-
Oral Diseases May 2024The aim of the present study was to conduct a systematic review of head and neck Ewing sarcoma (ES) concerning patients' demographic and clinical features,... (Review)
Review
OBJECTIVE
The aim of the present study was to conduct a systematic review of head and neck Ewing sarcoma (ES) concerning patients' demographic and clinical features, histopathological findings, treatment, follow-up, and survival rate.
MATERIALS AND METHODS
An electronic search was undertaken in four databases. Articles describing case reports or case series were included. Outcomes were evaluated by the Kaplan-Meier method along with Cox regression.
RESULTS
The search yielded 186 studies describing 227 ES cases. The mean age was 22.7 years, and males were slightly more affected. Interestingly, more than half the cases were diagnosed up to 20 years. The respiratory tract was the most reported site, followed by the jawbones. Clinically, symptomatic swelling or nodules were described, with a mean duration of 4 months. Management involved multimodal treatment regimens. Local recurrence, lymph node and distant metastasis were observed in 10.7%, 12.6%, and 20.3% of cases, respectively. Statistical analysis revealed that older patients with distant metastasis had a lower overall survival rate (p < 0.05).
CONCLUSION
This study provides an overall view of head and neck ES that can assist oral and maxillofacial pathologists with the diagnosis and extend the knowledge of surgeons and oncologists about this condition.
Topics: Female; Humans; Male; Head and Neck Neoplasms; Neoplasm Recurrence, Local; Sarcoma, Ewing; Survival Rate; Young Adult
PubMed: 37392420
DOI: 10.1111/odi.14644 -
Scandinavian Journal of Urology Jun 2016Objective Primary androgen deprivation therapy (ADT) remains the gold standard in the management of patients with advanced prostate cancer (PCa). ADT relieves symptoms... (Review)
Review
Objective Primary androgen deprivation therapy (ADT) remains the gold standard in the management of patients with advanced prostate cancer (PCa). ADT relieves symptoms and reduces tumor burden, but it has never been demonstrated to increase either PCa-specific or overall survival per se. Several trials have challenged this dogma. The aim of this study was to evaluate how endocrine therapy (ET) affects survival in different clinical settings of PCa. Materials and methods A review of published phase II, III and IV studies evaluating the effect of ET on survival was performed. Results In localized and locally advanced non-metastatic PCa, neoadjuvant ET before radical prostatectomy has no effect on survival. Neoadjuvant and adjuvant ET in combination with curatively intended radiotherapy results in PCa-specific and overall survival benefit, although the duration of ET remains under debate. In N + disease, the timing of ET is under debate, although data suggest that early ET is associated with decreased PCa-specific and overall mortality. In M + disease, no proper randomized trials have been performed in patients with newly diagnosed M1 disease. In metastatic castration-resistant PCa, two novel endocrine agents have been proven to increase overall survival significantly compared to placebo. Conclusions ET has never been proven to increase survival in newly diagnosed metastatic PCa in a randomized clinical trial. Nonetheless, a number of trials supports that ET with proper timing, sequencing and in combination with other therapeutic modalities increases survival in several stages of PCa.
Topics: Androgen Antagonists; Antineoplastic Agents, Hormonal; Clinical Trials as Topic; Humans; Male; Orchiectomy; Prostatic Neoplasms; Survival Rate
PubMed: 26907159
DOI: 10.3109/21681805.2016.1142472 -
Annals of the Rheumatic Diseases Dec 2017To determine trends in survival among adult and paediatric patients with systemic lupus erythematosus (SLE) from 1950 to the present. (Meta-Analysis)
Meta-Analysis Review
OBJECTIVE
To determine trends in survival among adult and paediatric patients with systemic lupus erythematosus (SLE) from 1950 to the present.
METHODS
We performed a systematic literature review to identify all published cohort studies on survival in patients with SLE. We used Bayesian methods to derive pooled survival estimates separately for adult and paediatric patients, as well as for studies from high-income countries and low/middle-income countries. We pooled contemporaneous studies to obtain trends in survival over time. We also examined trends in major causes of death.
RESULTS
We identified 125 studies of adult patients and 51 studies of paediatric patients. Among adults, survival improved gradually from the 1950s to the mid-1990s in both high-income and low/middle-income countries, after which survival plateaued. In 2008-2016, the 5-year, 10-year and 15-year pooled survival estimates in adults from high-income countries were 0.95, 0.89 and 0.82, and in low/middle-income countries were 0.92, 0.85 and 0.79, respectively. Among children, in 2008-2016, the 5-year and 10-year pooled survival estimates from high-income countries were 0.99 and 0.97, while in low/middle-income countries were 0.85 and 0.79, respectively. The proportion of deaths due to SLE decreased over time in studies of adults and among children from high-income countries.
CONCLUSIONS
After a period of major improvement, survival in SLE has plateaued since the mid-1990s. In high-income countries, 5-year survival exceeds 0.95 in both adults and children. In low/middle-income countries, 5-year and 10-year survival was lower among children than adults.
Topics: Adolescent; Adult; Bayes Theorem; Child; Cohort Studies; Developed Countries; Developing Countries; Female; Humans; Income; Lupus Erythematosus, Systemic; Male; Middle Aged; Risk Factors; Survival Rate; Time Factors
PubMed: 28794077
DOI: 10.1136/annrheumdis-2017-211663 -
International Journal of Implant... May 2021Currently, insufficient bone volume always occurs in the posterior maxilla which makes implantation difficult. Short implants combined with transcrestal sinus floor... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Currently, insufficient bone volume always occurs in the posterior maxilla which makes implantation difficult. Short implants combined with transcrestal sinus floor elevation (TSFE) may be an option to address insufficient bone volume.
PURPOSE
The clinical performance of short implants combined with TSFE was compared with that of conventional implants combined with TSFE according to the survival rate.
METHOD
In this systematic review and meta-analysis, we followed the Meta-Analysis of Observational Studies in Epidemiology (MOOSE) guidelines. Articles were identified through PubMed, Embase, the Cochrane Library, and manual searching. Eligibility criteria included clinical human studies. The quality assessment was performed according to the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines. The odds ratio (OR) with its confidence interval (CI) was considered the essential outcome for estimating the effect of short implants combined with TSFE.
RESULTS
The registration number is INPLASY202050092. Eleven studies met the inclusion criteria, including 1 cohort study and 10 cross-sectional studies. With respect to the 1-year survival rate, no significant effect was observed between short implants (length ≤ 8 mm) and conventional implants combined with TSFE (I=0%, OR=1.04, 95% CI: 0.55-1.96). Similarly, no difference was seen between the two groups regarding the survival rate during the healing period (I=10%, OR=0.74, 95% CI: 0.28-1.97) and 3-year loading (OR=1.76, 95% CI: 0.65-4.74).
CONCLUSION
There was no evidence that the survival rate of short implants combined with TSFE was lower or higher than that of conventional implants combined with TSFE when the residual bone height was poor and the implant protrusion length of short implants was less than or similar to conventional implants. Nevertheless, the results should be interpreted cautiously due to the lack of random controlled trials in our meta-analysis.
Topics: Cohort Studies; Cross-Sectional Studies; Maxillary Sinus; Observational Studies as Topic; Sinus Floor Augmentation; Survival Rate
PubMed: 34013452
DOI: 10.1186/s40729-021-00325-y -
The British Journal of Surgery Aug 2021Bariatric surgery is an established treatment for severe obesity; however, fewer than 1 per cent of eligible patients undergo surgery. The perceived risk of surgery may... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Bariatric surgery is an established treatment for severe obesity; however, fewer than 1 per cent of eligible patients undergo surgery. The perceived risk of surgery may contribute to the low uptake. The aim of this study was to determine perioperative mortality associated with bariatric surgery, comparing different operation types and data sources.
METHODS
A literature search of Ovid MEDLINE, Embase, and the Cochrane Central Register of Controlled Trials was conducted to identify studies published between 1 January 2014 and 31 July 2020. Inclusion criteria were studies of at least 1000 patients reporting short-term mortality after bariatric surgery. Data were collected on RCTs. Meta-analysis was performed to establish overall mortality rates across different study types. The primary outcome measure was perioperative mortality. Different operation types were compared, along with study type, in subgroup analyses. The study was registered at PROSPERO (2019: CRD 42019131632).
RESULTS
Some 4356 articles were identified and 58 met the inclusion criteria. Data were available on over 3.6 million patients. There were 4707 deaths. Pooled analysis showed an overall mortality rate of 0.08 (95 per cent c.i. 0.06 to 0.10; 95 per cent prediction interval 0 to 0.21) per cent. In subgroup analysis, there was no statistically significant difference between overall, 30-day, 90-day or in-hospital mortality (P = 0.29). There was no significant difference in reported mortality for RCTs, large studies, national databases or registries (P = 0.60). The pooled mortality rates by procedure type in ascending order were: 0.03 per cent for gastric band, 0.05 per cent for sleeve gastrectomy, 0.09 per cent for one-anastomosis gastric bypass, 0.09 per cent for Roux-en-Y gastric bypass, and 0.41 per cent for duodenal switch (P < 0.001 between operations).
CONCLUSION
Bariatric surgery is safe, with low reported perioperative mortality rates.
Topics: Bariatric Surgery; Global Health; Humans; Laparoscopy; Obesity, Morbid; Perioperative Period; Survival Rate; Weight Loss
PubMed: 34297806
DOI: 10.1093/bjs/znab245 -
Pediatric Surgery International Dec 2017Biliary atresia (BA) is an idiopathic neonatal cholangiopathy characterized by progressive inflammatory obliteration of the intrahepatic or extrahepatic bile ducts.... (Review)
Review
Biliary atresia (BA) is an idiopathic neonatal cholangiopathy characterized by progressive inflammatory obliteration of the intrahepatic or extrahepatic bile ducts. Although the Kasai operation has dramatically improved the outcomes in children with BA, most patients with BA eventually require liver transplantation (LT) even after undergoing a successful Kasai procedure. The Japanese LT Society (JLTS) was established in 1980 to characterize and follow trends in patient characteristics and the graft survival among all liver transplant patients in Japan. The 1-, 5-, 10-, 15- and 20-year survival rates for the patients and grafts undergoing living donor LT were 91.6, 91.5, 87.1, 85.4 and 84.2 and 90.5, 90.4, 84.6, 82.0 and 79.9%, respectively. LDLT was able to be performed even in patients weighing less than 5 kg with early liver failure following a Kasai operation using a reduced left lateral segments. As LT has been revealed to increase the donor pool and decrease the waiting list mortality with an excellent long-term graft survival, early referral to a transplant center should be considered when at least one complication of cirrhosis occurs during its natural history, especially in adolescents.
Topics: Biliary Atresia; Global Health; Graft Survival; Humans; Infant, Newborn; Liver Transplantation; Living Donors; Survival Rate; Treatment Outcome; Waiting Lists
PubMed: 28983725
DOI: 10.1007/s00383-017-4173-5 -
Journal of Psychosomatic Research Oct 2016Although the predictive value of vagal nerve activity, indexed by heart rate variability (HRV), has been confirmed in a variety of diseases, its value in the prediction... (Meta-Analysis)
Meta-Analysis Review
PURPOSE
Although the predictive value of vagal nerve activity, indexed by heart rate variability (HRV), has been confirmed in a variety of diseases, its value in the prediction of survival in cancer patients still remains controversial. The aim of this meta-analysis was to evaluate the predictive value of HRV in cancer patients in an evidence based manner.
METHODS
A systematic review and meta-analysis was conducted through a comprehensive search of the PubMed, EMBASE and the Cochrane Central Library databases for all studies regarding HRV, vagal nerve activity and cancer. Pooled data of overall survival was analyzed.
RESULTS
Six studies with 1286 patients were included in our meta analysis. Analysis of the pooled data revealed that overall survival was significantly longer in the higher HRV group than in the lower HRV group (HR 0.70, 95% CI [0.60, 0.82]; P<0.001, I2=27%).
CONCLUSION
The current evidence indicates a predictive value of HRV in the survival of patients with cancer and higher vagal nerve activity might predict longer survival, but the results should be applied with caution considering the heterogeneity between included studies.
Topics: Heart Rate; Humans; Neoplasms; Predictive Value of Tests; Survival Rate; Vagus Nerve
PubMed: 27663106
DOI: 10.1016/j.jpsychores.2016.08.004 -
JAMA Cardiology Jun 2022Data on long-term survival beyond 12 months after out-of-hospital cardiac arrest (OHCA) of a presumed cardiac cause are scarce. (Meta-Analysis)
Meta-Analysis
IMPORTANCE
Data on long-term survival beyond 12 months after out-of-hospital cardiac arrest (OHCA) of a presumed cardiac cause are scarce.
OBJECTIVE
To investigate the long-term survival of adult patients after surviving the initial hospital stay for an OHCA.
DATA SOURCES
A systematic search of the EMBASE and MEDLINE databases was performed from database inception to March 25, 2021.
STUDY SELECTION
Clinical studies reporting long-term survival after OHCA were selected based on predefined inclusion and exclusion criteria according to a preregistered study protocol.
DATA EXTRACTION AND SYNTHESIS
Patient data were reconstructed from Kaplan-Meier curves using an iterative algorithm and then pooled to generate survival curves. As a separate analysis, an aggregate data meta-analysis was performed.
MAIN OUTCOMES AND MEASURES
The primary outcome was long-term survival (>12 months) after OHCA for patients surviving to hospital discharge or 30 days after OHCA.
RESULTS
The search identified 15 347 reports, of which 21 studies (11 800 patients) were included in the Kaplan-Meier-based meta-analysis and 33 studies (16 933 patients) in an aggregate data meta-analysis. In the Kaplan-Meier-based analysis, the median survival time for patients surviving to hospital discharge was 5.0 years (IQR, 2.3-7.9 years). The estimated survival rates were 82.8% (95% CI, 81.9%-83.7%) at 3 years, 77.0% (95% CI, 75.9%-78.0%) at 5 years, 63.9% (95% CI, 62.3%-65.4%) at 10 years, and 57.5% (95% CI, 54.8%-60.1%) at 15 years. Compared with patients with a nonshockable initial rhythm, patients with a shockable rhythm had a lower risk of long-term mortality (hazard ratio, 0.30; 95% CI, 0.23-0.39; P < .001). Different analyses, including an aggregate data meta-analysis, confirmed these results.
CONCLUSIONS AND RELEVANCE
In this comprehensive systematic review and meta-analysis, long-term survival after 10 years in patients surviving the initial hospital stay after OHCA was between 62% and 64%. Additional research is needed to understand and improve the long-term survival in this vulnerable patient population.
Topics: Adult; Cardiopulmonary Resuscitation; Humans; Out-of-Hospital Cardiac Arrest; Patient Discharge; Survival Rate
PubMed: 35507352
DOI: 10.1001/jamacardio.2022.0795 -
World Journal of Surgery Sep 2018The survival benefits, oncological adequacy, effectiveness, and safety of laparoscopic transverse colectomy (LTC) were compared with that of open transverse colectomy... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVES
The survival benefits, oncological adequacy, effectiveness, and safety of laparoscopic transverse colectomy (LTC) were compared with that of open transverse colectomy (OTC) using a meta-analysis.
METHODS
EMBASE, Medline, Cochrane library, and Google scholar databases were searched for the last 20 years. Meta-analyses were performed using both fixed-effects and random-effects models. Five-year disease-free survival and overall survival were estimated using the inverse variance hazard ratio method.
RESULTS
No survival benefits were detected between the two LTC and OTC cohorts. OTC showed shorter operative time by 38 min compared to LTC [mean difference (MD) = 38(15.23-60.77), p = 0.001]. However, LTC was associated with earlier postoperative recovery. The time to flatus and time to oral intake for LTC were MD = -1.12(-1.68 to -0.55, p = 0.001) and MD = -1.57(-2.38 to -0.76, p = 0.001), respectively. In addition, LTC was associated with a shorter hospital stay by 4.5 days [MD = -4.64(-7.52 to -1.75), p = 0.002].
CONCLUSIONS
Compared to OTC, LTC provides similar survival benefits, earlier postoperative recovery, and shorter hospital stay by 4.5 days.
Topics: Colectomy; Colon, Transverse; Colonic Neoplasms; Disease-Free Survival; Eating; Humans; Laparoscopy; Length of Stay; Operative Time; Postoperative Period; Recovery of Function; Survival Rate
PubMed: 29523909
DOI: 10.1007/s00268-018-4570-5 -
Asian Pacific Journal of Cancer... Oct 2023The objective of this study was to determine the survival rate and the effects of different treatments on patients with inflammatory breast cancer (IBC). The study... (Meta-Analysis)
Meta-Analysis
The objective of this study was to determine the survival rate and the effects of different treatments on patients with inflammatory breast cancer (IBC). The study employed a systematic approach that included a search strategy across four databases: Embase, Web of Sciences, PubMed, and Scopus. The results obtained were screened initially by titles and abstracts, followed by full-texts in EndNote 8 software. The next stage involved data extraction and qualitative evaluation, where the Metan command was used to estimate the pooled survival rate. A total of 28 studies with a sample size of 63,796 were finally analyzed. The overall 3- and 5-year survival rates (OS) for IBC patients were found to be 52% (95% CI; 46-58%, I2: 99.42%) and 61% (95% CI; 53-69%, I2: 93.63%), respectively. The 5-year OS rates in patients with non-metastatic and metastatic IBC were 59% (95% CI; 54-63%, I2: 98.31%) and 30% (95% CI; 26-35%, I2: 50.84%), respectively. The 5-year OS rate in non-metastatic patients who underwent BCS surgery was 60% (CI 95%; 26-94%, I2: 95.13%). The overall 5- and 3-year OS rates for patients with IBC were lower than those for all types of breast cancer, and the rates were even lower in patients with metastasis. Therefore, it is recommended that healthcare workers and women at risk should be vigilant of early symptoms of IBC to prevent metastasis by seeking medical attention on time.
Topics: Humans; Female; Inflammatory Breast Neoplasms; Survival Rate
PubMed: 37898836
DOI: 10.31557/APJCP.2023.24.10.3335