benefits are worth this extra cost.

Download Full-text

Lopinavir/ritonavir for the treatment of COVID-19: A living systematic review protocol

10.1101/2020.04.11.20062109 ◽

2020 ◽

Cited By ~ 1

Author(s):

Francisca Verdugo-Paiva ◽

Ariel Izcovich ◽

Martín Ragusa ◽

Gabriel Rada

Keyword(s):

Systematic Review ◽

Direct Evidence ◽

Grey Literature ◽

Cochrane Central Register ◽

Randomised Trials ◽

Eligibility Criteria ◽

Web Based ◽

Central Register ◽

Review Protocol ◽

Meta Analyses

ABSTRACTObjectiveTo assess the efficacy and safety of lopinavir/ritonavir for the treatment of patients with COVID-19.DesignThis is the protocol of a living systematic review.Data sourcesWe will conduct searches in PubMed/Medline, Embase, Cochrane Central Register of Controlled Trials (CENTRAL), grey literature and in a centralised repository in L·OVE (Living OVerview of Evidence). L·OVE is a platform that maps PICO questions to evidence from Epistemonikos database. In response to the COVID-19 emergency, L·OVE was adapted to expand the range of evidence it covers and customised to group all COVID-19 evidence in one place. The search will cover the period until the day before submission to a journal.Eligibility criteria for selecting studies and methodsWe adapted an already published common protocol for multiple parallel systematic reviews to the specificities of this question.We will include randomised trials evaluating the effect of lopinavir/ritonavir— as monotherapy or in combination with other drugs — versus placebo or no treatment in patients with COVID-19. Randomised trials evaluating lopinavir/ritonavir in infections caused by other coronaviruses, such as MERS-CoV and SARS-CoV, and non-randomised studies in COVID-19 will be searched in case no direct evidence from randomised trials is found, or if the direct evidence provides low- or very low-certainty for critical outcomes.Two reviewers will independently screen each study for eligibility, extract data, and assess the risk of bias. We will perform random-effects meta-analyses and use GRADE to assess the certainty of the evidence for each outcome.A living, web-based version of this review will be openly available during the COVID-19 pandemic. We will resubmit it if the conclusions change or there are substantial updates.Ethics and disseminationNo ethics approval is considered necessary. The results of this review will be widely disseminated via peer-reviewed publications, social networks and traditional media.PROSPERO RegistrationSubmitted to PROSPERO (awaiting ID allocation).

Download Full-text

Survival outcomes of patients with cervical cancer and accompanying hydronephrosis: A systematic review of the literature

Oncology Reviews ◽

10.4081/oncol.2019.387 ◽

2019 ◽

Vol 13 (1) ◽

Author(s):

Vasilios Pergialiotis ◽

Ioannis Bellos ◽

Nikolaos Thomakos ◽

Dimitrios Haidopoulos ◽

Despina N. Perrea ◽

...

Keyword(s):

Systematic Review ◽

Cervical Cancer ◽

Obstructive Uropathy ◽

Survival Rates ◽

Disease Free Survival ◽

Percutaneous Nephrostomy ◽

Future Research ◽

Cochrane Central Register ◽

Central Register ◽

Present Systematic Review

Hydronephrosis is a sign of advanced stage disease in patients with cervical cancer. Its presence is believed to negatively affect the survival of patients. To date, however, consensus in this field is still lacking. The purpose of the present systematic review is to gather the available data and to provide directions for future research in the field. We systematically searched Medline, Scopus, Clinicaltrials.gov, EMBASE, Cochrane Central Register of Controlled Trials CENTRA and Google Scholar databases from inception till June 2018. Overall, 22 studies were included in the present systematic review that evaluated outcomes from 8521 patients with cervical cancer. The findings of our systematic review support that hydronephrosis negatively affects the overall survival of cervical cancer patients. Specifically, the reported 5-year OS hazards ratio for hydronephrosis ranged between 1.34 and 3.74. Outcomes concerning the disease-free survival of these patients were, however, less discrete. None of the included studies reported whether the decreased survival of patients with hydronephrosis was attributed to complications of obstructive uropathy such as uremia and sepsis. Thus, it remains, to date, unclear whether placement of ureteral stents or percutaneous nephrostomy may actually benefit these patients. More studies are needed to evaluate the actual impact of hydronephrosis on survival rates at the various stages of cervical cancer and to help establish consensus regarding the optimal mode of management of these patients.

Download Full-text

Maternal and Fetal Outcomes after Prior Mid-Trimester Uterine Rupture: A Systematic Review with Our Experience

Medicina ◽

10.3390/medicina57121294 ◽

2021 ◽

Vol 57 (12) ◽

pp. 1294

Author(s):

Shinya Matsuzaki ◽

Tsuyoshi Takiuchi ◽

Takeshi Kanagawa ◽

Satoko Matsuzaki ◽

Misooja Lee ◽

...

Keyword(s):

Systematic Review ◽

Uterine Rupture ◽

Cochrane Central Register ◽

Fetal Outcomes ◽

Maternal Deaths ◽

Spontaneous Uterine Rupture ◽

Central Register ◽

Gestational Age At Delivery ◽

Placenta Accreta Spectrum ◽

Meta Analyses

Background and Objectives: Since spontaneous uterine rupture in the mid-trimester is rare, maternal and fetal outcomes in subsequent pregnancies remain unclear. Therefore, this study aimed to examine the maternal and fetal outcomes of subsequent pregnancies after prior mid-trimester uterine rupture. Materials and Methods: A systematic review using PubMed, the Cochrane Central Register of Controlled Trials, and Scopus until 30 September 2021, was conducted in compliance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The studies that clarified the maternal and fetal outcomes after prior mid-trimester uterine rupture and our case (n = 1) were included in the analysis. Results: Among the eligible cases, there were five women with eight subsequent pregnancies after prior mid-trimester uterine rupture. The timing of prior mid-trimester uterine rupture ranged from 15 to 26 weeks of gestation. The gestational age at delivery in subsequent pregnancies was 23–38 gestational weeks. Among the included cases (n = 8), those involving prior mid-trimester uterine rupture appeared to be associated with an increased prevalence of placenta accreta spectrum (PAS) (n = 3, 37.5%) compared with those involving term uterine rupture published in the literature; moreover, one case exhibited recurrent uterine rupture at 23 weeks of gestation (12.5%). No maternal deaths have been reported in subsequent pregnancies following prior mid-trimester uterine rupture. Fetal outcomes were feasible, except for one pregnancy with recurrent mid-trimester uterine rupture at 23 weeks of gestation, whose fetus was alive complicated by cerebral palsy. Conclusions: Our findings suggest that clinicians should be aware of the possibility of PAS and possible uterine rupture in pregnancies after prior mid-trimester uterine rupture. Further case studies are warranted to assess maternal and fetal outcomes in pregnancies following prior mid-trimester prior uterine rupture.

Download Full-text

Contemporary Sterilization Protocols of Healing Abutments for Reusability: A Systematic Review

JDR Clinical & Translational Research ◽

10.1177/23800844211045897 ◽

2021 ◽

pp. 238008442110458

Author(s):

P. Eswaramurthy ◽

K.M. DSouza ◽

A. Nagarsekar ◽

R.B. Gaunkar

Keyword(s):

Systematic Review ◽

Dental Implant ◽

English Language ◽

Cost Effective ◽

Cochrane Central Register ◽

Effective Measure ◽

Bias Assessment ◽

Central Register ◽

Therapeutic Decisions ◽

Single Use

Introduction: Although healing abutments are designated for single use by most implant manufacturers, it is common practice for clinicians to reuse healing abutments. However, there is a lack of adequate references that describe detailed sterilization protocols for reuse of healing abutments. Objectives: The purpose of this systematic review was to compile, organize, and describe the most common techniques for the sterilization of healing abutments and their efficiency in eliminating traces of microorganisms. Methods: An electronic search in 5 different databases was performed, including the National Library of Medicine (MEDLINE via PubMed), Embase, Cochrane Central Register of Controlled Trials, Web of Science, and Google Scholar from January 2000 to December 2020. Search variables included were dental implant, healing abutment, contaminate, contamination, reuse, and sterilization. Studies reporting with a minimum sample size of 10 healing abutments (5 per group) published in the English language were evaluated. Risk of bias assessment was elaborated for included investigations. Results: In total, 812 articles were identified, of which 8 were included in the analysis. Steam autoclave was the most widely used form of resterilization. Not a single protocol, however, was able to achieve 100% virgin surface of the healing abutments. Conclusion: Although reuse of dental implant healing abutments is a cost-effective measure in dental practice, thorough surface decontamination followed by resterilization is highly recommended before reuse. Knowledge Transfer Statement: With consideration of cost and patient preference, results of this review would be useful in knowing various sterilization protocols for reusing healing abutments that could lead to more appropriate therapeutic decisions.

Download Full-text

Fatigue symptoms associated with COVID-19 in convalescent or recovered COVID-19 patients; a systematic review and meta-analysis

10.31234/osf.io/c4w7p ◽

2021 ◽

Author(s):

Sanjay Rao ◽

Tarek Benzouak ◽

Sasha Gunpat ◽

Rachel Burns ◽

Tayyeb A. Tahir ◽

...

Keyword(s):

Systematic Review ◽

Meta Analysis ◽

Female Gender ◽

Acute Stage ◽

Self Report ◽

Multiple Time ◽

Cochrane Central Register ◽

Central Register ◽

Multiple Time Points ◽

Meta Analyses

BackgroundThe prevalence and prognosis of post-acute stage SARS-CoV-2 infection fatigue symptoms remain largely unknown.AimsWe performed a systematic review to evaluate the prevalence of fatigue in post-recovery from SARS-CoV-2 infection.MethodMedline, Embase, PsycINFO, CINAHL, Web of Science, Scopus, trial registries, Cochrane Central Register of Controlled Trials and Google Scholar were searched for studies on fatigue in samples that recovered from PCR diagnosed COVID-19. Meta-analyses were conducted separately for each recruitment setting.ResultsWe identified 39 studies with 8825 patients that recovered from COVID-19. Post-COVID-19 patients self-report of fatigue was higher compared to healthy controls (RR = 3.688, 95%CI [2.502, 5.436], p < 0.001). Over 50% of patients discharged from inpatient care reported symptoms of fatigue during the first (ER = 0.517, 95%CI [0.278, 0.749]) and second month following recovery (ER = 0.527, 95%CI [0.337, 0.709]). 10% of the community patients reported fatigue in the first month post-recovery. Patient setting moderated the association between COVID-19 recovery and fatigue symptoms (R2 = 0.12, p < 0.001). Female gender was associated with greater self-report of fatigue (OR =1.782, 95%CI [1.531, 2.870]). Patients recruited through social media had fatigue above 90% across multiple time points. Fatigue was highest in studies from Europe.ConclusionFatigue is a symptom associated with functional challenges which could have economic and social impacts. Developing long-term planning for fatigue management amongst patients beyond acute stages of SARS-CoV-2 infection is essential to optimizing patient care and public health outcomes.

Download Full-text

Treatments for subacute cough in primary care: systematic review and meta-analyses of randomised clinical trials

British Journal of General Practice ◽

10.3399/bjgp18x698885 ◽

2018 ◽

Vol 68 (675) ◽

pp. e694-e702 ◽

Cited By ~ 6

Author(s):

Benjamin Speich ◽

Anja Thomer ◽

Soheila Aghlmandi ◽

Hannah Ewald ◽

Andreas Zeller ◽

...

Keyword(s):

Systematic Review ◽

Clinical Trials ◽

Treatment Options ◽

Combined Treatment ◽

Randomised Clinical Trials ◽

Cochrane Central Register ◽

Central Register ◽

Severity Scores ◽

Drug Treatments ◽

Meta Analyses

BackgroundSubacute cough following a non-specific viral infection lasting 3–8 weeks is common. However, despite many treatment options there are no systematic reviews evaluating these.AimTo provide a systematic overview of treatment options and outcomes evaluated in randomised clinical trials (RCTs).Design and settingSystematic review and meta-analyses assessing the overall effects of any treatment for subacute cough.MethodThe authors systematically searched PubMed/MEDLINE and the Cochrane Central Register of Controlled Trials (last search March 2017) for RCTs in adult patients with subacute cough. The authors considered trials evaluating any outcome of any drug or non-drug treatments, apart from traditional Chinese and Asian medicines. They combined treatment effects on cough-related outcomes in random effects meta-analyses.ResultsSix eligible RCTs including 724 patients were identified. These assessed montelukast, salbutamol plus ipratropium bromide, gelatine, fluticasone propionate, budesonide, and nociception opioid 1 receptor agonist and codeine. Five studies reported effects on various cough severity scores at various timepoints. No treatment option was associated with a clear benefit on cough recovery or other patient-relevant outcomes in any of the studies or in meta-analyses for cough outcomes at 14 days and 28 days. Reported adverse events were rather mild and reported for 14% of patients across all treatments.ConclusionEvidence on treatment options for subacute cough is weak. There is no treatment showing clear patient-relevant benefits in clinical trials.

Download Full-text

Chloroquine and hydroxychloroquine for the treatment of COVID-19: A living systematic review protocol

10.1101/2020.04.03.20052530 ◽

2020 ◽

Cited By ~ 1

Author(s):

Rocío Bravo-Jeria ◽

María Ximena Rojas Reyes ◽

Juan Víctor Ariel Franco ◽

María Paz Acuña ◽

Luz Ángela Torres López ◽

...

Keyword(s):

Systematic Review ◽

Direct Evidence ◽

Grey Literature ◽

Controlled Trials ◽

Cochrane Central Register ◽

Randomised Trials ◽

Eligibility Criteria ◽

Central Register ◽

Randomised Controlled ◽

Meta Analyses

ABSTRACTObjectiveTo determine the relative impact of the use of chloroquine and hydroxychloroquine on outcomes important to patients with COVID 19.DesignThis is the protocol of a living systematic review.Data sourcesWe will conduct searches in PubMed/Medline, Embase, Cochrane Central Register of Controlled Trials (CENTRAL), trial registries, grey literature and in a centralised repository in L·OVE (Living OVerview of Evidence). L·OVE is a platform that maps PICO questions to evidence from Epistemonikos database. In response to the COVID-19 emergency, L·OVE was adapted to expand the range of evidence it covers and customised to group all COVID-19 evidence in one place. The search will cover the period until the day before submission to a journal.Eligibility criteria for selecting studies and methodsWe will follow a common protocol for multiple parallel systematic reviews, already published and submitted to PROSPERO (awaiting ID allocation).We will include randomised controlled trials evaluating the effect of chloroquine and hydroxychloroquine — as monotherapy or in combination with other drugs — versus placebo or no treatment in patients with COVID-19. Randomised trials evaluating chloroquine and hydroxychloroquine in infections caused by other coronaviruses, such as MERS-CoV and SARS-CoV, and non-randomised studies in COVID-19 will be searched in case no direct evidence from randomised trials is found, or if the direct evidence provides low- or very low-certainty for critical outcomes.Two reviewers will independently screen each study for eligibility, extract data, and assess the risk of bias. We will perform random-effects meta-analyses and use GRADE to assess the certainty of the evidence for each outcome.A living, web-based version of this review will be openly available during the COVID-19 pandemic. We will resubmit it if the conclusions change or there are substantial updates.Ethics and disseminationNo ethics approval is considered necessary. The results of this review will be widely disseminated via peer-reviewed publications, social networks and traditional media.

Download Full-text

The Prevalence of Urinary Incontinence among Adolescent Female Athletes: A Systematic Review

Journal of Functional Morphology and Kinesiology ◽

10.3390/jfmk6010012 ◽

2021 ◽

Vol 6 (1) ◽

pp. 12

Author(s):

Tamara Rial Rebullido ◽

Cinta Gómez-Tomás ◽

Avery D. Faigenbaum ◽

Iván Chulvi-Medrano

Keyword(s):

Systematic Review ◽

Urinary Incontinence ◽

Female Athletes ◽

Adolescent Female ◽

Cochrane Central Register ◽

Research Education ◽

Targeted Interventions ◽

Central Register ◽

Meta Analyses ◽

Rope Skipping

This review aimed to synthesize the most up-to-date evidence regarding the prevalence of urinary incontinence (UI) among adolescent female athletes. We conducted a systematic review of studies regarding UI in female athletes less than 19 years of age. This review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRIMSA). The electronic databases of PubMed, Embase, Cochrane Central Register of Controlled Trials (CENTRAL), Scopus, and Web of Science (WOS) were searched between October and November 2020. After blinded peer evaluation, a total of 215 studies were identified and nine were included. Risk of bias was assessed using the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) checklist. This review identified a prevalence of UI in adolescent female athletes between 18% to 80% with an average of 48.58%. The most prevalent sports were trampolining followed by rope skipping. The prevalence of UI among adolescent female athletes practicing impact sports was significantly prevalent. There is a need for further research, education, and targeted interventions for adolescent female athletes with UI.

Download Full-text