miRNA Predictors of Pancreatic Cancer Chemotherapeutic Response: A Systematic Review and Meta-Analysis

Background: pancreatic cancer (PC) has increasing incidence and mortality in developing countries, and drug resistance is a significant hindrance to the efficacy of successful treatment. The objective of this systematic review and meta-analysis was to evaluate the association between miRNAs and response to chemotherapy in pancreatic cancer patients. Methods: the systematic review and meta-analysis was based on articles collected from a thorough search of PubMed and Science Direct databases for publications spanning from January 2008 to December 2018. The articles were screened via a set of inclusion and exclusion criteria based on the preferred reporting items for systematic review and meta-analysis (PRISMA) guidelines. Data was extracted, collated and tabulated in MS Excel for further synthesis. Hazard ratio (HR) was selected as the effect size metric to be pooled across studies for the meta-analysis, with the random effects model being applied. Subgroup analysis was also conducted, and the presence of publication bias in the selected studies was assessed. Publication bias of the included studies was quantified. Findings: of the 169 articles screened, 43 studies were included in our systematic review and 13 articles were included in the meta-analysis. Gemcitabine was observed to be the principal drug used in a majority of the studies. A total of 48 miRNAs have been studied, and 18 were observed to have possible contributions to chemoresistance, while 15 were observed to have possible contributions to chemosensitivity. 41 drug-related genetic pathways have been identified, through which the highlighted miRNA may be affecting chemosensitivity/resistance. The pooled HR value for overall survival was 1.603; (95% Confidence Interval (CI) 1.2–2.143; p-value: 0.01), with the subgroup analysis for miR-21 showing HR for resistance of 2.061; 95% CI 1.195–3.556; p-value: 0.09. Interpretation: our results highlight multiple miRNAs that have possible associations with modulation of chemotherapy response in pancreatic cancer patients. Further studies are needed to discover the molecular mechanisms underlying these associations before they can be suggested for use as biomarkers of response to chemotherapeutic interventions in pancreatic cancer.

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A Systematic Review and Meta-analysis to Determine the Effect of Oral Anticoagulants on Incidence of Dementia in Patients with Atrial Fibrillation

10.22541/au.161555710.03366973/v1 ◽

2021 ◽

Author(s):

Mingjie Lin ◽

Wenqiang Han ◽

Jingquan Zhong ◽

Lin Wu

Keyword(s):

Atrial Fibrillation ◽

Systematic Review ◽

Publication Bias ◽

Subgroup Analysis ◽

Meta Analysis ◽

Significant Risk ◽

Risk Of Bias ◽

Cochrane Library ◽

Adjusted Risk ◽

Incidence Of Dementia

Aims: To assess the effect of oral anticoagulant (OAC) administration on incidence of dementia in patients with atrial fibrillation (AF) with Systematic review and meta-analysis in according with the Preferred Reporting Items for Systematic Review and Meta-analysis Protocols. Methods: We systematically searched the electronic databases including Pubmed, Embase, Cochrane library, and ClinicalTrails.gov for relevant articles. The primary outcome was the incidence of dementia. The adjusted risk ratio (RR), odds ratio, or hazard ratio were extracted and pooled by the random-effects models. Subgroup analysis was performed according to the setting observational window. Risk of bias was assessed using the Newcastle-Ottawa Scale, while publication bias was assessed by the Begg’s and Egger’s tests. Results: Nine studies included in this review (2 prospective and 7 retrospective observational studies, including 613,920 patients). The results presented the significant association between OAC therapy and the reduced risk of dementia compared with no treatment (RR [95%CI] =0.72 [0.60, 0.86], I2=97.2%; P =0.000). In the subgroup analysis, the pooled RR became statistically non-significant (including four studies, RR [95%CI] =0.75 [0.51, 1.10], I2=98.8%; P =0.000). There is no significant risk of bias and publication bias. Conclusions: This study indicated the protective effect of OAC therapy for dementia in patients with AF. However, the results are limited because of high heterogeneity, inconsistent direction of effect in subgroup analysis. Further prospective well-designed study is needed with longer follow-up duration in younger patients.

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Correlation between body mass index and two-stage revision failure of periprosthetic joint infection following total joint arthroplasty: A systematic review and meta-analysis

Journal of Orthopaedic Surgery ◽

10.1177/23094990211055231 ◽

2021 ◽

Vol 29 (3) ◽

pp. 230949902110552

Author(s):

Junbiao Guo ◽

Shuxu Wu ◽

Huimin Wang ◽

Wenzhi Chen ◽

Xiaoqiang Deng

Keyword(s):

Systematic Review ◽

Body Mass Index ◽

Publication Bias ◽

Periprosthetic Joint Infection ◽

Total Joint Arthroplasty ◽

Subgroup Analysis ◽

Meta Analysis ◽

Joint Infection ◽

Joint Arthroplasty ◽

Two Stage

Background: Although the correlation between body mass index (BMI) and two-stage revision failure of periprosthetic joint infection (PJI) following total joint arthroplasty (TJA) have been frequently reported, the results remain controversial. Therefore, the correlation between them was systematically evaluated and meta-classified in this study. Methods: Literature on the correlation between BMI and two-stage revision failure of PJI following TJA was retrieved in PubMed, Embase and Cochrane Library due May 2020. Stata 13.0 software and Cochrane Collaboration Review Manager software (RevMan version 5.3) were applied to data synthesis, subgroup analysis, analyses of publication bias, and sensitivity. Results: A total of 15 observational studies included 1267 patients, of which 15 studies were included in systematic review and 11 studies in meta-analysis. Eight studies found a correlation between BMI and two-stage revision failure of PJI following TJA, but seven other studies found no correlation. Meta-analysis found that the risk of two-stage revision failure of PJI following TJA significantly boosted by 3.53 times in patients with BMI ≥ 30 kg/m2 (OR = 3.53; 95% CI = 1.63–7.64 for the BMI ≥ 30 kg/m2 vs. BMI < 30 kg/m2) and the risk of two-stage revision failure of PJI following TJA significantly increased by 2.92 times in patients with BMI ≥ 40 kg/m2 ( OR = 2.92; 95% CI = 1.06–8.03 for the BMI ≥ 40 kg/m2 vs. BMI < 30 kg/m2). The subgroup analysis showed that significant association was observed among the studies performed in TKA ( OR = 3.63; 95% CI = 2.27–5.82), but not among those conducted in THA ( OR = 3.06; 95% CI = 0.42–22.19). A significant association remained consistent, as indicated by sensitivity analyses. Because there are too few studies that can be combined in the included studies, Egger’s and Begg’s tests were not performed. Conclusion: Meta-analysis suggests that the risk of two-stage revision failure of PJI following TJA significantly boosted in obese patients. However, because there may be publication bias of this study, combined overall systematically evaluated and meta-analysis results, we cannot yet conclude that BMI is associated with two-stage revision failure of PJI following TJA.

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Variation in outcome of invasive mechanical ventilation between different countries for patients with severe COVID-19: a systematic review and meta-analysis

10.21203/rs.3.rs-52224/v1 ◽

2020 ◽

Author(s):

Hany Hasan Elsayed ◽

Aly Sherif Hassaballa ◽

Taha Aly Ahmed ◽

Mohamed Gumaa ◽

Hazem Youssef Sharkawy

Keyword(s):

Systematic Review ◽

Mechanical Ventilation ◽

Publication Bias ◽

Risk Ratio ◽

Mortality Risk ◽

Subgroup Analysis ◽

Meta Analysis ◽

Invasive Mechanical Ventilation ◽

Random Effect ◽

Meta Regression

Abstract Background: COVID 19 is the most recent cause of Adult respiratory distress syndrome ARDS. Invasive mechanical ventilation IMV can support gas exchange in patients failing non-invasive ventilation, but its reported outcome is highly variable between countries. We conducted a systematic review and meta-analysis on IMV for COVID-associated ARDS to study its outcome among different countries.Methods: CENTRAL, MEDLINE/PubMed, Cochrane Library, and Scopus were systematically searched from June 8 2019 to June 8, 2020. Studies reporting five or more patients with end point outcome for severe COVID 19 infection treated with IMV were included. The main outcome assessed was mortality. Baseline, procedural, outcome, and validity data were systematically appraised and pooled with random-effect methods. Subgroup analysis for different countries was performed. Meta-regression for the effect of study timing and patient age and were tested. Publication bias was examined. This trial was registered with PROSPERO under registration number CRD42020190365Findings: Our electronic search retrieved 4770 citations, 103 of which were selected for full-text review. Twenty-one studies with a combined population of 37359 patients with COVID-19 fulfilled the inclusion criteria. From this population, 5800 patients were treated by invasive mechanical ventilation. Out of those, 3301 patients reached an endpoint of ICU discharge or death after invasive mechanical ventilation while the rest were still in the ICU. Mortality from IMV was highly variable among the included studies ranging between 21% and 100%. Random-effect pooled estimates suggested an overall in-hospital mortality risk ratio of 0.70 (95% confidence interval 0.608 to 0.797; I2 = 98%). Subgroup analysis according to country of origin showed homogeneity in the 8 Chinese studies with high pooled mortality risk ratio of 0.97 (I2 = 24%, p=0.23) (95% CI = 0.94-1.00), similar to Italy with a low pooled mortality risk ratio of 0.26 (95% CI 0.08-0.43) with homogeneity (p=0.86) while the later larger studies coming from the USA showed pooled estimate mortality risk ratio of 0.60 (95% CI 0.43-0.76) with persistent heterogeneity (I2 = 98%, p<0.001). Meta-regression showed that outcome from IMV improved with time (p<0.001). Age had no statistically significant effect on mortality (p= 0.102). Publication bias was excluded by visualizing the funnel plot of standard error, Egger's test with p=0.714 and Begg&Mazumdar test with p=0.334Interpretation: The study included the largest number of patients with outcome findings of IMV in this current pandemic. Our findings showed that the use of IMV for selected COVID 19 patients with severe ARDS carries a high mortality, but outcome has improved over the last few months and in more recent studies. The results should encourage physicians to use this facility when indicated for severely ill COVID-19 patients.

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Rectal Cancer: 20% Risk Reduction Thanks to Dietary Fibre Intake. Systematic Review and Meta-Analysis

Nutrients ◽

10.3390/nu11071579 ◽

2019 ◽

Vol 11 (7) ◽

pp. 1579 ◽

Cited By ~ 8

Author(s):

Vincenza Gianfredi ◽

Daniele Nucci ◽

Tania Salvatori ◽

Giulia Dallagiacoma ◽

Cristina Fatigoni ◽

...

Keyword(s):

Systematic Review ◽

Rectal Cancer ◽

Publication Bias ◽

Dietary Fibre ◽

Meta Analysis ◽

P Value ◽

Computer Search ◽

Fibre Intake ◽

Statistical Heterogeneity ◽

Dietary Fibre Intake

The aim of this systematic review and meta-analysis was to evaluate the association between dietary fibre intake and rectal cancer (RC) risk. In January 2019, a structured computer search on PubMed/Medline, Excerpta Medica dataBASE (EMBASE) and Scopus was performed for studies reporting the results of primary research evaluating dietary fibre intake in women and men as well as the risk of developing RC. Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) recommendations were followed. Highest vs. lowest fibre concentrations was compared. The Egger test was used to estimate publication bias. Heterogeneity between studies was evaluated with I2 statistics. The search strategy identified 912 papers, 22 of which were included in our meta-analysis. Having evaluated a total of 2,876,136 subjects, the results suggest a protective effect of dietary fibre intake on RC prevention. The effect Size (ES) was [0.77 (95% CI = 0.66–0.89), p-value = 0.001)]. Moderate statistical heterogeneity (Chi2 = 51.36, df = 21, I2 = 59.11%, p-value = 0.000) was found. However, no publication bias was found, as confirmed by Egger’s linear regression test (Intercept −0.21, t = −0.24, p = 0.816). The findings suggest that dietary fibre intake could be protective against RC, with a clinically relevant reduction of RC risk. Identifying preventive measures to avoid the development of RC, especially by following a healthy lifestyle including healthy diet, is pivotal.

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Predictive role of skin rash in advanced pancreatic cancer patients treated with gemcitabine plus erlotinib: a systematic review and meta-analysis

OncoTargets and Therapy ◽

10.2147/ott.s168418 ◽

2018 ◽

Vol Volume 11 ◽

pp. 6633-6646

Author(s):

Minyan Zeng ◽

Qi Feng ◽

Ming Lu ◽

Jun Zhou ◽

Zuyao Yang ◽

...

Keyword(s):

Systematic Review ◽

Pancreatic Cancer ◽

Cancer Patients ◽

Skin Rash ◽

Meta Analysis ◽

Advanced Pancreatic Cancer ◽

Predictive Role

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Clinical and Prognostic Implications of P21 (WAF1/CIP1) Expression in Patients with Esophageal Cancer: A Systematic Review and Meta-Analysis

Disease Markers ◽

10.1155/2020/6520259 ◽

2020 ◽

Vol 2020 ◽

pp. 1-12 ◽

Cited By ~ 1

Author(s):

Junbo Wu ◽

Liang Liu ◽

Feng Wu ◽

Li Qiu ◽

Ming Luo ◽

...

Keyword(s):

Systematic Review ◽

Esophageal Cancer ◽

Prognostic Factor ◽

Clinical Outcomes ◽

Publication Bias ◽

Malignant Tumors ◽

Meta Analysis ◽

Clinical Stage ◽

Clinicopathological Characteristics ◽

Response To Chemotherapy

Background. Previous studies have demonstrated that P21 (WAF1/CIP1) is a valuable prognostic factor in several malignant tumors. However, it is not known whether P21 can predict the prognosis in patients with esophageal cancer (EC). The aim of this research was to investigate the contribution of P21 expression to the clinicopathological characteristics and of EC. Methods. A systematic review and meta-analysis of study focusing on P21 expression, clinicopathological characteristics, and clinical outcomes in patients with EC was performed using seven databases (PubMed, Embase, Web of Science, and four Chinese databases). Pooled hazard ratios and odds ratios were used to explore the association between P21 expression, clinicopathological characteristics, and outcomes in patients with EC. The heterogeneity of the studies was classified by the I2 statistic. The sensitivity analysis was then utilized to assess the robustness of the results. Finally, the funnel plot and Begg’s test were used to evaluate the publication bias. Results. Forty-five studies with 3098 patients were eligible for inclusion in the meta-analysis. Thirty of these studies reported on clinicopathological characteristics and 15 on clinical outcomes. The pooled hazard ratio of 1.456 (95% confidence intervals 1.033–2.053, P=0.032) for overall survival indicated that a low P21 expression level was an unfavorable prognostic factor for a clinical outcome in patients with EC. Furthermore, the pooled odds ratio confirmed an association between decreased P21 expression and poor clinicopathological characteristics, including differentiation, lymph node metastasis, invasion, and higher grade and clinical stage. Notably, high P21 expression was a significant predictor of a favorable response to chemotherapy. There was no evidence of publication bias. Conclusion. Reduced P21 expression is associated with a poor outcome in patients with EC.

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Statins Use and Overall Survival in Pancreatic Cancer Patients: A Systematic Review and Meta-Analysis

Gastroenterology ◽

10.1016/s0016-5085(17)31225-8 ◽

2017 ◽

Vol 152 (5) ◽

pp. S277-S278

Author(s):

Srikar R. Mapakshi ◽

Jennifer R. Kramer ◽

Kathryn E. Royse ◽

Elizabeth Chiao ◽

Jose M. Garcia ◽

...

Keyword(s):

Systematic Review ◽

Pancreatic Cancer ◽

Overall Survival ◽

Cancer Patients ◽

Meta Analysis

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Primary Thromboprophylaxis in Ambulatory Pancreatic Cancer Patients Receiving Chemotherapy: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Cancers ◽

10.3390/cancers12082028 ◽

2020 ◽

Vol 12 (8) ◽

pp. 2028 ◽

Cited By ~ 1

Author(s):

Corinne Frere ◽

Benjamin Crichi ◽

Barbara Bournet ◽

Cindy Canivet ◽

Nassim Ait Abdallah ◽

...

Keyword(s):

Systematic Review ◽

Pancreatic Cancer ◽

Cancer Patients ◽

Meta Analysis ◽

Random Effect ◽

Random Effect Model ◽

Phase Iii ◽

Number Needed To Treat ◽

Randomized Controlled ◽

Randomized Controlled Studies

Patients with pancreatic cancer (PC) carry the highest risk of venous thromboembolism (VTE) amongst all cancer patients. Appropriate use of primary thromboprophylaxis might significantly and safely reduce its burden. We performed a systematic review of published studies and meeting abstracts using MEDLINE and EMBASE through July 2020 to evaluate the efficacy and safety of primary thromboprophylaxis in ambulatory PC patients receiving chemotherapy. The Mantel–Haenszel random effect model was used to estimate the pooled event-based risk ratio (RR) and the pooled absolute risk difference (RD) with a 95% confidence interval (CI). Five randomized controlled studies with 1003 PC patients were included in this meta-analysis. Compared to placebo, thromboprophylaxis significantly decreased the risk of VTE (pooled RR 0.31, 95% CI 0.19–0.51, p < 0.00001, I2 = 8%; absolute RD −0.08, 95% CI −0.12–−0.05, p < 0.00001, I2 = 0%), with an estimated number needed to treat of 11.9 patients to prevent one VTE event. Similar reductions of VTE were observed in studies with parenteral (RR 0.30, 95% CI 0.17–0.53) versus oral anticoagulants (RR 0.37, 95% CI 0.14–0.99) and in studies using prophylactic doses of anticoagulants (RR 0.34, 95% CI 0.17–0.70) versus supra-prophylactic doses of anticoagulants (RR 0.27, 95% CI 0.08–0.90). The pooled RR for major bleeding was 1.08 (95% CI 0.47–2.52, p = 0.85, I2 = 0%) and the absolute RD was 0.00 (95% CI −0.02–0.03, p = 0.85, I2 = 0%). Evidence supports a net clinical benefit of thromboprophylaxis in ambulatory PC patients receiving chemotherapy. Adequately powered randomized phase III studies assessing the most effective anticoagulant and the optimal dose, schedule and duration of thromboprophylaxis to be used are warranted.

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Dietary Fibre Protective against Colorectal Cancer Patients in Asia: A Meta-Analysis

Open Access Macedonian Journal of Medical Sciences ◽

10.3889/oamjms.2019.265 ◽

2019 ◽

Vol 7 (10) ◽

pp. 1723-1727 ◽

Cited By ~ 1

Author(s):

Masrul Masrul ◽

Ricvan Dana Nindrea

Keyword(s):

Colorectal Cancer ◽

Systematic Review ◽

Cancer Patients ◽

Publication Bias ◽

Dietary Fibre ◽

Meta Analysis ◽

Random Effect ◽

Colorectal Cancer Patients ◽

Published Research ◽

Random Effect Models

BACKGROUND: The association between dietary fibre and colorectal cancer risk is controversial. AIM: This systematic review and meta-analysis were performed to determine the dietary fibre protective against colorectal cancer patients in Asia. METHODS: The authors conducted a meta-analysis of published research articles on dietary fibre protective against colorectal cancer patients in Asia published between January 2000 and March 2019 in the online article databases of PubMed, ProQuest and EBSCO. Pooled odds ratios (OR) were calculated with fixed and random-effect models. Publication bias was visually evaluated by using funnel plots and statistically assessed through Egger’s and Begg’s tests. Data were processed using Review Manager 5.3 (RevMan 5.3) and Stata version 14.2 (Stata Corporation). RESULTS: This study reviewed 405 articles. There are 10 studies conducted a systematic review and continued with Meta-analysis of relevant data with several sample 49,964 patients. The results showed dietary fibre protective against colorectal cancer patients in Asia (OR = 0.66 [95% CI 0.56-0.77, p=0.008]). There was significant publication bias for studies included in dietary fibre protective against colorectal cancer patients in Asia. CONCLUSION: This analysis confirmed dietary fibre protective against colorectal cancer patients in Asia.

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