scholarly journals Pretreatment Lymphocyte Monocyte Ratio Predicts Long-Term Outcomes in Patients with Digestive System Tumor: A Meta-Analysis

2016 ◽  
Vol 2016 ◽  
pp. 1-11 ◽  
Author(s):  
Jingwen Zhang ◽  
Lishan Chen ◽  
Rui Zhou ◽  
Huiying Sun ◽  
Yulin Liao ◽  
...  
Keyword(s):  
Digestive System ◽  
Meta Analysis ◽  
Disease Recurrence ◽  
Sensitivity Analyses ◽  
Prognostic Impact ◽  
Cancer Specific Survival ◽  
Digestive System Cancer ◽  
Hazard Ratios ◽  
System Tumor

Purpose.The prognostic value of pretreatment lymphocyte monocyte ratio (LMR) in digestive system cancer patients remains controversial. The aim of this study was to quantify the prognostic impact of this biomarker and assess its consistency in digestive system tumors.Methods.We searched “PubMed,” “Embase,” and “CBM” for published eligible studies before June 2016 and conducted a meta-analysis to estimate the pooled hazard ratios (HRs) for disease recurrence and mortality focusing on LMR. Subgroup analyses, meta-regression, and sensitivity analyses were also performed.Results.A total of 22 cohort studies enrolling 12829 patients with digestive system cancer were included. The summary results showed that lower LMR was significantly associated with worse overall survival (OS), cancer-specific survival (CSS), and tumor disease or recurrence-free survival (DFS/RFS) in analyses using the studies reporting HRs either by the univariate analyses (HR = 1.32, HR = 1.35, and HR = 1.26 for OS, CSS, and DFS/RFS, resp.) or by multivariate analyses (HR = 1.21, HR = 1.18, and HR = 1.26 for OS, CSS, and DFS/RFS, resp.).Conclusion.Our results support the fact that decreased LMR indicates worse prognosis in multiple digestive system tumors.

Abstract 13315: Long-term Risk of Cardiovascular Events Following Hospitalization for Sepsis: A Systematic Review and Meta-analysis

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Leah B Kosyakovsky ◽  
Federico Angriman ◽  
Emma Katz ◽  
Neill Adhikari ◽  
Lucas C Godoy ◽  
...  
Keyword(s):  
Systematic Review ◽  
Cumulative Incidence ◽  
Meta Analysis ◽  
Hazard Ratios ◽  
Increased Risk ◽  
Significant Difference ◽  
Sepsis Survivors ◽  
Risk Ratios

Introduction: Sepsis results in dysregulated inflammation, coagulation, and metabolism, which may contribute to increased cardiovascular disease (CVD) risk. We conducted a systematic review and meta-analysis to determine the association between sepsis and subsequent long-term CVD events. Methods: MEDLINE, Embase, and the Cochrane Controlled Trials Register and Database of Systematic Reviews were searched from inception to May 2020 to identify observational studies of adult sepsis survivors (defined by diagnostic codes or consensus definitions) measuring long-term CV outcomes. The primary outcome was a composite of myocardial infarction, CV death, and stroke. Random-effects models estimated the pooled cumulative incidence and adjusted hazard ratios of CV events relative to hospital or population controls. Odds ratios were included as risk ratios assuming <10% incidence in non-septic controls, and risk ratios were taken as hazard ratios (HR) assuming no censoring. Outcomes were analyzed at maximum follow-up (primary analysis) and stratified by time (<1 year, 1-2 years, and >2 years) since sepsis. Results: Of 11,235 abstracts screened, 25 studies (22 cohort studies, 2 case-crossover studies, and 1 case-control) involving 1,949,793 sepsis survivors were included. The pooled cumulative incidence of CVD events was 9% (95% CI; 5-14%). Sepsis was associated with an increased risk (HR 1.59, 95% CI 1.37-1.86) of CVD events at maximum follow-up ( Figure ); between-study heterogeneity was substantial (I 2 =97.3%). There was no significant difference when comparing studies using population and hospital controls. Significantly elevated risk was observed up to 5 years following sepsis. Conclusions: Sepsis survivors experience an approximately 50% increased risk of CVD events, which may persist for years following the index episode. These results highlight a potential unmet need for early cardiac risk stratification and optimization in sepsis survivors.

The impact of myosteatosis on outcomes following surgery for gastro-intestinal malignancy: A systematic review and meta-analysis.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e15540-e15540
Author(s):  
Andrew MacCormick ◽  
Mark Puckett ◽  
Adam Streeter ◽  
Somaiah Aroori
Keyword(s):  
Systematic Review ◽  
Meta Analysis ◽  
Group Analysis ◽  
Long Term Outcomes ◽  
Cancer Specific Survival ◽  
Mesh Terms ◽  
Similar Term ◽  
Colorectal Cancer Patients ◽  
The Impact

e15540 Background: Recent research has demonstrated the impact that body composition parameters can have on the outcomes following cancer surgery. Adipose tissue deposition in muscle, known as myosteatosis, can be detected on pre-operative imaging. This systematic review aims to analyse the impact of pre-operative myosteatosis on long-term outcomes following surgery for gastro-intestinal malignancy. Methods: Using MeSH terms, a systematic search of the databases PubMed MEDLINE, EMBASE, Cochrane, CINAHL and AMED was performed. Studies were included if they reported hazard ratios (HR) analysing the impact of pre-operatively defined myosteatosis, or similar term, on the long-term outcomes following surgery for gastro-intestinal malignancy. A total of 39 full texts articles were reviewed for inclusion, with 19 being included after the inclusion criteria were applied. A sub-group analysis was performed for those studies reporting outcomes for colorectal cancer patients only. Results: The total number of included patients across all studies was 14,481. Patients with myosteatosis had a significantly poorer overall survival, according to univariate (HR 1.82, 95% CI 1.67 – 1.99) and multivariable (HR 1.66, 95% CI 1.49 – 1.86) analysis. This was also demonstrated with regards to cancer-specific survival (univariate HR 1.62, 95% CI 1.18 – 2.22, multivariable HR 1.73, 95% CI 1.48 – 2.03) and recurrence-free survival (univariate HR 1.28, 95% CI 1.10 – 1.48, multivariable HR 1.38, 95% CI 1.07 – 1.77). Conclusions: This review demonstrates that patients with pre-operative myosteatosis have poorer long-term outcomes following surgery for gastro-intestinal malignancy. Therefore, myosteatosis should be used for pre-operative optimisation and as a prognostic tool before surgery. More standardised definitions of myosteatosis and further cohort studies of patients with non-colorectal malignancies are required.

scholarly journals Prognostic and predictive values of PD-L1 expression in patients with digestive system cancer: a meta-analysis

2017 ◽  
Vol Volume 10 ◽  
pp. 3625-3634 ◽  
Author(s):  
Cong Dai ◽  
Meng Wang ◽  
Jun Lu ◽  
Zhiming Dai ◽  
Shuai Lin ◽  
...  
Keyword(s):  
Digestive System ◽  
Meta Analysis ◽  
Predictive Values ◽  
Digestive System Cancer

The prognostic relevance of 14-3-3 expression in cancers: a meta-analysis

2021 ◽  
pp. 1-9
Author(s):  
Caihong Li ◽  
Honglan Zhu ◽  
Changlu Liu ◽  
Ya Liu ◽  
Ting Huang ◽  
...  
Keyword(s):  
Cancer Patients ◽  
Meta Analysis ◽  
Disease Free Survival ◽  
Size Analysis ◽  
Tumor Type ◽  
Cancer Specific Survival ◽  
Free Survival ◽  
Hazard Ratios ◽  
Prognostic Importance ◽  
Patient Prognosis

AbstractObjective: A number of recent clinical studies have identified a relationship between elevated expressions of 14-3-3 and poorer patient prognosis in the context of several cancers. The present meta-analysis was therefore conducted to gain an enhanced understanding of the prognostic importance of 14-3-3 levels in cancer patients. Methods: Two reviewers independently systematically reviewed the Web of Science, Embase, and PubMed databases to identify published, suitable studies through October 2019. The correlation between the level of 14-3-3 and cancer patient survival were assessed based upon pooled HR (hazard ratios) and 95% CI (confidence intervals) derived from chosen studies. Results: In total we were able to identify 22 eligible studies that had enrolled 2676 patients in the present meta-analysis. Assessment of these studies revealed that elevated 14-3-3 level correlated significantly with poorer OS (overall survival) (HR : 1.93, 95% CI : 1.42-2.61) in cancer patients. This was true even when studies were analyzed in subgroups according to tumor type, sample size, analysis type, and method of HR determination. With respect to disease-free survival (DFS), the pooled HR for cancer patients expressing high levels of 14-3-3 was 1.89 (95% CI: 1.56-2.30). Patients with elevated 14-3-3 expression also exhibited reduced CSS (cancer-specific survival) (HR: 3.47, 95% CI: 2.12-5.69).Conclusions: The outcomes indicate that higher level of 14-3-3 correlates with poorer patient prognosis in a range of cancer types.Keywords: Meta-analysis, Prognosis, 14-3-3 Proteins C Continuous...

Network meta-analysis (NMA) of immuno-oncology (IO) monotherapy as first-line (1L) treatments (txs) for advanced non-small cell lung cancer (NSCLC) with PD-L1 expression ≥50%.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e21091-e21091
Author(s):  
Nicholas Freemantle ◽  
Yingxin Xu ◽  
Florence Wilson ◽  
Patricia Guyot ◽  
Chieh-I Chen ◽  
...  
Keyword(s):  
Advanced Nsclc ◽  
Meta Analysis ◽  
Objective Response ◽  
Progression Free Survival ◽  
Standard Of Care ◽  
Sensitivity Analyses ◽  
Current Standard ◽  
Feasibility Assessment ◽  
Hazard Ratios ◽  
Nsclc Patients

e21091 Background: For advanced NSCLC patients (pts) with high (≥50%) PD-L1 expression, effective IO mono options with survival benefits are approved (pembrolizumab mono, current standard of care) and emerging (cemiplimab). In a recent Phase 3 trial, cemiplimab, a high-affinity, highly potent human PD-1 inhibitor approved for tx of advanced cutaneous squamous cell carcinoma, demonstrated significantly improved overall survival (OS) and progression-free survival (PFS) vs chemotherapy (CT) in advanced NSCLC pts with PD-L1 ≥50%. A systematic literature review and NMA were conducted to identify/compare the efficacy/safety from randomized controlled trials (RCTs) for cemiplimab vs pembrolizumab or other IO mono published 2010–19. Methods: Relevant RCTs were identified by searching Embase, MEDLINE, Cochrane, and conference proceedings with predefined search strategies according to ISPOR, NICE, and PRISMA guidelines. An NMA with time-varying hazard ratios (HRs) was performed for OS and PFS. Analyses were conducted for objective response rate (ORR), Grade (G) 3–5 all-cause adverse events (AE), G3–5 immune-mediated AE (IMAE) and discontinuation due to AEs (DAE). Fixed-effect models were used due to limited evidence. Results with standard constant HRs and various sensitivity analyses were conducted to account for differences in RCT designs and other txs. Results: The feasibility assessment determined that EMPOWER-Lung 1, KEYNOTE-024, and KEYNOTE-042 trials were eligible. IMpower110 was excluded since an incompatible PD-L1 assay (SP142) was used for pt selection. For 1L advanced NSCLC with PD-L1 ≥50%, cemiplimab was associated with significantly greater PFS and ORR, and comparable OS, G3–5 AEs, IMAEs, and all-cause DAEs vs pembrolizumab (Table). At 2 yrs, numerically more pts receiving cemiplimab vs pembrolizumab were alive (59% vs 49%) and significantly more were alive w/o progression (37% vs 18%). Conclusions: In advanced NSCLC pts with PD-L1 ≥50%, cemiplimab mono demonstrated significant improvements in PFS and ORR, and comparable OS, safety/tolerability vs pembrolizumab.[Table: see text]

Meta-Analysis of Long-Term Outcomes in Patients with Colorectal Liver Metastases Undergoing Hepatectomy with or without Radiofrequency Ablation

2018 ◽  
Vol 84 (12) ◽  
pp. 1913-1923
Author(s):  
Li Long ◽  
Li Wei ◽  
Wu Hong
Keyword(s):  
Radiofrequency Ablation ◽  
Liver Metastases ◽  
Colorectal Liver Metastases ◽  
Meta Analysis ◽  
Disease Free Survival ◽  
Medical Subject Headings ◽  
Long Term Outcomes ◽  
Hazard Ratios ◽  
Long Term Prognosis

This meta-analysis aimed to compare the long-term prognosis of patients with colorectal liver metastases undergoing liver resection (LR) with or without radiofrequency ablation (RFA). A systematic search was performed using both medical subject headings and truncated word searches to identify all comparative studies published on this topic. The primary outcomes were postoperative overall survival (OS) and disease-free survival (DFS). Pooled hazard ratios (HR) with 95 per cent confidence intervals (95% CI) were calculated. A total of 10 studies which included 3900 patients were finally enrolled in the meta-analysis. Patients treated by LR gained better OS (HR: 2.07, 95% CI: 1.82–2.37) and DFS (HR: 1.91, 95% CI: 1.70–2.15) than those patients treated by LR 1 RFA, after pooling unadjusted HRs from the 10 studies. Five studies provided the data of adjusted HR. The pooled results showed that patients in the LR 1 RFA group had shorter OS (HR: 1.66, 95% CI: 1.18–2.32, P = 0.004) but similar DFS (HR: 1.36, 95% CI: 0.99–1.88) compared with patients in the LR group. Our meta-analysis showed that colorectal liver metastases patients who underwent LR gained better long-term outcomes compared with patients undergoing LR 1 RFA. However, after adjusting confounders, LR 1 RFA achieved comparable DFS with LR alone.

Randomized controlled trials (RCTs) examining continuous (CS) versus intermittent strategies (IS) of delivering systemic treatment (Tx) for untreated metastatic colorectal cancer (mCRC): A meta-analysis from the Cancer Care Ontario program in evidence-based care.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. 3534-3534 ◽  
Author(s):  
Scott R. Berry ◽  
Roxanne Cosby ◽  
Timothy R. Asmis ◽  
Kelvin K. Chan ◽  
Nazik Hammad ◽  
...  
Keyword(s):  
Systemic Treatment ◽  
Meta Analysis ◽  
Sensitivity Analyses ◽  
Controlled Trials ◽  
Evidence Based ◽  
Random Effects Model ◽  
Randomized Controlled ◽  
Hazard Ratios ◽  
Evidence Based Care ◽  
Review Manager

3534 Background: Given the varying impact on efficacy demonstrated in individual RCTs of CS vs IS of delivering systemic Tx for mCRC, a meta-analysis of the available RCTs was performed. Methods: RCTs that compared a CS versus IS of delivering systemic Tx were identified by a systematic search (MEDLINE, EMBASE and ASCO and ESMO proceedings) and review. The results of identified trials were clinically homogeneous (Table) so the data was pooled using Review Manager software (RevMan 5.2). Overall survival (OS) hazard ratios were extracted directly from the most recently reported trial results. A random effects model was used for all pooling. Results: 10 RCTs were identified (n= 4,296). After an induction period, the maintenance Tx patients received during the IS was: none (5 trials, n=2,562), fluoropyrimidine (F) (2 trials, n=759), biologic (B) (2 trials, n=852), F+B (1 trial, n=123). Results of the meta-analysis are summarized in the Table (HR>1 favors CS). Sensitivity analyses performed demonstrate results are robust independent of the induction or maintenance Tx used. QOL (data from 2 trials) was either the same in both arms (single Tx induction trial with no maintenance Tx, n=354) or improved in the IS arm (combination tx induction trial with no maintenance Tx, n=1,630). Conclusions: IS of delivering systemic Tx for mCRC do not result in a statistically significant reduction in OS compared to a CS of delivery whether or not maintenance therapy is included. QOL is the same or better with an IS. [Table: see text]

scholarly journals FGFR4 Gly388Arg Polymorphism Reveals a Poor Prognosis, Especially in Asian Cancer Patients: A Meta-Analysis

2021 ◽  
Vol 11 ◽  
Author(s):  
Jung Han Kim ◽  
Soo Young Jeong ◽  
Hyun Joo Jang ◽  
Sung Taek Park ◽  
Hyeong Su Kim
Keyword(s):  
Cancer Patients ◽  
Transmembrane Domain ◽  
Meta Analysis ◽  
Disease Free Survival ◽  
Disease Stage ◽  
Prognostic Impact ◽  
Free Survival ◽  
Patients With Cancer ◽  
Ovid Medline ◽  
Hazard Ratios

The fibroblast growth factor-4 receptor (FGFR4) is a member of receptor tyrosine kinase. The FGFR4 Gly388Arg polymorphism in the transmembrane domain of the receptor has been shown to increase genetic susceptibility to cancers. However, its prognostic impact in cancer patients still remains controversial. Herein, we performed this meta-analysis to evaluate the clinicopathological and prognostic impacts of the FGFR4 Gly388Arg polymorphism in patients with cancer. We carried out a computerized extensive search using PubMed, Medline, and Ovid Medline databases up to July 2021. From 44 studies, 11,574 patients were included in the current meta-analysis. Regardless of the genetic models, there was no significant correlation of the FGFR4 Gly388Arg polymorphism with disease stage 3/4. In the homozygous model (Arg/Arg vs. Gly/Gly), the Arg/Arg genotype tended to show higher rate of lymph node metastasis compared with the Gly/Gly genotype (odds ratio = 1.21, 95% confidence interval (CI): 0.99-1.49, p = 0.06). Compared to patients with the Arg/Gly or Arg/Arg genotype, those with the Gly/Gly genotype had significantly better overall survival (hazard ratios (HR) = 1.19, 95% CI: 1.05-1.35, p = 0.006) and disease-free survival (HR = 1.25, 95% CI: 1.03-1.53, p = 0.02). In conclusion, this meta-analysis showed that the FGFR4 Gly388Arg polymorphism was significantly associated with worse prognosis in cancer patients. Our results suggest that this polymorphism may be a valuable genetic marker to identify patients at higher risk of recurrence or mortality.

scholarly journals Prognostic Impact of Late Gadolinium Enhancement by Cardiovascular Magnetic Resonance in Myocarditis

2021 ◽  
Vol 14 (1) ◽  
Author(s):  
Georgios Georgiopoulos ◽  
Stefano Figliozzi ◽  
Francesca Sanguineti ◽  
Giovanni Donato Aquaro ◽  
Gianluca di Bella ◽  
...  
Keyword(s):  
Cardiovascular Magnetic Resonance ◽  
Late Gadolinium Enhancement ◽  
Magnetic Resonance ◽  
Meta Analysis ◽  
Left Ventricular ◽  
Prognostic Impact ◽  
Gadolinium Enhancement ◽  
End Point ◽  
Hazard Ratios ◽  
Increased Risk

Background: Patients with acute myocarditis (AM) are at increased risk of adverse cardiac events after the index episode. Late gadolinium enhancement (LGE) detected by cardiovascular magnetic resonance in patients with AM plays an important diagnostic role, but its prognostic significance remains unresolved. This systematic review and meta-analysis sought to assess the prognostic implications of cardiovascular magnetic resonance-derived LGE in patients with AM. Methods: Data search was conducted from inception through February 28, 2020, using the following Medical Subject Heading terms: Myocarditis, CMR, Magnetic Resonance Imaging, Magnetic Resonance . From 2422 articles retrieved, we selected 11 studies reporting baseline cardiovascular magnetic resonance assessment and long-term clinical follow-up in patients with AM. Hazard ratios and CIs for a combined clinical end point were recorded for LGE presence, extent (>2 segments or >10% of left ventricular [LV] mass or >17g) and location (anteroseptal versus non-anteroseptal). A combined end point comprised all-cause mortality, cardiac mortality, and major adverse cardiovascular events. Hartung and Knapp correction improved robustness of the results. Prespecified sensitivity analyses explored potential sources of heterogeneity. The meta-analysis was conducted according to the Meta-analysis of Observational Studies in Epidemiology guidelines. Results: LGE presence (pooled hazard ratios, 3.28 [95% CIs, 1.69–6.39], P <0.001 [95% CIs, 1.33–8.11] after Hartung and Knapp correction) and anteroseptal LGE (pooled-hazard ratios, 2.58 [95% CIs, 1.87–3.55], P <0.001 [95% CIs, 1.64–4.06] after Hartung and Knapp correction) were associated with an increased risk of the combined end point. Extensive LGE was associated with worse outcomes (pooled-hazard ratios, 1.96 [95% CIs, 1.08–3.56], P =0.027), but this association was not confirmed after Hartung and Knapp correction (95% CIs, 0.843–4.57). Conclusions: LGE presence and anteroseptal location at baseline cardiovascular magnetic resonance are important independent prognostic markers that herald an increased risk of adverse cardiac outcomes in patients with AM. Registration: https://www.crd.york.ac.uk/PROSPERO/ Unique identifier: CRD42019146619.

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