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The International Journal of Behavioral... May 2021Physical activity has been associated with reduced risk of seven types of cancer. It remains unclear, however, whether muscle-strengthening activities also reduce cancer... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Physical activity has been associated with reduced risk of seven types of cancer. It remains unclear, however, whether muscle-strengthening activities also reduce cancer incidence and mortality.
METHODS
PubMed, Embase, Web of Science and Scopus were searched from inception to March 2020. Summary hazard ratio (HR) and 95% confidence intervals (CI) were estimated using random-effects models.
RESULTS
Twelve studies (11 cohorts; 1 case-control), 6 to 25 years of follow-up, including 1,297,620 participants, 32,196 cases and 31,939 deaths, met inclusion criteria. Muscle-strengthening activities were associated with a 26% lower incidence of kidney cancer (HR for high vs low levels of muscle-strengthening activities: 0.74; 95% CI 0.56 to 0.98; I 0%; 2 studies), but not with incidence of other 12 types of cancer. Muscle-strengthening activities were associated with lower total cancer mortality: HRs for high vs low levels of muscle-strengthening activities was 0.87 (95% CI 0.73 to 1.02; I 58%; 6 studies); and HR for ≥2 times/week vs < 2 times/week of muscle-strengthening activities was 0.81 (95% CI 0.74 to 0.87; I 0%; 4 studies). Regarding the weekly duration of muscle-strengthening activities, HR for total cancer mortality were 0.91 (95% CI 0.82 to 1.01; I 0%; 2 studies) for 1-59 min/week and 0.98 (95% CI 0.89 to 1.07; I 0%) for ≥60 min/week vs none. Combined muscle-strengthening and aerobic activities (vs none) were associated with a 28% lower total cancer mortality (HR 0.72; 95% CI 0.53 to 0.98; I 85%; 3 studies).
CONCLUSIONS
Muscle-strengthening activities were associated with reduced incidence of kidney cancer and total cancer mortality. Combined muscle-strengthening and aerobic activities may provide a greater reduction in total cancer mortality.
Topics: Humans; Incidence; Neoplasms; Observational Studies as Topic; Resistance Training
PubMed: 34051796
DOI: 10.1186/s12966-021-01142-7 -
Supportive Care in Cancer : Official... May 2024The impact of sarcopenia in oncology is increasingly recognized, yet little is known about its clinical implications in breast cancer. This systematic review and... (Meta-Analysis)
Meta-Analysis Review
PURPOSE
The impact of sarcopenia in oncology is increasingly recognized, yet little is known about its clinical implications in breast cancer. This systematic review and meta-analysis estimates the overall prevalence of sarcopenia in breast cancer, quantifies skeletal muscle index (SMI), and comprehensively evaluates sarcopenia's impact on clinical outcomes.
METHODS
We systematically searched primary original research published before June 2023 in four databases: the Cochrane Library via Wiley, CINAHL Plus with Full Text, Embase via Elsevier Excerpta Medica, and Medline via Ovid. Standardized mean SMI and 95% confidence interval (CI) were calculated by applying the random-effects model. The methodological quality of the included studies was assessed using the National Institutes of Health quality assessment checklist.
RESULTS
The systematic review included 17 studies with a total of 9863 patients; the meta-analysis included 12 of these studies. The mean prevalence of sarcopenia in breast cancer (stages I-III) was 32.5%. The mean SMI assessed by CT was 43.94 cm/m (95% CI 42.87, 45.01; p < .01). Overall, low muscle mass was associated with chemotherapy toxicities, dose reductions, dose delays, or treatment discontinuation. Low muscle mass was generally associated with poor survival, but in some studies, this association was not significant or reversed direction.
CONCLUSION
Sarcopenia is not just a state of muscle mass loss, but an influencing factor on therapeutic effects and survival rates in oncology. It is thus necessary to recognize the risk of sarcopenia throughout the trajectory of cancer treatment, identify low muscle mass early, and manage it from a prehabilitation perspective.
Topics: Humans; Sarcopenia; Breast Neoplasms; Prevalence; Female
PubMed: 38702479
DOI: 10.1007/s00520-024-08532-0 -
Acta Otorrinolaringologica Espanola 2022The gracilis muscle free flap has gained popularity in head and neck reconstruction due to minimal donor-site morbidity, reliable vascular pedicle, strong muscular... (Review)
Review
INTRODUCTION
The gracilis muscle free flap has gained popularity in head and neck reconstruction due to minimal donor-site morbidity, reliable vascular pedicle, strong muscular component, and possibility to perform nerve coaptation. However, almost all the existing evidence in the literature is related to its use for facial palsy reanimation. The aim of this study was therefore to review and provide a comprehensive summary of all the possible indications and outcomes of this versatile free flap in head neck reconstructive surgery.
MATERIALS AND METHODS
A systematic review of the literature was conducted including articles from 1970 to 2019. All articles were examined and described.
RESULTS
Twenty-seven papers published between 1994 and 2019 were identified for analysis. The evidence highlights the use of the gracilis muscle free flap for parotid, forehead and midface defects, oral tongue, oral sphincter, lower and upper lip, cheek, and oral commissure defects, among others, as the most common defects reconstructed.
CONCLUSION
This flap represents an easy to harvest and versatile free flap with low donor-site morbidity and multiple proven uses in head & neck reconstruction. We therefore encourage reconstructive surgeons to include this flap in their armoury, either as a first or as a second-line option.
Topics: Facial Paralysis; Free Tissue Flaps; Head and Neck Neoplasms; Humans; Neck; Plastic Surgery Procedures
PubMed: 36113921
DOI: 10.1016/j.otoeng.2022.01.003 -
Actas Urologicas Espanolas 2021Kidney transplantation is associated with an increased risk of bladder cancer; however guidelines have not been established on the management of bladder cancer after... (Review)
Review
INTRODUCTION AND OBJECTIVES
Kidney transplantation is associated with an increased risk of bladder cancer; however guidelines have not been established on the management of bladder cancer after kidney transplantation.
MATERIALS AND METHODS
A systematic literature review using PubMed was performed in accordance with the PRISMA statement to identify studies concerning the prevalence and survival of bladder cancer after kidney transplantation. The risk factors and management of bladder cancer after kidney transplantation were also reviewed and discussed.
RESULTS
A total of 41 studies, published between 1996 and 2018, reporting primary data on bladder cancer after kidney transplantation were identified. Marked heterogeneity in bladder cancer prevalence, time to diagnosis, non-muscle invasive/muscle-invasive bladder cancer prevalence, and survival was noted. Four studies, published between 2003 and 2017, reporting primary data on bladder cancer treated with Bacillus Calmette-Guérin (BCG) after kidney transplantation were identified. Disease-free survival, cancer-specific survival, and overall survival were similar between BCG studies (75-100%).
CONCLUSIONS
Carcinogen exposure that led to ESRD, BKV, HPV, immunosuppressive agents, and the immunosuppressed state likely contribute to the increased risk of bladder cancer after renal transplantation. Non-muscle invasive disease should be treated with transurethral resection. BCG can be safely used in transplant recipients and likely improves the disease course. Muscle-invasive disease should be treated with radical cystectomy, with special consideration to the dissection and urinary diversion choice. Chemotherapy and immune checkpoint inhibitors can be safely used in regionally advanced bladder cancer with potential benefit. mTOR inhibitors may reduce the risk of developing bladder cancer, and immunosuppression medications should be reduced if malignancy develops.
Topics: Adjuvants, Immunologic; Cystectomy; Humans; Kidney Transplantation; Risk Factors; Urinary Bladder Neoplasms
PubMed: 34147429
DOI: 10.1016/j.acuroe.2020.09.009 -
Food and Chemical Toxicology : An... Mar 2018The ingestion of heavy metals through contaminated seafood can causes significant outcomes on human health. In recent years, consume fishes and shrimps has increased in... (Meta-Analysis)
Meta-Analysis Review
The ingestion of heavy metals through contaminated seafood can causes significant outcomes on human health. In recent years, consume fishes and shrimps has increased in Iran, and several study about heavy metals content in fishes and shrimps from Persian Gulf were carried out to check their food safety. The aims of these systematic reviews and meta-analysis was to summarize the evidence on the relation of the intakes of Arsenic (As) and lead (Pb) levels, based on the origin and sub-groups of shrimp species consumed, Hence that we can estimate the risk of oral cancer induced by Pb and As in these groups of shrimp from the persian gulf. We carried out a search of all suitable studies published between 1995 and 2017 in Scopus, Science Direct, PubMed and Web of Science databases. Since the heterogeneity among studied was significant, we used the random effect model (REM) to perform meta-analysis of data. Data were obtained from 9 articles (14 studies), with 511 samples, and it was reported that pooled levels of As and Pb in the muscle shrimps were 1.37 (95% CI: 0.66-2.08 mg/kg d.w.) and 0.58 (95% CI: 0.33-0.82 mg/kg d.w.), respectively. This pooled levels in muscle shrimps were higher than safe dose reported on Food and Agriculture Organization/World Health Organization guidelines (FAO/WHO). The rank order of shrimps species based on As was Panulirus homarus > Penaeus semisulcatus and for the Pb levels was Litopenaeus vannamei > Panulirus homarus > Fenneropenaeus indicus > Metapenaeus affinis. The lowest and highest risk levels of oral cancer, divided by consumers age groups, were respectively 45-54 (6.94E-04) and 15-24 (8.42E-04) for the Pb, and 45-54 (2.87E-01) and 15-24 (3.51E-01) for arsenic. Incremental Lifetime Cancer Risk (ILCR) of Pb and As was higher than 10-4 and 10-3, respectively. All groups (age) of consumers are subject to the cancer risk of due to the consumption of shrimps contaminated by Pb and As, therefore, should be started a control plan for the reduction of the heavy metal bioaccumulation levels in shrimps of the Persian Gulf coupled to a capillary food safety communication.
Topics: Adolescent; Adult; Animals; Arsenic; Carcinogens; Crustacea; Female; Humans; Indian Ocean; Lead; Male; Middle Aged; Mouth Neoplasms; Muscles; Population Health; Risk Assessment; Seafood; Species Specificity; Young Adult
PubMed: 29407475
DOI: 10.1016/j.fct.2018.01.046 -
Pediatric Research Mar 2022Research indicates reduced physical performance from diagnosis into survivorship of pediatric cancer patients. However, there is no systematic information or guideline...
BACKGROUND
Research indicates reduced physical performance from diagnosis into survivorship of pediatric cancer patients. However, there is no systematic information or guideline available on the methods to assess physical performance and function in this population. The purpose was to systematically compile and describe assessments of physical performance and function in patients and survivors of pediatric cancer, including cardiorespiratory fitness, muscle strength, speed, balance, flexibility, functional mobility, gait and motor performance test batteries.
METHODS
We searched the databases PubMed, SPORTDiscus, and Cochrane Database and performed abstract and full-text selection of 2619 articles according to the Cochrane Handbook of Systematic Reviews. Information on patients characteristics, assessments, information on validity and reliability, and relevant references was extracted.
RESULTS
In summary, 63 different assessments were found in 149 studies including 11639 participants. Most studies evaluated cardiorespiratory fitness and muscle strength with the majority conducted off treatment. Some outcomes (e.g. speed) and diagnoses (e.g. neuroblastoma) were severely underrepresented. With the exception of gait, leukemia patients represented the largest group of individuals tested.
CONCLUSIONS
Insufficient data and patient heterogeneity complicate uniform recommendations for assessments. Our results support researchers and practitioners in selecting appropriate assessment to meet their specific research questions or individual daily practice needs.
IMPACT
This systematic review includes 149 studies and provides a comprehensive summary of 63 assessments to evaluate cardiorespiratory fitness, muscle strength, speed, balance, flexibility, functional mobility, gait or motor performance test batteries in patients and survivors of pediatric cancer. We present the most studied fields within the pediatric cancer population, which are cardiorespiratory fitness and muscle strength, off treatment phase, and leukemia patients. We propose research priorities by identification of subgroups in terms of cancer type, phase of treatment, and outcome of interest that are underrepresented in studies currently available.
Topics: Child; Humans; Leukemia; Neoplasms; Physical Fitness; Physical Functional Performance; Reproducibility of Results
PubMed: 33859367
DOI: 10.1038/s41390-021-01523-5 -
European Urology Mar 2015Although open radical cystectomy (ORC) is still the standard approach, laparoscopic radical cystectomy (LRC) and robot-assisted radical cystectomy (RARC) are... (Review)
Review
CONTEXT
Although open radical cystectomy (ORC) is still the standard approach, laparoscopic radical cystectomy (LRC) and robot-assisted radical cystectomy (RARC) are increasingly performed.
OBJECTIVE
To report on a systematic literature review and cumulative analysis of pathologic, oncologic, and functional outcomes of RARC in comparison with ORC and LRC.
EVIDENCE ACQUISITION
Medline, Scopus, and Web of Science databases were searched using a free-text protocol including the terms robot-assisted radical cystectomy or da Vinci radical cystectomy or robot* radical cystectomy. RARC case series and studies comparing RARC with either ORC or LRC were collected. A cumulative analysis was conducted.
EVIDENCE SYNTHESIS
The searches retrieved 105 papers, 87 of which reported on pathologic, oncologic, or functional outcomes. Most series were retrospective and had small case numbers, short follow-up, and potential patient selection bias. The lymph node yield during lymph node dissection was 19 (range: 3-55), with half of the series following an extended template (yield range: 11-55). The lymph node-positive rate was 22%. The performance of lymphadenectomy was correlated with surgeon and institutional volume. Cumulative analyses showed no significant difference in lymph node yield between RARC and ORC. Positive surgical margin (PSM) rates were 5.6% (1-1.5% in pT2 disease and 0-25% in pT3 and higher disease). PSM rates did not appear to decrease with sequential case numbers. Cumulative analyses showed no significant difference in rates of surgical margins between RARC and ORC or RARC and LRC. Neoadjuvant chemotherapy use ranged from 0% to 31%, with adjuvant chemotherapy used in 4-29% of patients. Only six series reported a mean follow-up of >36 mo. Three-year disease-free survival (DFS), cancer-specific survival (CSS), and overall survival (OS) rates were 67-76%, 68-83%, and 61-80%, respectively. The 5-yr DFS, CSS, and OS rates were 53-74%, 66-80%, and 39-66%, respectively. Similar to ORC, disease of higher pathologic stage or evidence of lymph node involvement was associated with worse survival. Very limited data were available with respect to functional outcomes. The 12-mo continence rates with continent diversion were 83-100% in men for daytime continence and 66-76% for nighttime continence. In one series, potency was recovered in 63% of patients who were evaluable at 12 mo.
CONCLUSIONS
Oncologic and functional data from RARC remain immature, and longer-term prospective studies are needed. Cumulative analyses demonstrated that lymph node yields and PSM rates were similar between RARC and ORC. Conclusive long-term survival outcomes for RARC were limited, although oncologic outcomes up to 5 yr were similar to those reported for ORC.
PATIENT SUMMARY
Although open radical cystectomy (RC) is still regarded as the standard treatment for muscle-invasive bladder cancer, laparoscopic and robot-assisted RCs are becoming more popular. Templates of lymph node dissection, lymph node yields, and positive surgical margin rates are acceptable with robot-assisted RC. Although definitive comparisons with open RC with respect to oncologic or functional outcomes are lacking, early results appear comparable.
Topics: Chemotherapy, Adjuvant; Chi-Square Distribution; Cystectomy; Disease Progression; Disease-Free Survival; Humans; Lymph Node Excision; Lymphatic Metastasis; Neoadjuvant Therapy; Neoplasm Recurrence, Local; Neoplasm, Residual; Odds Ratio; Postoperative Complications; Risk Factors; Robotic Surgical Procedures; Time Factors; Treatment Outcome; Urinary Bladder Neoplasms
PubMed: 25560797
DOI: 10.1016/j.eururo.2014.12.008 -
International Journal of Hyperthermia :... Jun 2016Bladder cancer therapy remains suboptimal as morbidity and mortality remain high amongst those with non-muscle-invasive and muscle-invasive disease. Regional... (Review)
Review
CONTEXT
Bladder cancer therapy remains suboptimal as morbidity and mortality remain high amongst those with non-muscle-invasive and muscle-invasive disease. Regional hyperthermia therapy (RHT) is a promising adjunctive therapy being tested in multiple clinical contexts.
OBJECTIVE
The aim of this study was to systematically review the literature on the efficacy and toxicity of RHT.
EVIDENCE ACQUISITION
This systematic review was registered with the PROSPERO database (Registration number: CRD42015025780) and was conducted according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines. We queried PubMed, EMBASE, and Cochrane libraries. Two reviewers reviewed abstracts independently and a third reviewer arbitrated disagreements. The last search was performed on 28 August 2015. A descriptive analysis was performed and quality assessment was conducted using the Newcastle-Ottawa Quality Assessment Scale for observational studies, and the Cochrane Risk of Bias Assessment Tool for trials.
EVIDENCE SYNTHESIS
We identified 859 publications in the initial search, of which 24 met inclusion criteria for full-text review. Of these, we were able to obtain data on the outcomes of interest for 15 publications.
CONCLUSIONS
The review underscores the limited nature of the evidence; definitive conclusions are elusive. However, the promising results of RHT in the setting of intravesical chemotherapy, chemotherapy and radiotherapy show a trend towards legitimate efficacy.
Topics: Humans; Hyperthermia, Induced; Treatment Outcome; Urinary Bladder Neoplasms
PubMed: 27134130
DOI: 10.3109/02656736.2016.1157903 -
Annals of Medicine 2023The optimal cycle of neoadjuvant chemotherapy (NAC) for muscle-invasive bladder cancer (MIBC) remains controversial. This study aimed to compare the efficacy of three... (Meta-Analysis)
Meta-Analysis
OBJECTIVE
The optimal cycle of neoadjuvant chemotherapy (NAC) for muscle-invasive bladder cancer (MIBC) remains controversial. This study aimed to compare the efficacy of three and four cycles of NAC in the treatment of MIBC through a systematic review and meta-analysis of the literature.
MATERIALS AND METHODS
Relevant studies were systematically collected and reviewed in PubMed, Medline, Embase, Web of Science Databases, and the Cochrane Library. Relative ratios (RRs), Hazard ratios (HRs) and their 95% confidence intervals (CIs) were used to estimate outcome measures. Studies comparing the pathological response and prognosis of three versus four cycles of NAC for MIBC were included.
RESULTS
Five studies were included in this meta-analysis, including 2190 patients, of whom 1016 underwent three cycles of NAC and 1174 underwent four cycles of NAC. All studies were retrospective cohort studies. We found that 4 cycles of NAC had significantly better cancer-specific survival than 3 cycles (HR = 1.31, 95%CI,1.03-1.67, = 0.029). There was no significant difference in overall survival between patients who received 3 and 4 cycles of chemotherapy (HR = 1.18, 95%CI = 0.83-1.69, = 0.345). Similarly, no significant difference was observed in pathological objective response (RR = 0.95, 95%CI= 0.81-1.11, = 0.515) and complete response rates (RR = 0.87, 95%CI = 0.69-1.11, = 0.256) in MIBC after 3 or 4 cycles of NAC.
CONCLUSIONS
Three and four cycles of NAC had similar pathological responses and prognosis for MIBC, although the cancer-specific survival rate of four cycles was better than that of three cycles.
Topics: Humans; Neoadjuvant Therapy; Retrospective Studies; Chemotherapy, Adjuvant; Urinary Bladder Neoplasms; Muscles
PubMed: 37963224
DOI: 10.1080/07853890.2023.2281654 -
Chronic Respiratory Disease 2022Computed tomography (CT) is commonly utilized in chronic obstructive pulmonary disease (COPD) for lung cancer screening and emphysema characterization. Computed... (Review)
Review
BACKGROUND
Computed tomography (CT) is commonly utilized in chronic obstructive pulmonary disease (COPD) for lung cancer screening and emphysema characterization. Computed tomography-morphometric analysis of body composition (muscle mass and adiposity) has gained increased recognition as a marker of disease severity and prognosis. This systematic review aimed to describe the CT-methodology used to assess body composition and identify the association of body composition measures and disease severity, health-related quality of life (HRQL), cardiometabolic risk factors, respiratory exacerbations, and survival in patients with COPD.
METHODS
Six databases were searched (inception-September 2021) for studies evaluating adult COPD patients using thoracic or abdominal CT-muscle or adiposity body composition measures. The systematic review was conducted in accordance with the PRISMA guidelines.
RESULTS
Twenty eight articles were included with 15,431 COPD patients, across all GOLD stages with 77% males, age range (mean/median 59-78 years), and BMI range 19.8-29.3 kg/m. There was heterogeneity in assessment of muscle mass and adiposity using thoracic ( = 22) and abdominal ( = 8) CT-scans, capturing different muscle groups, anatomic locations, and adiposity compartments (visceral, subcutaneous, and epicardial). Low muscle mass and increased adiposity were associated with increased COPD severity measures (lung function, exercise capacity, dyspnea) and lower HRQL, but were not consistent across studies. Increased visceral adiposity ( = 6) was associated with cardiovascular disease or risk factors (hypertension, hyperlipidemia, and diabetes). Low muscle CSA was prognostic of respiratory exacerbations or mortality in three of six studies, whereas the relationship with increased intermuscular adiposity and greater mortality was only observed in one of three studies.
CONCLUSION
There was significant variability in CT-body composition measures. In several studies, low muscle mass was associated with increased disease severity and lower HRQL, whereas adiposity with cardiovascular disease/risk factors. Given the heterogeneity in body composition measures and clinical outcomes, the prognostic utility of CT-body composition in COPD requires further study.
Topics: Adult; Aged; Body Composition; Body Mass Index; Cardiovascular Diseases; Early Detection of Cancer; Female; Humans; Lung Neoplasms; Male; Middle Aged; Obesity; Pulmonary Disease, Chronic Obstructive; Quality of Life; Tomography, X-Ray Computed
PubMed: 36223552
DOI: 10.1177/14799731221133387