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Wiener Klinische Wochenschrift Apr 2003To update our published systematic review of clinical trials of distant healing. (Review)
Review
AIM
To update our published systematic review of clinical trials of distant healing.
DESIGN
Systematic review.
DATA SOURCES
Medline, Embase, Cochrane Library and personal files.
STUDY SELECTION
Any type of clinical study of any type of distant healing published between 2000 and December 2002.
DATA EXTRACTION
For each included study, essential data were extracted and summarised in narrative form.
RESULTS
8 non-randomised and 9 randomised clinical trials were located. The majority of the rigorous trials do not to support the hypothesis that distant healing has specific therapeutic effects. The results of two studies furthermore suggest that distant healing can be associated with adverse effects.
CONCLUSION
Since the publication of our previous systematic review in 2000, several rigorous new studies have emerged. Collectively they shift the weight of the evidence against the notion that distant healing is more than a placebo.
Topics: Clinical Trials as Topic; Faith Healing; Humans; Mental Healing; Placebo Effect; Therapeutic Touch; Treatment Outcome
PubMed: 12778776
DOI: 10.1007/BF03040322 -
Journal of Oral and Maxillofacial... Sep 2021Recently, histologic grade was removed from salivary tumor nomenclature by the WHO to include disease of higher grade. One such entity, cribriform adenocarcinoma (CAC),... (Review)
Review
BACKGROUND
Recently, histologic grade was removed from salivary tumor nomenclature by the WHO to include disease of higher grade. One such entity, cribriform adenocarcinoma (CAC), is an aggressive group of polymorphous adenocarcinoma (PAC), with frequent nodal metastasis and locoregional recurrence. We aim to examine the biologic behavior of this disease as compared with the PAC general cohort inclusive of all subtypes.
METHODS
A systematic review of the literature on polymorphous adenocarcinoma and cribriform adenocarcinoma was completed. A descriptive analysis was performed for the following predictor variables: nodal and distant metastasis, in addition to recurrence. The outcome variables, disease free recurrence, and disease specific survival, where plotted using Kaplan-Meier curves.
RESULTS
PAC and CAC both show median age of diagnosis in the sixth decade of life and a female predominance. CAC occurs most frequently in the tongue and PAC in the palate. The 2 groups show a similar biologic behavior in regards to incidence of distant metastasis (4.1 vs 5.5%), recurrence (12.5 vs 17.8%), and death from disease (3 vs 2.7%). However, there was an increased incidence of nodal metastasis in CAC (53%) as compared with that in PAC of all subtypes (14%).
CONCLUSIONS
CAC exhibits more aggressive biologic behavior as compared with the PAC cohort. Although CAC is not an officially recognized entity, these tumors likely comprise a significant portion of the cases of PAC with poor outcomes and are deserving of attention and consideration for escalation in oncologic treatment.
Topics: Adenocarcinoma; Aggression; Female; Humans; Medical Oncology; Neoplasm Recurrence, Local; Salivary Gland Neoplasms; Transforming Growth Factor beta
PubMed: 34023291
DOI: 10.1016/j.joms.2021.03.027 -
Head & Neck Oct 2018The purpose of this study was to determine the clinical outcomes and review the management strategies for metastatic esthesioneuroblastoma. (Meta-Analysis)
Meta-Analysis
BACKGROUND
The purpose of this study was to determine the clinical outcomes and review the management strategies for metastatic esthesioneuroblastoma.
METHODS
We conducted a systematic review and meta-analysis.
RESULTS
Forty-eight studies totaling 118 patients met inclusion criteria. Chemotherapy in combination with surgery and/or radiation exhibited the best overall survival when compared to monotherapy and no treatment (P < .001). However, most patients (66%) received either monotherapy or no therapy. The number and location of metastases among the 3 treatment groups did not significantly differ (P = .85). Treatment modality remained significantly associated with overall survival on multivariable analysis (P < .001). Platinum-based chemotherapy was most commonly utilized but did not provide a survival benefit when compared with all other regimens (P = .88).
CONCLUSION
Distant metastases with esthesioneuroblastoma portend a poor prognosis. Chemotherapy in combination with surgery and/or radiation was associated with improved overall survival. Further research into the optimal systemic therapeutic regimen for patients with distant metastases is critical.
Topics: Age Factors; Combined Modality Therapy; Esthesioneuroblastoma, Olfactory; Humans; Nasal Cavity; Neoplasm Metastasis; Nose Neoplasms; Prognosis
PubMed: 29756250
DOI: 10.1002/hed.25209 -
Gynecologic Oncology May 2014The purpose of this study is to summarize the data on the incidence, clinical behavior and overall survival of patients with glassy cell cervical carcinoma (GCCC). (Meta-Analysis)
Meta-Analysis Review
OBJECTIVE
The purpose of this study is to summarize the data on the incidence, clinical behavior and overall survival of patients with glassy cell cervical carcinoma (GCCC).
METHODS
Twenty-four case series and fifteen case reports identified by searching PubMed database qualified for inclusion in this study. The published cases were combined with data from a retrospective chart review of patients with GCCC in two major teaching hospitals in Brooklyn, NY.
RESULTS
A total of 292 cases were collected through our literature and chart review. Median age at diagnosis was 45 years old (range 12-87 years of age). GCCC incidence ranges from 0.2 to 9.3% of all cervical cancers and 2 to 30.2% of cervical adenocarcinomas. The stage distribution is similar to squamous cell carcinoma with 79% of the patients being diagnosed with Stage I or II disease. Most common sites of recurrence for Stage I patients are the vagina and pelvis. In Stage II patients locoregional and distant metastases are equally common. Recurrence rate was higher among patients treated only with surgery (32.7%), as compared to patients treated with surgery followed by radiation (11%) or patients treated with radiation only (10%). Median overall survival (OS) was 25 months (95% CI 8.4-41.6). Overall 5-year survival for all stages is lower when compared to all cervical cancers (54.8% vs 75%). There was no interaction between race and OS (p=0.66).
CONCLUSION
GCCC is a rare histologic type of cervical cancer that presents at a younger age, is associated with high risk for distant failure and carries worse prognosis as compared to the squamous cell type. Radiation therapy is associated with decreased risk of recurrence.
Topics: Adolescent; Adult; Aged; Aged, 80 and over; Antineoplastic Agents; Carcinoma, Adenosquamous; Child; Combined Modality Therapy; Female; Humans; Hysterectomy; Middle Aged; Neoplasm Recurrence, Local; Neoplasm Staging; Prognosis; Radiotherapy; Retrospective Studies; Uterine Cervical Neoplasms; Young Adult
PubMed: 24503463
DOI: 10.1016/j.ygyno.2014.01.048 -
International Journal of Medical... Sep 2021Long-distance caregiving (LDC) technologies play a significant role in enabling distant care and facilitating living-alone older adults to keep socially connected.... (Review)
Review
PURPOSE
Long-distance caregiving (LDC) technologies play a significant role in enabling distant care and facilitating living-alone older adults to keep socially connected. However, there is scarce research exploring the older adults' attitudes towards and intention to use such technologies. This paper is based on a systematic review of existing literature to explore the multifarious factors influencing independent community-living older adults' attitudes towards and intention to use LDC technologies.
METHODS
Articles published in English between 2006 and 2020 were reviewed by searching electronic databases of PubMed, ProQuest, EBSCOhost. The inclusion criteria were limited to quantitative, qualitative, or mixed-methods studies that involved: 1) distant caregiving; 2) older adults aged 60 years or above, who were living alone or with only their spouse in the community (even though the samples might also involve other non-older adults); 3) technologies including ICT-based devices, systems, or programs enabling data transmission were used; 4), intention to use or behavioral usage in regard to the technologies were reported or discussed.
RESULTS
In total, 41 out of 8674 articles were included. Both determinants and moderators of affecting the use of the ICT-based LDC technologies were identified with theoretical guidance. To summarize, there are personal factors involved, such as personality, concerns regarding security and privacy, health conditions, requisite knowledge, financial conditions, and influence from significant others, encompassing formal and informal caregivers; and factors related to the devices, in terms of their user-friendliness and functionality.
CONCLUSION
This review highlights the importance of striking a good balance between functionality and privacy concerns, besides considering the direct and indirect cost to users. LDC technology education should be promoted at the societal level to facilitate older adults' better understanding of the device utilities by enhancing their technological literacy. Implications for various stakeholders to cope with the challenges of an aging population are also discussed.
Topics: Aged; Aging; Attitude; Humans; Independent Living; Intention; Technology
PubMed: 34325206
DOI: 10.1016/j.ijmedinf.2021.104536 -
Diagnostics (Basel, Switzerland) Jan 2023The aim of the study was to analyse papers describing the use of Electrochemotherapy (ECT) in local treatment of primary and secondary liver tumours located at different... (Review)
Review
The aim of the study was to analyse papers describing the use of Electrochemotherapy (ECT) in local treatment of primary and secondary liver tumours located at different sites and with different histologies. Other Local Ablative Therapies (LAT) are also discussed. Analyses of these papers demonstrate that ECT use is safe and effective in lesions of large size, independently of the histology of the treated lesions. ECT performed better than other thermal ablation techniques in lesions > 6 cm in size and can be safely used to treat lesions distant, close, or adjacent to vital structures. ECT spares vessel and bile ducts, is repeatable, and can be performed between chemotherapeutic cycles. ECT can fill the gap in local ablative therapies due to being lesions too large or localized in highly challenging anatomical sites.
PubMed: 36673019
DOI: 10.3390/diagnostics13020209 -
European Journal of Nuclear Medicine... Dec 2021Fibroblast activation protein-α (FAPα) is overexpressed on cancer-associated fibroblasts in approximately 90% of epithelial neoplasms, representing an appealing target... (Meta-Analysis)
Meta-Analysis
INTRODUCTION
Fibroblast activation protein-α (FAPα) is overexpressed on cancer-associated fibroblasts in approximately 90% of epithelial neoplasms, representing an appealing target for therapeutic and molecular imaging applications. [ Ga]Ga-labelled radiopharmaceuticals-FAP-inhibitors (FAPI)-have been developed for PET. We systematically reviewed and meta-analysed published literature to provide an overview of its clinical role.
MATERIALS AND METHODS
The search, limited to January 1st, 2018-March 31st, 2021, was performed on MedLine and Embase databases using all the possible combinations of terms "FAP", "FAPI", "PET/CT", "positron emission tomography", "fibroblast", "cancer-associated fibroblasts", "CAF", "molecular imaging", and "fibroblast imaging". Study quality was assessed using the QUADAS-2 criteria. Patient-based and lesion-based pooled sensitivities/specificities of FAPI PET were computed using a random-effects model directly from the STATA "metaprop" command. Between-study statistical heterogeneity was tested (I-statistics).
RESULTS
Twenty-three studies were selected for systematic review. Investigations on staging or restaging head and neck cancer (n = 2, 29 patients), abdominal malignancies (n = 6, 171 patients), various cancers (n = 2, 143 patients), and radiation treatment planning (n = 4, 56 patients) were included in the meta-analysis. On patient-based analysis, pooled sensitivity was 0.99 (95% CI 0.97-1.00) with negligible heterogeneity; pooled specificity was 0.87 (95% CI 0.62-1.00), with negligible heterogeneity. On lesion-based analysis, sensitivity and specificity had high heterogeneity (I = 88.56% and I = 97.20%, respectively). Pooled sensitivity for the primary tumour was 1.00 (95% CI 0.98-1.00) with negligible heterogeneity. Pooled sensitivity/specificity of nodal metastases had high heterogeneity (I = 89.18% and I = 95.74%, respectively). Pooled sensitivity in distant metastases was good (0.93 with 95% CI 0.88-0.97) with negligible heterogeneity.
CONCLUSIONS
FAPI-PET appears promising, especially in imaging cancers unsuitable for [F]FDG imaging, particularly primary lesions and distant metastases. However, high-level evidence is needed to define its role, specifically to identify cancer types, non-oncological diseases, and clinical settings for its applications.
Topics: Endopeptidases; Fluorodeoxyglucose F18; Gelatinases; Head and Neck Neoplasms; Humans; Membrane Proteins; Positron Emission Tomography Computed Tomography; Positron-Emission Tomography; Serine Endopeptidases
PubMed: 34173007
DOI: 10.1007/s00259-021-05475-0 -
European Journal of Surgical Oncology :... May 2016Oncoplastic surgery consists a new approach for extending breast conserving surgery possibilities This manuscript aimed to systematically review data on the oncological... (Review)
Review
UNLABELLED
Oncoplastic surgery consists a new approach for extending breast conserving surgery possibilities This manuscript aimed to systematically review data on the oncological outcome of oncoplastic breast surgery. Electronic databases were searched with the appropriate search term up to and included April 2013.
INCLUSION CRITERIA
full publications including at least 10 patients and providing evidence on at least one of the following outcomes: margin involvement, local recurrence, metastatic disease, death number. Forty studies including 2830 patients, met inclusion criteria; twenty one studies investigated volume displacement techniques; fifteen studies investigated volume replacement techniques; four studies presented data on various oncoplastic techniques. Study quality was low. The majority of studies were observational studies. The length of follow up was relatively short, with only two studies reporting a median duration longer than 60 months. Only seven studies including more than 100 patients. There was great variation in the frequency of margin involvement ranging between 0% and 36% of patients. Local recurrence was observed in 0-10.8% of patients. Distant metastasis was observed in 0-18.9% of patients. In conclusion, long term oncological outcome of oncoplastic surgery for breast cancer is not adequately investigated. Further research efforts should focus on Level I evidence on oncological outcome of oncoplastic surgery.
Topics: Breast Neoplasms; Female; Humans; Mammaplasty; Mastectomy, Segmental; Neoplasm Metastasis; Neoplasm Recurrence, Local
PubMed: 26922045
DOI: 10.1016/j.ejso.2016.02.002 -
Oral Diseases Nov 2022To integrate the available data published on malignant peripheral nerve sheath tumours (MPNST) of the oral and maxillofacial region. Searches in Embase, PubMed, Web of... (Review)
Review
To integrate the available data published on malignant peripheral nerve sheath tumours (MPNST) of the oral and maxillofacial region. Searches in Embase, PubMed, Web of Science and Scopus were conducted for the identification of case reports/case series in English language. The risk of bias was assessed using the Joanna Briggs Institute tool. Outcomes were evaluated by Cox regression and Kaplan-Meier methods. A total of 306 articles were retrieved, 50 of which reporting 57 MPNST were included. The lesion showed a predilection for the mandible (n = 18/31.57%) of middle-aged adults (~40.5 years) with a male/female ratio of 1.1:1. The individuals were mostly symptomatic with a mean evolution time of 9.6 months. Surgical removal plus adjuvant therapy (especially radiotherapy) was the main approach (51.86%). Recurrence was reported in 39.62% of cases. Nodal and distant metastases were identified in 28.26% and 26.66% of cases, respectively. The 2-year cumulative survival rate was 55%. Independent predictors of poor survival were the presence of neurofibromatosis type 1 (p = 0.04) and distant metastases (p = 0.004). The diagnosis of MPNST is challenging due to the variety of its clinical and histopathological presentations. Local aggressiveness and the potential for metastases are common outcomes of this neoplasm.
Topics: Adult; Combined Modality Therapy; Female; Humans; Male; Middle Aged; Mouth Neoplasms; Neoplasm Recurrence, Local; Nerve Sheath Neoplasms; Neurofibromatosis 1; Neurofibrosarcoma
PubMed: 34333825
DOI: 10.1111/odi.13982 -
Acta Oncologica (Stockholm, Sweden) Jun 2020To determine the frequency of discordance in programmed death-ligand 1(PD-L1) expression between primary tumors and paired distant metastases in advanced cancers. We... (Meta-Analysis)
Meta-Analysis
Frequency of discordance in programmed death-ligand 1 (PD-L1) expression between primary tumors and paired distant metastases in advanced cancers: a systematic review and meta-analysis.
To determine the frequency of discordance in programmed death-ligand 1(PD-L1) expression between primary tumors and paired distant metastases in advanced cancers. We searched MEDLINE and EMBASE for eligible studies and assessed their methodologic quality using QUADAS-2 tool. We estimated the discordant rates (positive to negative or vice versa) of PD-L1 expression in primary tumors and paired distant metastases using logistic-normal random effects model. We performed subgroup analyses based on the PD-L1 status of primary tumors (positive or negative), location of primary tumors (lung or others) and distant metastases (central nervous system or others), timing of distant metastases (synchronous or metachronous), positivity thresholds of PD-L1 expression (1% or 5%) and types of antibody clones used (E1L3N or SP142). Thirteen eligible studies including 451 cases were identified. The included studies were judged to have low to unclear risk of bias. The pooled estimate of discordant rates in PD-L1 expression was 31% (95% CI= 19-47%), with high heterogeneity across the studies ( = 75%). There was no significant effect modification in the discordant rates according to the predefined subgroups. Approximately one-third of advanced cancer cases have discordance in PD-L1 expression between primary tumors and paired distant metastases. A more liberal testing of PD-L1 expression in both primary and metastatic tumors is recommended in order to identify patients who may benefit from immune checkpoint blockade treatment. Further research exploring the mechanisms and its impact are warranted.
Topics: B7-H1 Antigen; Bias; Confidence Intervals; Humans; Neoplasm Metastasis; Neoplasm Proteins; Neoplasms; Retrospective Studies
PubMed: 32193962
DOI: 10.1080/0284186X.2020.1741678