scholarly journals Timing of Adjuvant Chemotherapy and Survival in Colorectal, Gastric, and Pancreatic Cancer. A Systematic Review and Meta-Analysis

Cancers ◽  
2019 ◽  
Vol 11 (4) ◽  
pp. 550 ◽  
Author(s):  
Petrelli ◽  
Zaniboni ◽  
Ghidini ◽  
Ghidini ◽  
Turati ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Gastric Cancer ◽  
Pancreatic Cancer ◽  
Overall Survival ◽  
Adjuvant Chemotherapy ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Clinical Effects ◽  
Risk Of Death ◽  
Post Surgery

(1) Background: The optimal timing of adjuvant chemotherapy (CT) in gastrointestinal malignancies is still a matter of debate. For colorectal cancer, it is recommended to start post-operative treatment within eight weeks. The objective of this study was to assess the clinical effects of starting adjuvant CT within or after 6–8 weeks post-surgery in colorectal, gastric, and pancreatic cancer. (2) Methods: MEDLINE, EMBASE, and the Cochrane Library were searched in December 2018. Publications comparing the outcomes of patients treated with adjuvant CT administered before (early) or after (delayed) 6–8 weeks post-surgery for colorectal, gastric, and pancreatic cancer were identified. The primary endpoint was overall survival (OS). (3) Results: Out of 8752 publications identified, 34 comparative studies assessing a total of 141,853 patients were included. Meta-analysis indicated a statistically significant increased risk of death with delayed CT (>6–8 weeks post-surgery) in colorectal cancer (hazard ratio (HR) = 1.27, 95% confidence interval (CI) 1.21–1.33; p <0.001). Similarly, for gastric cancer, delaying adjuvant CT was associated with inferior overall survival (HR = 1.2, 95% CI 1.04–1.38; p = 0.01). Conversely, the benefit of earlier CT was not evident in pancreatic cancer (HR = 1, 95% CI 1–1.01; p = 0.37). Conclusions: Starting adjuvant CT within 6–8 weeks post-surgery is associated with a significant survival benefit for colorectal and gastric cancer, but not for pancreatic cancer.

scholarly journals Relationship between aspirin use of esophageal, gastric and colorectal cancer patient survival: a meta-analysis

2019 ◽  
Author(s):  
Juli Lin ◽  
Jian-xian Lin ◽  
Chao-hui Zheng ◽  
Ping Li ◽  
Jian-wei Xie ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Gastric Cancer ◽  
Overall Survival ◽  
Survival Benefit ◽  
Fixed Effects ◽  
Meta Analysis ◽  
Colorectal Cancer Patient ◽  
Cochrane Library ◽  
Cancer Specific Survival ◽  
Cox 2

Abstract Background: Many studies have found that use of aspirin can lengthen survival of gastrointestinal cancer. The aim of this study is to assess the survival benefit of aspirin use compared with non- aspirin use for patients with esophageal, gastric or colorectal cancer. Methods: We search online databases, including PubMed、Cochrane Library、Embase and www.clinicaltrials.gov before Feb 1th, 2019 to identify all relevant studies. The overall survival and cancer specific survival of esophageal, gastric and colorectal cancer in aspirin users compared with non-aspirin users. Data extraction and evaluation of studies’ quality were conducted independently by 2 investigators. A meta-analysis was performed to calculate the pooled risk ratios (RRs) for overall survival and cancer specific survival using either a fixed-effects or a random-effects model. Results: 17 studies were finally included in this meta-analysis, comprising more than 71,534 patients. There is no significant differences between post-diagnosis aspirin use and overall survival for esophageal and gastric cancer. The overall survival and cancer specific survival for colorectal cancer benefit associated with post-diagnosis aspirin use represented ［HR= 0.82, 95%CI(0.72, 0.94)］ and［HR= 0.70, 95%CI(0.57, 0.86)］. Overall survival and cancer specific survival for colorectal cancer did not benefit associated with aspirin use pre-diagnosis. The overall survival and cancer specific survival for colorectal cancer benefit associated with both pre and post-diagnosis aspirin use represented［HR=0.75，95%CI(0.61, 0.92)］and［HR=0.78, 95%CI(0.73, 0.85)］. Besides, the survival benefit of post-diagnosis aspirin use appeared to be confined to those patients with mutated PIK3CA tumors［HR= 0.78, 95%CI(0.50, 0.99)］and with positive PTGS2 (COX-2) expression［HR= 0.75, 95%CI(0.43, 1.30)］. Conclusions: These findings provide further indication that post-diagnosis aspirin therapy improved overall survival and cancer specific survival of colorectal cancer, especially for patients with positive PTGS2 (COX-2) expression and mutated PIK3CA tumors. However, it don’t improve overall survival of esophageal and gastric cancer and the meta-analysis is limited mainly to retrospective studies.

scholarly journals Relationship between aspirin use of esophageal, gastric and colorectal cancer patient survival: a meta-analysis

2020 ◽  
Author(s):  
Juli Lin ◽  
Jian-xian Lin ◽  
Chao-hui Zheng ◽  
Ping Li ◽  
Jian-wei Xie ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Gastric Cancer ◽  
Overall Survival ◽  
Survival Benefit ◽  
Fixed Effects ◽  
Meta Analysis ◽  
Colorectal Cancer Patient ◽  
Cochrane Library ◽  
Cancer Specific Survival ◽  
Cox 2

Abstract Background: Many studies have found that use of aspirin can lengthen survival of gastrointestinal cancer. The aim of this study is to assess the survival benefit of aspirin use compared with non- aspirin use for patients with esophageal, gastric or colorectal cancer. Methods: We search online databases, including PubMed、Cochrane Library、Embase and www.clinicaltrials.gov before Feb 1th, 2019 to identify all relevant studies. The overall survival and cancer specific survival of esophageal, gastric and colorectal cancer in aspirin users compared with non-aspirin users. Data extraction and evaluation of studies’ quality were conducted independently by 2 investigators. A meta-analysis was performed to calculate the pooled risk ratios (RRs) for overall survival and cancer specific survival using either a fixed-effects or a random-effects model. Results: 17 studies were finally included in this meta-analysis, comprising more than 71,534 patients. There is no significant differences between post-diagnosis aspirin use and overall survival for esophageal and gastric cancer. The overall survival and cancer specific survival for colorectal cancer benefit associated with post-diagnosis aspirin use represented ［HR= 0.82, 95%CI(0.72, 0.94)］ and［HR= 0.70, 95%CI(0.57, 0.86)］. Overall survival and cancer specific survival for colorectal cancer did not benefit associated with aspirin use pre-diagnosis. The overall survival and cancer specific survival for colorectal cancer benefit associated with both pre and post-diagnosis aspirin use represented［HR=0.75，95%CI(0.61, 0.92)］and［HR=0.78, 95%CI(0.73, 0.85)］. Besides, the survival benefit of post-diagnosis aspirin use appeared to be confined to those patients with mutated PIK3CA tumors［HR= 0.78, 95%CI(0.50, 0.99)］and with positive PTGS2 (COX-2) expression［HR= 0.75, 95%CI(0.43, 1.30)］. Conclusions: These findings provide further indication that post-diagnosis aspirin therapy improved overall survival and cancer specific survival of colorectal cancer, especially for patients with positive PTGS2 (COX-2) expression and mutated PIK3CA tumors. However, it don’t improve overall survival of esophageal and gastric cancer and the meta-analysis is limited mainly to retrospective studies.

scholarly journals Signal transduction pathway mutations in gastrointestinal (GI) cancers: a systematic review and meta-analysis

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Alireza Tabibzadeh ◽  
Fahimeh Safarnezhad Tameshkel ◽  
Yousef Moradi ◽  
Saber Soltani ◽  
Maziar Moradi-Lakeh ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Gastric Cancer ◽  
Systematic Review ◽  
Pancreatic Cancer ◽  
Wnt Pathway ◽  
Mapk Pathway ◽  
Meta Analysis ◽  
Signal Transduction Pathway ◽  
Transduction Pathway ◽  
Pooled Prevalence

Abstract The present study was conducted to evaluate the prevalence of the signaling pathways mutation rate in the Gastrointestinal (GI) tract cancers in a systematic review and meta-analysis study. The study was performed based on the PRISMA criteria. Random models by confidence interval (CI: 95%) were used to calculate the pooled estimate of prevalence via Metaprop command. The pooled prevalence indices of signal transduction pathway mutations in gastric cancer, liver cancer, colorectal cancer, and pancreatic cancer were 5% (95% CI: 3–8%), 12% (95% CI: 8–18%), 17% (95% CI: 14–20%), and 20% (95% CI: 5–41%), respectively. Also, the mutation rates for Wnt pathway and MAPK pathway were calculated to be 23% (95% CI, 14–33%) and 20% (95% CI, 17–24%), respectively. Moreover, the most popular genes were APC (in Wnt pathway), KRAS (in MAPK pathway) and PIK3CA (in PI3K pathway) in the colorectal cancer, pancreatic cancer, and gastric cancer while they were beta-catenin and CTNNB1 in liver cancer. The most altered pathway was Wnt pathway followed by the MAPK pathway. In addition, pancreatic cancer was found to be higher under the pressure of mutation compared with others based on pooled prevalence analysis. Finally, APC mutations in colorectal cancer, KRAS in gastric cancer, and pancreatic cancer were mostly associated gene alterations.

scholarly journals Comparison of Survival Benefits of Combined Chemotherapy and Radiotherapy Versus Chemotherapy Alone for Uterine Serous Carcinoma: A Meta-analysis

2016 ◽  
Vol 27 (1) ◽  
pp. 93-101 ◽  
Author(s):  
Yanying Lin ◽  
Jingyi Zhou ◽  
Yuan Cheng ◽  
Lijun Zhao ◽  
Yuan Yang ◽  
...  
Keyword(s):  
Overall Survival ◽  
Publication Bias ◽  
Meta Analysis ◽  
Serous Carcinoma ◽  
Cochrane Library ◽  
Combined Chemotherapy ◽  
Risk Of Death ◽  
Stage Disease ◽  
Uterine Serous Carcinoma ◽  
The Impact

ObjectiveTo date, there is no convincing evidence comparing the impact of combined chemotherapy and radiotherapy with chemotherapy alone in postoperative uterine serous carcinoma (USC), which remains an unclear issue. We conducted a meta-analysis assessing the impact of combined chemotherapy and radiotherapy compared to chemotherapy alone on overall survival in postoperative USC.MethodsA comprehensive search was performed in the databases of EMBASE, PubMed, Web of Science, and Cochrane Library from inception to March 2016. Studies comparing survival among patients who underwent combined chemotherapy and radiotherapy or chemotherapy alone after surgery for USC were included. Quality assessments were carried out by the Newcastle–Ottawa Scale. Hazard ratio (HR) for overall survival was extracted, and a random-effects model was used for pooled analysis. Publication bias was assessed using both funnel plot and the Egger regression test. Statistical analyses were performed using Stata version 13.0 software.ResultNine retrospective studies with relatively high quality containing 9354 patients were included for the final meta-analysis. The pooled results demonstrated that combined chemotherapy and radiotherapy significantly reduced the risk of death (HR, 0.72; P < 0.0001) compared to chemotherapy alone with a low heterogeneity (I2 = 21.0%, P = 0.256). Subgroup analyses indicated that calculating HR by unadjusted method may cause the heterogeneity among studies. Exploratory analyses showed that either patients with early stage disease (HR, 0.73; P = 0.011) or advanced stage disease (HR, 0.80; P < 0.0001) have survival benefits from combined chemotherapy and radiotherapy. No significant evidence of publication bias was found.ConclusionsThis is the first meta-analysis examining the role of combined chemotherapy and radiotherapy compared to chemotherapy alone in USC. Our results suggest the potential survival benefits of combined chemotherapy and radiotherapy. Further studies, preferably randomized clinical trials, are needed to confirm our results.

scholarly journals Impact of Physical Activity on Cancer-Specific and Overall Survival of Patients with Colorectal Cancer

2013 ◽  
Vol 2013 ◽  
pp. 1-6 ◽  
Author(s):  
Gaetan Des Guetz ◽  
Bernard Uzzan ◽  
Thierry Bouillet ◽  
Patrick Nicolas ◽  
Kader Chouahnia ◽  
...  
Keyword(s):  
Physical Activity ◽  
Colorectal Cancer ◽  
Overall Survival ◽  
Meta Analysis ◽  
Fixed Effect Model ◽  
Cochrane Library ◽  
Hazard Ratios ◽  
Effect Model ◽  
Keywords Colorectal Cancer ◽  
The Cochrane Library

Background. Physical activity (PA) reduces incidence of colorectal cancer (CRC). Its influence on cancer-specific (CSS) and overall survival (OS) is controversial.Methods. We performed a literature-based meta-analysis (MA) of observational studies, using keywords “colorectal cancer, physical activity, and survival” in PubMed and EMBASE. No dedicated MA was found in the Cochrane Library. References were cross-checked. Pre- and postdiagnosis PA levels were assessed by MET. Usually, “high” PA was higher than 17 MET hour/week. Hazard ratios (HRs) for OS and CSS were calculated, with their 95% confidence interval. We used more conservative adjusted HRs, since variables of adjustment were similar between studies. When higher PA was associated with improved survival, HRs for detrimental events were set to <1. We used EasyMA software and fixed effect model whenever possible.Results. Seven studies (8056 participants) were included, representing 3762 men and 4256 women, 5210 colon and 1745 rectum cancers. Mean age was 67 years. HR CSS for postdiagnosis PA (higher PA versus lower) was 0.61 (0.44–0.86). The corresponding HR OS was 0.62 (0.54–0.71). HR CSS for prediagnosis PA was 0.75 (0.62–0.91). The corresponding HR OS was 0.74 (0.62–0.89).Conclusion. Higher PA predicted a better CSS. Sustained PA should be advised for CRC. OS also improved (reduced cardiovascular risk).

scholarly journals Irreversible Electroporation in Patients with Pancreatic Cancer: How Important Is the New Weapon?

2018 ◽  
Vol 2018 ◽  
pp. 1-12 ◽  
Author(s):  
Guo Tian ◽  
Xueping Liu ◽  
Qiyu Zhao ◽  
Danxia Xu ◽  
Tian’an Jiang
Keyword(s):  
Pancreatic Cancer ◽  
Overall Survival ◽  
Fixed Effects ◽  
Large Scale ◽  
Meta Analysis ◽  
Irreversible Electroporation ◽  
Complete Response ◽  
Cochrane Library ◽  
Pooled Prevalence ◽  
Secondary Outcomes

Background. Pancreatic cancer (PC) is a deadly disease with poor prognosis in the general population. We aimed to quantitate overall survival of patients with PC after irreversible electroporation (IRE) and the incidence of relevant complications. Methods. We performed a literature search via five electronic databases (PubMed, Embase, Web of Science, Scopus, and Cochrane Library databases) up to August 2017. The primary outcomes were overall survival and prognosis. Secondary outcomes included the response of post-IRE complications. Fixed-effects or random-effects meta-analysis was conducted to pool these data. Results. A total of 15 eligible articles involving 535 patients were included. The primary outcomes showed that the pooled prevalence estimates of overall survival were 94.1% (95% CI: 90.7–97.5), 80.9% (95% CI: 72.5–89.4), 54.5% (95% CI: 38.3–70.6), and 33.8% (95% CI: 14.2–53.5) at 3, 6, 12, and 24 months, and the pooled prevalence data of complete response (CR) at 2 months, partial response (PR) at 3 months, and progression at 3 months were 12.5% (95% CI: 2.9–22.2), 48.5% (95% CI: 39.4–57.6), and 19.7% (95% CI: 7.3–32.2), respectively. The secondary outcomes showed that the pooled prevalence values of post-IRE complications were abscess 6.6% (95% CI: 0.2–13), fistula 10.6% (95% CI: 2.5–18.7), pain 33.5% (95% CI: 14.5–52.5), infection 16.1% (95% CI: 3.9–28.4), thrombosis 4.9% (95% CI: 1.2–8.5), pancreatitis 7.2% (95% CI: 3.1–11.2), bleeding 4.2% (95% CI: −0.5–8.9), cholangitis 4.2% (95% CI: −0.5–8.9), nausea 9.6% (95% CI: 4.4–14.8), biliary obstruction 13.8% (95% CI: 4.2–23.3), chest tightness 7.6% (95% CI: 0.5–14.6), and hypoglycemia 5.9% (95% CI: −0.4–12.2). Conclusions. This meta-analysis indicated a clear survival benefit for PC patients who received irreversible electroporation therapy, although future safety and effectivity monitoring from more large-scale studies will be needed.

scholarly journals Improved Overall Survival of Colorectal Cancer under Multidisciplinary Team: A Meta-Analysis

2021 ◽  
Vol 2021 ◽  
pp. 1-7
Author(s):  
Dong Peng ◽  
Yu-Xi Cheng ◽  
Yong Cheng
Keyword(s):  
Colorectal Cancer ◽  
Overall Survival ◽  
Multidisciplinary Team ◽  
Meta Analysis ◽  
Postoperative Mortality ◽  
Stage Iv ◽  
Cochrane Library ◽  
Stage Iv Colorectal Cancer ◽  
Significant Difference ◽  
Colorectal Cancer Patients

Purpose. The purpose of the current meta-analysis was to evaluate whether multidisciplinary team improved overall survival of colorectal cancer. Methods. PubMed, EMBASE, and Cochrane Library database were searched from inception to October 25, 2020. The hazard ratio (HR) and 95% confidence (CI) of overall survival (OS) were calculated. Results. A total of 11 studies with 30814 patients were included in this meta-analysis. After pooling the HRs, the MDT group was associated with better OS compared with the non-MDT group ( HR = 0.81 , 95% CI 0.69-0.94, p = 0.005 ). In subgroup analysis of stage IV colorectal cancer, the MDT group was associated with better OS as well ( HR = 0.73 , 95% CI 0.59-0.90, p = 0.004 ). However, in terms of postoperative mortality, no significant difference was found between MDT and non-MDT groups ( OR = 0.84 , 95% CI 0.44-1.61, p = 0.60 ). Conclusion. MDT could improve OS of colorectal cancer patients.

scholarly journals Partial Versus Total Omentectomy in Patients with Gastric Cancer: A Systemic Review and Meta-Analysis

Cancers ◽  
2021 ◽  
Vol 13 (19) ◽  
pp. 4971
Author(s):  
Shion Wei Chai ◽  
Suo-Hsien Wang ◽  
Chih-Yuan Wang ◽  
Yi-Chan Chen ◽  
Ruey-Shyang Soong ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Overall Survival ◽  
Meta Analysis ◽  
Disease Free Survival ◽  
Systemic Review ◽  
Cochrane Library ◽  
Free Survival ◽  
Significant Difference ◽  
Hospital Stays ◽  
Disease Free

Background: Surgical treatment is the key to cure localized gastric cancer. There is no strong evidence that supports the value of omentectomy. Thus, a meta-analysis was conducted to compare the safety and efficiency of partial and total omentectomy in patients with gastric cancer. Methods: PubMed, Embase, and Cochrane Library databases were searched. All studies that compared total and partial omentectomy as treatments for gastric cancer were included. The primary outcomes were patients’ overall survival and disease-free survival, while the secondary outcomes were perioperative outcome and postoperative complications. Results: A total of nine studies were examined, wherein 1043 patients were included in the partial omentectomy group, and 1995 in the total omentectomy group. The partial omentectomy group was associated with better overall survival (hazard ratio: 0.80, 95% CI: 0.66 to 0.98, p = 0.04, I2 = 0%), shorter operative time, and lesser blood loss than the total omentectomy group. In addition, no statistically significant difference was observed in the number of dissected lymph nodes, length of hospital stays, complication rate, and disease-free survival. Conclusions: Our results show that, compared with total omentectomy in gastric cancer surgery, partial omentectomy had non-inferior oncological outcomes and comparable safety outcomes.

Proximal gastrectomy versus total gastrectomy for adenocarcinoma of the esophagogastric junction: a meta-analysis

2019 ◽  
Vol 8 (10) ◽  
pp. 753-766 ◽  
Author(s):  
Yi-chuan Chen ◽  
Li Lu ◽  
Kai-hu Fan ◽  
Dao-han Wang ◽  
Wei-hua Fu
Keyword(s):  
Gastric Cancer ◽  
Overall Survival ◽  
Survival Rate ◽  
Total Gastrectomy ◽  
Recurrence Rate ◽  
Meta Analysis ◽  
Proximal Gastrectomy ◽  
Cochrane Library ◽  
Overall Survival Rate ◽  
Upper Third

Aim: To compare efficacy between total gastrectomy (TG) and proximal gastrectomy (PG) for upper-third gastric cancer. Materials & methods: PubMed, Embase and Cochrane library were searched to select suitable researches. Stata was used for meta-analysis including 5-year overall survival rate, recurrence rate, complication morbidities and serum nutritional levels. Results: Ten retrospective English researches were contained. Our study showed no significant difference of 5-year overall survival rate, recurrence rate, reflux symptoms and anastomotic leakage. TG experienced longer operation time, more lymph nodes-retrieved number, more estimated blood loss and higher ileus, but less anastomotic stricture. PG showed advantages over TG in terms of serum nutritional levels. Conclusion: PG is more preferable to TG for treatment of upper-third gastric cancer.

Sign in / Sign up

Export Citation Format

Share Document