scholarly journals Metformin Improves Overall Survival of Colorectal Cancer Patients with Diabetes: A Meta-Analysis

2017 ◽  
Vol 2017 ◽  
pp. 1-8 ◽  
Author(s):  
Fanqiang Meng ◽  
Li Song ◽  
Wenyue Wang
Keyword(s):  
Colorectal Cancer ◽  
Overall Survival ◽  
Cohort Studies ◽  
Meta Analysis ◽  
Good Choice ◽  
Cochrane Library ◽  
Cancer Specific Survival ◽  
Incidence And Mortality ◽  
Patients With Diabetes ◽  
Colorectal Cancer Patients

Introduction. Diabetic population has a higher risk of colorectal cancer (CRC) incidence and mortality than nondiabetics. The role of metformin in CRC prognosis is still controversial. The meta-analysis aims to investigate whether metformin improves the survival of diabetic CRC patients.Methods. PubMed, EMBASE, and Cochrane Library were searched till July 1, 2016. Cohort studies were included. All articles were evaluated by Newcastle-Ottawa Scale. Hazard Ratios (HRs) with 95% confidence intervals (CIs) for each study were calculated and pooled HRs with corresponding 95% CIs were generated using the random-effects model. Heterogeneity and publication bias were assessed.Results. We included seven cohort studies with a medium heterogeneity (I2= 56.1% andp=0.033) in our meta-analysis. An improved overall survival (OS) for metformin users over nonusers among colorectal cancers with diabetes was noted (HR 0.75; 95% CI 0.65 to 0.87). However, metformin reveals no benefits for cancer-specific survival (HR 0.79, 95%, CI 0.58 to 1.08).Conclusions. Metformin prolongs the OS of diabetic CRC patients, but it does not affect the CRC-specific survival. Metformin may be a good choice in treating CRC patients with diabetes mellitus in clinical settings.

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 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 ◽  
Overall Survival ◽  
Survival Benefit ◽  
Fixed Effects ◽  
Meta Analysis ◽  
Colorectal Cancer Patient ◽  
Cochrane Library ◽  
Cancer Specific Survival ◽  
Gastric Cancers ◽  
Cox 2

Abstract Background: Many studies have found that use of aspirin can lengthen survival in patients with gastrointestinal cancer. The aim of this study was to assess the survival benefit of aspirin use compared with non-aspirin use for patients with esophageal, gastric or colorectal cancer. Methods: We searched online databases, including PubMed, the Cochrane Library, Embase and www.clinicaltrials.gov for studies that were conducted,, before April 30th, 2020, to identify relevant studies. Overall survival and cancer-specific survival of esophageal, gastric and colorectal cancers among aspirin users were compared with those among non-aspirin users. Data extraction and quality evaluation were independently conducted by 2 investigators. A meta-analysis was performed to calculate the pooled risk ratios (RRs) for overall survival and cancer-specific survival by using either a fixed-effects model or a random-effects model. Results: A total of 18 studies were included in this meta-analysis, with more than 74,936 patients. There were no significant differences between postdiagnosis aspirin use and overall survival for esophageal and gastric cancers. For colorectal cancer, a benefit that was associated with postdiagnosis aspirin use was observed for overall survival and cancer-specific survival [HR= 0.83, 95%CI(0.75, 0.9.);HR= 0.78, 95%CI(0.66, 0.92), respectively. However, a prediagnosis of aspirin use did not provide a benefit for overall or cancer-specific survival in colorectal cancer. HR values for overall and cancer-specific survival benefits for colorectal cancer associated with both prediagnosis and postdiagnosis aspirin were as follows: HR=0.75，95%CI(0.61, 0.92) and HR=0.78, 95%CI(0.73, 0.85), respectively. In addition, the survival benefit of postdiagnosis aspirin use appeared to be confined to patients with mutated PIK3CA tumors [HR= 0.78, 95%CI(0.50, 0.99)] and was positive for PTGS2 (COX-2) expression [HR= 0.75, 95%CI(0.43, 1.30)]. Conclusions: These findings provide further indications that postdiagnosis aspirin use improves overall survival and cancer-specific survival in colorectal cancer, especially for patients who are positive for PTGS2 (COX-2) expression and PIK3CA-mutated tumors. However, aspirin therapy does not improve overall survival in esophageal and gastric cancers, although the meta-analysis was mainly limited to retrospective studies.

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 ◽  
Overall Survival ◽  
Survival Benefit ◽  
Fixed Effects ◽  
Meta Analysis ◽  
Colorectal Cancer Patient ◽  
Cochrane Library ◽  
Cancer Specific Survival ◽  
Gastric Cancers ◽  
Cox 2

Abstract Background: Many studies have found that use of aspirin can lengthen survival in patients with gastrointestinal cancer. The aim of this study was to assess the survival benefit of aspirin use compared with non-aspirin use for patients with esophageal, gastric or colorectal cancer.Methods: We searched online databases, including PubMed, the Cochrane Library, Embase and www.clinicaltrials.gov for studies that were conducted, before April 30th, 2020, to identify relevant studies. Overall survival and cancer-specific survival of esophageal, gastric and colorectal cancers among aspirin users were compared with those among non-aspirin users. Data extraction and quality evaluation were independently conducted by 2 investigators. A meta-analysis was performed to calculate the pooled risk ratios (RRs) for overall survival and cancer-specific survival by using either a fixed-effects model or a random-effects model.Results: A total of 18 studies were included in this meta-analysis, with more than 74,936 patients. There were no significant differences between postdiagnosis aspirin use and overall survival for esophageal and gastric cancers. For colorectal cancer, a benefit that was associated with postdiagnosis aspirin use was observed for overall survival and cancer-specific survival [HR= 0.83, 95%CI(0.75, 0.9.);HR= 0.78, 95%CI(0.66, 0.92), respectively. However, a prediagnosis of aspirin use did not provide a benefit for overall or cancer-specific survival in colorectal cancer. HR values for overall and cancer-specific survival benefits for colorectal cancer associated with both prediagnosis and postdiagnosis aspirin were as follows: HR=0.75，95%CI(0.61, 0.92) and HR=0.78, 95%CI(0.73, 0.85), respectively. In addition, the survival benefit of postdiagnosis aspirin use appeared to be confined to patients with mutated PIK3CA tumors [HR= 0.78, 95%CI(0.50, 0.99)] and was positive for PTGS2 (COX-2) expression [HR= 0.75, 95%CI(0.43, 1.30)].Conclusions: These findings provide further indications that postdiagnosis aspirin use improves overall survival and cancer-specific survival in colorectal cancer, especially for patients who are positive for PTGS2 (COX-2) expression and PIK3CA-mutated tumors. However, aspirin therapy does not improve overall survival in esophageal and gastric cancers, although the meta-analysis was mainly limited 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 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 ◽  
Overall Survival ◽  
Survival Benefit ◽  
Fixed Effects ◽  
Meta Analysis ◽  
Colorectal Cancer Patient ◽  
Cochrane Library ◽  
Cancer Specific Survival ◽  
Gastric Cancers ◽  
Cox 2

Abstract Background: Many studies have found that use of aspirin can lengthen survival in patients with gastrointestinal cancer. The aim of this study was to assess the survival benefit of aspirin use compared with non-aspirin use for patients with esophageal, gastric or colorectal cancer. Methods : We searched online databases, including PubMed, the Cochrane Library, Embase and www.clinicaltrials.gov for studies that were conducted,, before April 30th, 2020, to identify relevant studies. Overall survival and cancer-specific survival of esophageal, gastric and colorectal cancers among aspirin users were compared with those among non-aspirin users. Data extraction and quality evaluation were independently conducted by 2 investigators. A meta-analysis was performed to calculate the pooled risk ratios (RRs) for overall survival and cancer-specific survival by using either a fixed-effects model or a random-effects model. Results : A total of 18 studies were included in this meta-analysis, with more than 74,936 patients. There were no significant differences between postdiagnosis aspirin use and overall survival for esophageal and gastric cancers. For colorectal cancer, a benefit that was associated with postdiagnosis aspirin use was observed for overall survival and cancer-specific survival [HR= 0.83, 95%CI(0.75, 0.9.);HR= 0.78, 95%CI(0.66, 0.92), respectively. However, a prediagnosis of aspirin use did not provide a benefit for overall or cancer-specific survival in colorectal cancer. HR values for overall and cancer-specific survival benefits for colorectal cancer associated with both prediagnosis and postdiagnosis aspirin were as follows: HR=0.75，95%CI(0.61, 0.92) and HR=0.78, 95%CI(0.73, 0.85), respectively. In addition, the survival benefit of postdiagnosis aspirin use appeared to be confined to patients with mutated PIK3CA tumors [HR= 0.78, 95%CI(0.50, 0.99)] and was positive for PTGS2 (COX-2) expression [HR= 0.75, 95%CI(0.43, 1.30)]. Conclusions: These findings provide further indications that postdiagnosis aspirin use improves overall survival and cancer-specific survival in colorectal cancer, especially for patients who are positive for PTGS2 (COX-2) expression and PIK3CA-mutated tumors. However, aspirin therapy does not improve overall survival in esophageal and gastric cancers, although the meta-analysis was mainly limited to retrospective studies.

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 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 Bevacizumab improves survival in metastatic colorectal cancer patients with primary tumor resection: A meta-analysis

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Dedong Cao ◽  
Yongfa Zheng ◽  
Huilin Xu ◽  
Wei Ge ◽  
Ximing Xu
Keyword(s):  
Colorectal Cancer ◽  
Metastatic Colorectal Cancer ◽  
Primary Tumor ◽  
Meta Analysis ◽  
Tumor Resection ◽  
Progression Free Survival ◽  
Primary Tumor Resection ◽  
Cochrane Library ◽  
Colorectal Cancer Patients ◽  
Resected Primary Tumor

AbstractIt is not well determined whether primary tumor resection is associated with better outcomes in metastatic colorectal cancer (mCRC) patients treated with bevacizumab. In this meta-analysis, we aimed to assess the prognostic role of primary tumor resection in mCRC treated with bevacizumab. Electronic databases including the Cochrane library, Embase, and Pubmed were searched until April 2018. Clinical studies assessing the influence of primary tumor resection on the efficacy of bevacizumab in patients with mCRC were identified. The primary endpoint was overall survival (OS), and the secondary endpoint was progression-free survival (PFS). Seven studies including 2760 mCRC patients were finally included. The results of the meta-analysis were in favor of bevacizumab to patients with resected primary tumor in terms of OS (HR = 0.50, 95%CI: 0.39–0.64; p < 0.01), and PFS (HR = 0.65, 95%CI: 0.51–0.81; p < 0.01). Administration of bevacizumab in mCRC patients with resected primary tumor had a better OS (HR = 0.65, 95%CI: 0.56–0.74; p < 0.01), when compared to chemotherapy(CT). Adding bevacizumab to mCRC patients without resection of primary tumor also had a better OS (HR = 0.78, 95%CI: 0.65–0.94; p < 0.01) and PFS (HR = 0.71, 95%CI: 0.57–0.88; p < 0.01) compared to chemotherapy alone. In conclusion, mCRC patients with resected primary tumor have better survival than those without surgery of primary tumor when treated with bevacizumab. Primary tumor resection status should be taken into consideration when using bevacizumab in mCRC.

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