scholarly journals P.049 Repeat surgery in recurrent glioblastoma: a systematic review and meta-analysis

2018 ◽  
Vol 45 (s2) ◽  
pp. S28-S28
Author(s):  
JZ Wang ◽  
F Nassiri ◽  
JH Badhiwala ◽  
G Zadeh
Keyword(s):  
Systematic Review ◽  
Overall Survival ◽  
Meta Analysis ◽  
Performance Status ◽  
Recurrent Glioblastoma ◽  
Repeat Surgery ◽  
Significant Survival Advantage ◽  
Initial Surgery ◽  
Significant Survival

Background: Recurrent glioblastoma portends a poor prognosis and the role of repeat surgery in improving survival remains uncertain. Our systematic review and meta-analysis aims to address whether re-resection provides a meaningful survival benefit and to what degree. Methods: Articles were collected from Pubmed, -CINAHL, EMBASE, Medline and Cochrane from January 1990 to 2018. Studies in the temozolomide era with both single surgery and re-resection cohorts were included. Primary outcomes were odds ratio for survival at 6, 12, and 24 months following re-resection and initial surgery. Results: Fourteen articles were included for analysis (3048 patients). Meta-analysis showed improved overall survival following re-resection at 6- (OR 1.73, 95% CI 1.23-2.45, p<0.05), 12- (OR 1.71, 95% CI 1.20-2.45, p<0.05), and 24-months (OR 2.24, 95% CI 1.01-4.95, p<0.05). Overall survival from diagnosis or first surgery was also improved in patients who underwent re-resection at -recurrence, similarly at 6- (OR 8.22, 95% CI 5.23-12.93, p<0.01), 12- (OR 4.16, 95% CI 3.25-5.36, p<0.01), and 24- (2.35, 95% CI 1.77-3.11, p<0.05) months. Subgroup analyses were done for patients stratified by age, performance status, and number of re-resections. Conclusions: Repeat surgery for recurrent glioblastoma is associated with a significant survival advantage independent of other salvage therapies that include chemotherapy, radiation, and other antineoplastic regimens.

scholarly journals The Role of Total Parenteral Nutrition in Patients with Peritoneal Carcinomatosis: A Systematic Review and Meta-Analysis

Cancers ◽  
2021 ◽  
Vol 13 (16) ◽  
pp. 4156
Author(s):  
Xing-Yi Sarah Ong ◽  
Rehena Sultana ◽  
Joey Wee-Shan Tan ◽  
Qiu Xuan Tan ◽  
Jolene Si Min Wong ◽  
...  
Keyword(s):  
Systematic Review ◽  
Overall Survival ◽  
Parenteral Nutrition ◽  
Peritoneal Carcinomatosis ◽  
Total Parenteral Nutrition ◽  
Median Overall Survival ◽  
Meta Analysis ◽  
Significant Survival Advantage ◽  
Significant Survival

Peritoneal carcinomatosis (PC) is often associated with malnutrition and an inability to tolerate enteral feeding. Although total parenteral nutrition (TPN) can be lifesaving for patients with no other means of nutritional support, its use in the management of PC patients remains controversial. Therefore, a systematic review and meta-analysis was performed to evaluate the benefit of TPN on the overall survival of PC patients, in accordance with PRISMA guidelines. A total of 187 articles were screened; 10 were included in this review and eight were included in the meta-analysis. The pooled median overall survival of patients who received TPN was significantly higher than patients who did not receive TPN (p = 0.040). When only high-quality studies were included, a significant survival advantage was observed in PC patients receiving TPN (p < 0.001). Subgroup analysis of patients receiving chemotherapy demonstrated a significant survival benefit (p = 0.008) associated with the use of TPN. In conclusion, TPN may improve survival outcomes in PC patients. However, further studies are needed to conclude more definitively on the effect of TPN.

scholarly journals Circulating MicroRNAs as Prognostic Molecular Biomarkers in Human Head and Neck Cancer: A Systematic Review and Meta-Analysis

2019 ◽  
Vol 2019 ◽  
pp. 1-12 ◽  
Author(s):  
Shree Ram Lamichhane ◽  
Thanuja Thachil ◽  
Harriet Gee ◽  
Natalie Milic
Keyword(s):  
Systematic Review ◽  
Overall Survival ◽  
Head And Neck Cancer ◽  
Head And Neck ◽  
Cancer Patients ◽  
Neck Cancer ◽  
Meta Analysis ◽  
Prognostic Role ◽  
Circulating Micrornas

Background. Circulating microRNAs (miRNAs) are potential molecular biomarkers for cancer detection; however, little is known about their prognostic role in head and neck cancer. This current study is aimed at evaluating the role of novel miRNAs in the survival of head and neck cancer patients. Materials and Methods. We performed a systematic literature search using online databases for articles published between December 2006 and February 2019. A meta-analysis was conducted to assess the correlation between miRNA expressions and overall survival (OS) among the selected head and neck cancer studies. After multilevel screening by reviewers, meta-analysis was performed using hazard ratios (HR) and associated 95% confidence interval (CI) of survival to calculate a pooled effect size. Result. A total of 1577 patients across 13 studies were included in the literature review, with 18 miRNAs upregulated and 4 miRNAs downregulated predicting a poor overall survival. The forest plot generated using cumulated survival data resulted in a pooled HR value of 2.943 (95% CI: 2.394-3.618) indicating a strong association of dysregulated miRNA expression with a poor outcome. Only 2 miRNAs—low levels of miR-9 and high levels of miR-483-5p—were observed in two studies, both showing a significant association with overall cancer survival. Conclusion. To our knowledge, this is the first comprehensive systematic review and meta-analysis that examines the prognostic role of circulating miRNAs from blood in head and neck cancer patients. The combined effect estimates a HR across multiple studies and also supports the previous individual findings that an alteration in miRNA expression is highly associated with poor prognosis. This has the potential to use serum and/or plasma miRNAs as biomarkers and become novel tools for predicting the prognosis of head and neck cancer patients in the near future.

scholarly journals Role of new Immunophenotypic Markers on Prognostic and Overall Survival of Acute Myeloid Leukemia: a Systematic Review and Meta-Analysis

2017 ◽  
Vol 7 (1) ◽  
Author(s):  
A. F. O. Costa ◽  
D. L. Menezes ◽  
L. H. S. Pinheiro ◽  
A. F. Sandes ◽  
M. A. P. Nunes ◽  
...  
Keyword(s):  
Systematic Review ◽  
Overall Survival ◽  
Acute Myeloid Leukemia ◽  
Myeloid Leukemia ◽  
Meta Analysis ◽  
Acute Myeloid

scholarly journals The prognostic role of microRNA in epithelial ovarian cancer: a systematic review of literature with an overall survival meta-analysis

Oncotarget ◽  
2020 ◽  
Vol 11 (12) ◽  
pp. 1085-1095 ◽  
Author(s):  
Patricia Ferreira ◽  
Rosimeire Aparecida Roela ◽  
Rossana Veronica Mendoza Lopez ◽  
Maria Del Pilar Estevez-Diz
Keyword(s):  
Systematic Review ◽  
Ovarian Cancer ◽  
Overall Survival ◽  
Epithelial Ovarian Cancer ◽  
Meta Analysis ◽  
Review Of Literature ◽  
Prognostic Role

Gemcitabine-based combinations (gem+x) vs gemcitabine (gem) alone in the treatment of advanced pancreatic cancer: a meta- analysis of sixteen randomized trials

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 4515-4515 ◽  
Author(s):  
V. Heinemann ◽  
A. Hinke ◽  
S. Böck ◽  
R. Labianca ◽  
C. Louvet
Keyword(s):  
Pancreatic Cancer ◽  
Combination Chemotherapy ◽  
Meta Analysis ◽  
Performance Status ◽  
Advanced Pancreatic Cancer ◽  
Hazard Ratio ◽  
Cytotoxic Agents ◽  
Randomised Trials ◽  
Significant Survival

4515 Background: Sixteen randomised trials have compared Gem-based combination chemotherapy to Gem alone in advanced and metastatic pancreatic cancer. This analysis was performed to better define the role of combination chemotherapy in pancreatic cancer. Methods: The meta-analysis included 16 studies comparing Gem vs. Gem+X. Fifteen trials were evaluable for survival, the primary end-point of the investigation. Overall, 4465 patients (pts) were included, 2222 pts in the Gem+X arm, and 2243 pts in the Gem arm). The analysis was predominantly based on published summary data. Results: Three groups were formed: combinations with platinum analogs, fluoropyrimidines, or other cytotoxic agents. Five trials evaluated platinum-based combinations (3 cisplatin, 2 oxaliplatin). The combined analysis indicated a hazard ratio (HR) of 0.85 (95% CI: 0.76–0.96) demonstrating a significant (p=0.010) superiority of the combination. Further 6 trials investigated the combination of Gem with fluoropyrimidines (3 5-FU, 3 capecitabine). Again, a significant superiority of the combination therapy was observed with a HR of 0.90 (95% CI: 0.81–0.99; p=0.030). Among the fluoropyrimidine combinations greatest homogeneity of results was observed in trials combining gemcitabine with capecitabine. In four randomised trials no improvement of survival was observed when Gem was combined with other cytotoxic agents such as pemetrexed, exatecan or irinotecan (HR=0.99; 95% CI: 0.88–1.10; p=0.80). When all 15 evaluable trials are taken together, an overall hazard ratio of HR=0.91 (95% CI: 0.85–0.97; p=0.004) was achieved. Five trials including 1682 pts provided adequate information on baseline performance status (PS). Combination chemotherapy had a marked benefit on survival in pts with a good PS (HR=0.76; 95%CI: 0.67 - 0.87; p<0.0001), while it was not more effective than Gem alone in pts with an initially poor PS (HR=1.08; 95% CI: 0.90 - 1.29). Conclusions: A meta-analysis of fifteen randomised trials indicated a significant survival benefit for Gem+X as compared to Gem alone when Gem was combined with either a platinum analog or capecitabine. This benefit was greatest in pts with a good PS, while no benefit was evident in poor PS pts. No significant financial relationships to disclose.

scholarly journals Role of New Immunophenotypic Markers on Prognostic and Overall Survival of Acute Lymphoblastic Leukaemia – A Systematic Review and Meta-analysis

2019 ◽  
Vol 15 (2) ◽  
pp. 113
Author(s):  
Wesley Messias Santos ◽  
Amanda Fernandes Oliveira Costa ◽  
Lucio Henrique Sousa Pinheiro ◽  
Nathanielly de Lima Silva ◽  
Alex Freire Sandes ◽  
...  
Keyword(s):  
Systematic Review ◽  
Overall Survival ◽  
Acute Lymphoblastic Leukaemia ◽  
Lymphoblastic Leukaemia ◽  
Meta Analysis

The role of altered long noncoding RNAs in overall survival of ovarian cancer: A systematic review and meta-analysis

2021 ◽  
Vol 219 ◽  
pp. 153363
Author(s):  
Elahe Seyed Hosseini ◽  
Marziyeh Alizadeh Zarei ◽  
Hamed Haddad Kashani ◽  
Alireza Milajerdi ◽  
Zahra Zare Dehghanani ◽  
...  
Keyword(s):  
Systematic Review ◽  
Ovarian Cancer ◽  
Overall Survival ◽  
Meta Analysis ◽  
Noncoding Rnas ◽  
Long Noncoding Rnas

scholarly journals The role of revision surgery and adjuvant therapy following subtotal resection of osteosarcoma of the spine: a systematic review with meta-analysis

2017 ◽  
Vol 27 (1) ◽  
pp. 97-104 ◽  
Author(s):  
Ganesh M. Shankar ◽  
Michelle J. Clarke ◽  
Tamir Ailon ◽  
Laurence D. Rhines ◽  
Shreyaskumar R. Patel ◽  
...  
Keyword(s):  
Systematic Review ◽  
Overall Survival ◽  
Radiation Therapy ◽  
Adjuvant Therapy ◽  
Revision Surgery ◽  
Meta Analysis ◽  
Adjuvant Radiation ◽  
En Bloc ◽  
Adjuvant Radiation Therapy

OBJECTIVEPrimary osteosarcoma of the spine is a rare osseous neoplasm. While previously reported retrospective studies have demonstrated that overall patient survival is impacted mostly by en bloc resection and chemotherapy, the continued management of residual disease remains to be elucidated. This systematic review was designed to address the role of revision surgery and multimodal adjuvant therapy in cases in which en bloc excision is not initially achieved.METHODSA systematic literature search spanning the years 1966 to 2015 was performed on PubMed, Medline, EMBASE, and Web of Science to identify reports describing outcomes of patients who underwent biopsy alone, neurological decompression, or intralesional resection for osteosarcoma of the spine. Studies were reviewed qualitatively, and the clinical course of individual patients was aggregated for quantitative meta-analysis.RESULTSA total of 16 studies were identified for inclusion in the systematic review, of which 8 case reports were summarized qualitatively. These studies strongly support the role of chemotherapy for overall survival and moderately support adjuvant radiation therapy for local control. The meta-analysis revealed a statistically significant benefit in overall survival for performing revision tumor debulking (p = 0.01) and also for chemotherapy at relapse (p < 0.01). Adjuvant radiation therapy was associated with longer survival, although this did not reach statistical significance (p = 0.06).CONCLUSIONSWhile the initial therapeutic goal in the management of osteosarcoma of the spine is neoadjuvant chemotherapy followed by en bloc marginal resection, this objective is not always achievable given anatomical constraints and other limitations at the time of initial clinical presentation. This systematic review supports the continued aggressive use of revision surgery and multimodal adjuvant therapy when possible to improve outcomes in patients who initially undergo subtotal debulking of osteosarcoma. A limitation of this systematic review is that lesions amenable to subsequent resection or tumors inherently more sensitive to adjuvants would exaggerate a therapeutic effect of these interventions when studied in a retrospective fashion.

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