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American Journal of Rhinology & Allergy Sep 2023Leiomyomas are benign smooth muscle tumors that are rarely diagnosed in the nasal cavity and paranasal sinuses. (Review)
Review
BACKGROUND
Leiomyomas are benign smooth muscle tumors that are rarely diagnosed in the nasal cavity and paranasal sinuses.
OBJECTIVE
This systematic review summarizes the histopathologic and clinical tumor characteristics, surgical management, and follow-up of sinonasal leiomyomas.
METHODS
A systematic review of the literature on sinonasal leiomyoma was performed by applying the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. Studies that met the inclusion criteria were assessed for level of evidence. Patient demographics, clinical and pathological tumor characteristics, primary intervention, and results of follow-up were evaluated.
RESULTS
Forty studies including 84 patients with sinonasal leiomyoma were identified. The tumor was most often located in the nasal cavity (47/84, 56%) originating from the inferior turbinate (32/84, 38%). Patients mostly presented with symptoms originating from an intranasal mass, including recurrent epistaxis (41/84, 49%), nasal obstruction (43/84, 51.2%), and localized facial or head pain (25/84, 29.8%). Surgery was performed in all cases. An endoscopic approach was most frequently chosen. Recurrence occurred only twice (2.4%). Morbidity was noted in 2 cases (2.4%) following postoperative bleeding and 1 (1.2%) case following a CSF leak.
CONCLUSION
Sinonasal leiomyomas are neoplasms of the smooth muscle manifesting clinically with recurrent epistaxis and nasal obstruction. Management goal is total resection with clear margins to avoid local recurrence.
Topics: Humans; Paranasal Sinus Neoplasms; Nasal Obstruction; Epistaxis; Follow-Up Studies; Leiomyoma; Nose Neoplasms
PubMed: 37093753
DOI: 10.1177/19458924231170464 -
Oncology Nursing Forum Sep 2021Cancer-related fatigue (CRF) substantially affects daily living and quality of life, but objective CRF measures remain limited. This review aimed to identify the... (Meta-Analysis)
Meta-Analysis
PROBLEM IDENTIFICATION
Cancer-related fatigue (CRF) substantially affects daily living and quality of life, but objective CRF measures remain limited. This review aimed to identify the correlation between muscle strength and body composition measures and CRF, as well as potential objective indicators for assessing CRF.
LITERATURE SEARCH
PubMed®, MEDLINE®, CINAHL®/PsycINFO®, and Embase® were searched for studies published from January 2000 to January 2021.
DATA EVALUATION
Study selection and quality assessment were conducted using the Critical Appraisals Skills Programme checklist and the Strengthening the Reporting of Observational Studies in Epidemiology statement. Comprehensive Meta-Analysis software was used to perform meta-analysis.
SYNTHESIS
25 studies were selected, and 19 measures were analyzed. CRF negatively correlated with hand grip strength, knee extensor strength, and the sit-to-stand test. No significant correlation was found between body composition measures and CRF.
IMPLICATIONS FOR NURSING
The evidence suggests that muscle strength measures may be potential indicators for CRF assessment. Combining objective and subjective CRF assessments could assist clinicians in evaluating the effectiveness of CRF interventions more accurately.
Topics: Body Composition; Fatigue; Hand Strength; Humans; Muscle Strength; Neoplasms; Quality of Life
PubMed: 34411084
DOI: 10.1188/21.ONF.558-576 -
Acta Oncologica (Stockholm, Sweden) Mar 2023In patients with cancer, sarcopenia is associated with treatment related complications, treatment cessation, poor quality of life and reduced overall survival. Despite... (Meta-Analysis)
Meta-Analysis
BACKGROUND
In patients with cancer, sarcopenia is associated with treatment related complications, treatment cessation, poor quality of life and reduced overall survival. Despite this, there is limited knowledge about changes in skeletal muscle mass during chemotherapy. The aim of this systematic review and meta-analysis was to investigate the change of skeletal muscle mass and sarcopenia during chemotherapy treatment among patients with lung cancer.
METHODS
A systematic literature search was conducted in three databases, PubMed, EMBASE and Web of Science. Observational studies with patients with lung cancer were eligible for inclusion if skeletal muscle mass was measured before and after receiving chemotherapy treatment.
RESULTS
Ten cohort studies with a total of 867 participants met the inclusion criteria. During 5.2 ± 2.9 months of chemotherapy treatment, patients with lung cancer experienced a significant loss of skeletal muscle mass with a standardized mean difference (SMD) of: -0.25 (95% CI -0.47 to -0.03). The pretreatment prevalence of sarcopenia varied across studies from 35% to 74%. Only one study reported prevalence of sarcopenia both before and after chemotherapy treatment with an increase from 35% to 59%.
CONCLUSION
The present data demonstrate a marked loss of skeletal muscle mass in patients with lung cancer undergoing chemotherapy treatment, as well as a high prevalence of sarcopenia. As sarcopenia is associated with poor clinical outcomes, it seems important to include and use assessments of skeletal muscle mass in clinical practice to identify patients in need for interventions. Moreover, interventional studies to hinder development of sarcopenia are needed.
Topics: Humans; Sarcopenia; Muscle, Skeletal; Quality of Life; Lung Neoplasms
PubMed: 37051865
DOI: 10.1080/0284186X.2023.2180660 -
Scientific Reports Jun 2017This systematic review and cumulative analysis aimed to explore the efficacy and safety of the combination of intravesical mitomycin C (MMC) plus bacillus... (Review)
Review
This systematic review and cumulative analysis aimed to explore the efficacy and safety of the combination of intravesical mitomycin C (MMC) plus bacillus Calmette-Guerin (BCG) for non-muscle-invasive bladder cancer (NMIBC) patients. A comprehensive literature search using Pubmed, Embase, Medline, Cochrane Library, CBM, CNKI and VIP databases was performed to identify studies applying intravesical MMC plus BCG therapy on NMIBC patients up to June 2016. Summarized unadjusted odds ratios (ORs) with 95% confidence intervals (CIs) were calculated to assess the efficacy and safety of the combination therapy. A total of 25 studies containing 2749 NMIBC patients were included in this systematic review. Compared with BCG monotherapy, the combination therapy could significantly reduce the tumor recurrence rate (OR = 0.64, 95% CI: 0.44-0.94, P = 0.02) and cancer-specific mortality (OR = 0.54, 95% CI: 0.34-0.87, P = 0.01), without more toxicities (OR = 0.58, 95% CI: 0.17-1.94, P = 0.37). The combination therapy could also lead to significant lower tumor recurrence rate than MMC monotherapy (OR = 0.41, 95% CI: 0.24-0.69, P = 0.0009). Our study indicates that the combination of MMC plus BCG instillation is an effective and safe adjuvant treatment for NMIBC patients.
Topics: Aged; Antineoplastic Combined Chemotherapy Protocols; BCG Vaccine; Female; Humans; Male; Middle Aged; Mitomycin; Muscle, Skeletal; Neoplasm Invasiveness; Urinary Bladder Neoplasms
PubMed: 28600516
DOI: 10.1038/s41598-017-03421-5 -
World Journal of Urology Feb 2023Bladder cancer detection and follow-up is based on cystoscopy and/or cytology, but it remains imperfect and invasive. Current research focuses on diagnostic biomarkers... (Review)
Review
BACKGROUND
Bladder cancer detection and follow-up is based on cystoscopy and/or cytology, but it remains imperfect and invasive. Current research focuses on diagnostic biomarkers that could improve bladder cancer detection and follow-up by discriminating patients at risk of aggressive cancer who need confirmatory TURBT (Transurethral Resection of Bladder Tumour) from patients at no risk of aggressive cancer who could be spared from useless explorations.
OBJECTIVE
To perform a systematic review of data on the clinical validity and clinical utility of eleven urinary biomarkers (VisioCyt, XpertBladder, BTA stat, BTA TRAK™, NMP22 BC, NMP22 BladderChek Test, ImmunoCyt™/uCyt1+™, UroVysion Bladder Cancer Kit, Cxbladder, ADXBLADDER, Urodiag) for bladder cancer diagnosis and for non-muscle invasive bladder cancer (NMIBC) follow-up.
METHODS
All available studies on the 11 biomarkers published between May 2010 and March 2021 and present in MEDLINE were reviewed. The main endpoints were clinical performance for bladder cancer detection, recurrence or progression during NMIBC monitoring, and additional value compared to cytology and/or cystoscopy.
RESULTS
Most studies on urinary biomarkers had a prospective design and high level of evidence. However, their results should be interpreted with caution given the heterogeneity among studies. Most of the biomarkers under study displayed higher detection sensitivity compared with cytology, but lower specificity. Some biomarkers may have clinical utility for NMIBC surveillance in patients with negative or equivocal cystoscopy or negative or atypical urinary cytology findings, and also for recurrence prediction.
CONCLUSION
Urinary biomarkers might have a complementary place in bladder cancer diagnosis and NMIBC surveillance. However, their clinical benefit remains to be confirmed.
Topics: Humans; Urinary Bladder; Biomarkers, Tumor; Urinary Bladder Neoplasms; Cystoscopy; Cytodiagnosis; Neoplasm Recurrence, Local
PubMed: 36592175
DOI: 10.1007/s00345-022-04253-3 -
BMC Anesthesiology Jun 2023Regional anesthesia appears to reduce cancer recurrence, but the optimal anesthesia modality for non-muscle invasive bladder cancer (NMIBC) were still under debate.... (Meta-Analysis)
Meta-Analysis
Effect of regional versus general anesthesia on recurrence of non-muscle invasive bladder cancer: a systematic review and meta-analysis of eight retrospective cohort studies.
BACKGROUND
Regional anesthesia appears to reduce cancer recurrence, but the optimal anesthesia modality for non-muscle invasive bladder cancer (NMIBC) were still under debate. Therefore, we sought to assess the effect of regional and GA only upon the recurrence and long-term prognosis of NMIBC through this meta-analysis.
METHODS
We performed an extensive literature search of PubMed, Embase, Web of Science, the Cochrane Library and China National Knowledge Infrastructure (up to October 30, 2022) to identify eligible articles on the possible impact of different anesthetic modalities for the recurrence rate of NMIBC.
RESULTS
Eight studies comprising 3764 participants, including 2117 subjects with RA and 1647 with GA, were finally enrolled. Cancer recurrence rate was significantly lower in subjects with RA than those with GA (RR 0.84, 95%CI 0.72-0.98, P = 0.03). We didn't detect the differences between GA and RA in the time of recurrence (SMD 2.07, 95% CI -0.49-4.63, P = 0.11) and cancer progression (RR 1.14, 95%CI 0.71-1.84, P = 0.59). Results from subgroup analysis demonstrated that spinal anesthesia could significantly decrease the incidence of cancer recurrence in comparison with general anesthesia (RR 0.80, 95%CI 0.72-0.88, P < 0.001) and high-risk NMIBC patients who received RA tended to have less recurrence (HR 0.55, 95%CI 0.39-0.79, P = 0.001) than those receiving GA.
CONCLUSIONS
RA, especially spinal anesthesia, may be effective in reducing the recurrence rate after transurethral resection of NMIBC. More prospective experimental and clinical studies are needed to validate our findings.
TRIAL REGISTRATION
INPLASY registration INPLASY2022110097.
Topics: Humans; Non-Muscle Invasive Bladder Neoplasms; Prospective Studies; Retrospective Studies; Urinary Bladder Neoplasms; Anesthesia, General
PubMed: 37312019
DOI: 10.1186/s12871-023-02136-7 -
Annals of Surgery Nov 2022Sarcopenia has been identified as a prognostic factor among certain types of cancer. In esophageal cancer, patients are at increased risk of malnutrition and sarcopenia,... (Meta-Analysis)
Meta-Analysis
Sarcopenia Determined by Skeletal Muscle Index Predicts Overall Survival, Disease-free Survival, and Postoperative Complications in Resectable Esophageal Cancer: A Systematic Review and Meta-analysis.
BACKGROUND
Sarcopenia has been identified as a prognostic factor among certain types of cancer. In esophageal cancer, patients are at increased risk of malnutrition and sarcopenia, ultimately contributing to poor outcomes. A systematic review was conducted to determine whether sarcopenia, defined by the skeletal muscle index, is predictive of overall survival, disease-free survival, and postoperative complications in resectable esophageal cancer.
MATERIALS AND METHODS
A systematic search of MEDLINE, EMBASE, Scopus, Web of Science, and Cochrane Library was conducted according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines up until January 2021. The primary outcome was overall survival; secondary outcomes included disease-free survival, pulmonary complications, and anastomotic leak.
RESULTS
Twenty-one studies (4 prospective; 17 retrospective; 3966 patients) were included. Sarcopenia was present in 1940 (48.1%) patients and was associated with lower overall survival [hazard ratio (HR): 1.56; 95% confidence interval (CI): 1.25-1.95; P <0.00001; I2 =71%] and disease-free survival (HR: 1.73; 95% CI: 1.04-2.87; P =0.03; I2 =51%). A decrease in skeletal muscle index, independent of sarcopenia status, was associated with lower overall survival (HR: 1.81; 95% CI: 1.20-2.73; P =0.005; I2 =92%). Sarcopenia was associated with increased odds of pulmonary complications (odds ratio: 1.86; 95% CI: 1.29-2.66; P =0.0008; I2 =41%) and increased odds of anastomotic leak (odds ratio: 1.46; 95% CI: 1.11-1.93; P =0.008; I2 =0%).
CONCLUSIONS
Sarcopenia is a predictor of overall survival, disease-free survival, and postoperative complications in patients with resectable esophageal cancer. Studies on the modifiability of sarcopenia in the preoperative period will help determine the utility of nutritional interventions.
Topics: Anastomotic Leak; Disease-Free Survival; Esophageal Neoplasms; Humans; Muscle, Skeletal; Postoperative Complications; Prognosis; Prospective Studies; Retrospective Studies; Risk Factors; Sarcopenia
PubMed: 35794004
DOI: 10.1097/SLA.0000000000005452 -
European Urology Nov 2017Tumour grade is an important prognostic indicator in non-muscle-invasive bladder cancer (NMIBC). Histopathological classifications are limited by interobserver... (Comparative Study)
Comparative Study Review
Prognostic Performance and Reproducibility of the 1973 and 2004/2016 World Health Organization Grading Classification Systems in Non-muscle-invasive Bladder Cancer: A European Association of Urology Non-muscle Invasive Bladder Cancer Guidelines Panel Systematic Review.
CONTEXT
Tumour grade is an important prognostic indicator in non-muscle-invasive bladder cancer (NMIBC). Histopathological classifications are limited by interobserver variability (reproducibility), which may have prognostic implications. European Association of Urology NMIBC guidelines suggest concurrent use of both 1973 and 2004/2016 World Health Organization (WHO) classifications.
OBJECTIVE
To compare the prognostic performance and reproducibility of the 1973 and 2004/2016 WHO grading systems for NMIBC.
EVIDENCE ACQUISITION
A systematic literature search was undertaken incorporating Medline, Embase, and the Cochrane Library. Studies were critically appraised for risk of bias (QUIPS). For prognosis, the primary outcome was progression to muscle-invasive or metastatic disease. Secondary outcomes were disease recurrence, and overall and cancer-specific survival. For reproducibility, the primary outcome was interobserver variability between pathologists. Secondary outcome was intraobserver variability (repeatability) by the same pathologist.
EVIDENCE SYNTHESIS
Of 3593 articles identified, 20 were included in the prognostic review; three were eligible for the reproducibility review. Increasing tumour grade in both classifications was associated with higher disease progression and recurrence rates. Progression rates in grade 1 patients were similar to those in low-grade patients; progression rates in grade 3 patients were higher than those in high-grade patients. Survival data were limited. Reproducibility of the 2004/2016 system was marginally better than that of the 1973 system. Two studies on repeatability showed conflicting results. Most studies had a moderate to high risk of bias.
CONCLUSIONS
Current grading classifications in NMIBC are suboptimal. The 1973 system identifies more aggressive tumours. Intra- and interobserver variability was slightly less in the 2004/2016 classification. We could not confirm that the 2004/2016 classification outperforms the 1973 classification in prediction of recurrence and progression.
PATIENT SUMMARY
This article summarises the utility of two different grading systems for non-muscle-invasive bladder cancer. Both systems predict progression and recurrence, although pathologists vary in their reporting; suggestions for further improvements are made.
Topics: Disease Progression; Disease-Free Survival; Humans; Neoplasm Grading; Neoplasm Invasiveness; Neoplasm Metastasis; Neoplasm Recurrence, Local; Observer Variation; Practice Guidelines as Topic; Predictive Value of Tests; Reproducibility of Results; Treatment Outcome; Urinary Bladder Neoplasms; World Health Organization
PubMed: 28457661
DOI: 10.1016/j.eururo.2017.04.015 -
Clinical Nutrition ESPEN Jun 2022Hepatocellular carcinoma (HCC) is the fifth most common malignant tumor disease in the world. The impact of sarcopenia on survival outcomes in patients with HCC has been... (Meta-Analysis)
Meta-Analysis
BACKGROUND & AIMS
Hepatocellular carcinoma (HCC) is the fifth most common malignant tumor disease in the world. The impact of sarcopenia on survival outcomes in patients with HCC has been studied, but the extent of the impact remains unclear. This systematic review and meta-analysis aimed to analyze the prevalence of low skeletal muscle mass (LSMM) as a surrogate parameter for sarcopenia in patients with HCC and its influence on survival parameters after various treatments in a large study population.
METHODS
Different databases such as MEDLINE, Cochrane database, and SCOPUS were screened for studies on sarcopenia, respectively LSMM and survival in HCC up to March 2021. Twenty-seven studies met the inclusion criteria. The methodological quality was analyzed via QUADAS-2. We investigated the prevalence of LSMM and its impact on overall and recurrence/disease-free survival.
RESULTS
The prevalence of LSMM, defined by different cut-off values, was 38.5%. In patients with LSMM, overall survival (OS) was strongly impaired in univariable and multivariable analyses: HR = 1.84, 95% CI = 1.64-2.07, p < 0.00001 and HR = 1.89, 95% CI = 1.61-2.23, p < 0.00001, respectively. Subanalyses on patients treated with kinase inhibitors such as Sorafenib or Lenvatinib (4 studies) or hepatectomy (6 studies) showed lower overall survival in multivariable regression with HR = 2.24, 95% = 1.60-3.14, p < 0.00001 and HR = 2.17, 95% CI = 1.48-3.19, p < 0.00001, respectively. Patients with LSMM post-resection also showed lower recurrence-free survival with HR = 1.79, 95% CI = 1.28-2.50, p < 0.00001 in multivariable analysis.
CONCLUSION
LSMM is very frequent in patients with HCC. Due to its impact on survival, there is a need for adequate treatment and prevention, which proves to be challenging due to its multifactorial nature. For future investigation, one should focus on prospective study protocols as well as standardized assessment methods and cut-off values.
Topics: Carcinoma, Hepatocellular; Humans; Liver Neoplasms; Muscle, Skeletal; Prevalence; Prospective Studies; Sarcopenia
PubMed: 35623801
DOI: 10.1016/j.clnesp.2022.04.009 -
European Journal of Surgical Oncology :... Jul 2022Sarcopenia represents an index of frailty amongst cancer patients and it is associated with poor oncological outcomes and a higher risk of surgical complications in... (Meta-Analysis)
Meta-Analysis Review
Prevalence of computed tomography-based sarcopenia and the prognostic value of skeletal muscle index and muscle attenuation amongst women with epithelial ovarian malignancy: A systematic review and meta-analysis.
BACKGROUND
Sarcopenia represents an index of frailty amongst cancer patients and it is associated with poor oncological outcomes and a higher risk of surgical complications in several types of malignancy.
AIM
To further delineate the impact of sarcopenia assessed via computed tomography scan (CT) on oncological outcomes and post-operative complications amongst women with epithelial ovarian carcinoma (EOC). Our secondary objective was to quantify and understand the prevalence of sarcopenia in EOC.
DESIGN
We systematically searched MEDLINE, SCOPUS, ClinicalTrials.gov, and Cochrane Database, from inception up to August 2021. Quality assessment was performed using the Newcastle-Ottawa scale (NOS). Outcomes consisted of prevalence, overall survival (OS), progression-free survival (PFS) and post-operative complications. Pooled analyses of proportion estimates, hazard ratios (HRs) and odds ratios (ORs) were performed with STATA and Review Manager 5.3.
RESULTS
21 studies were included in this meta-analysis. NOS scores ranged from six to nine. Pooled analysis yielded an overall sarcopenia prevalence of 41%. Pooled analysis of adjusted HRs demonstrated significant association between low muscle attenuation (MA) [aHR = 1.23, (95% CI 1.02-1.47), p-value = 0.03] and OS, whilst low skeletal muscle index (SMI) trended towards shorter OS [aHR = 1.37, (95% CI 0.99-1.90), p-value = 0.05. Low-SMI was also associated with higher risk of total post-operative complications [uOR = 1.56, (95% CI 1.16-2.11), p-value = 0.004].
CONCLUSION
Our findings suggest that CT-assessed skeletal mass and radiodensity represent rather accurate indices of nutritional status and could prospectively be incorporated into the decision-making process in women with EOC.
Topics: Carcinoma, Ovarian Epithelial; Female; Humans; Muscle, Skeletal; Ovarian Neoplasms; Postoperative Complications; Prevalence; Prognosis; Sarcopenia; Tomography, X-Ray Computed
PubMed: 35260290
DOI: 10.1016/j.ejso.2022.02.024