-
Oncotarget Feb 2017Red blood cell distribution width (RDW), a parameter that used to differentiate the type of anemia for several decades, recent studies suggest it was a prognostic factor... (Meta-Analysis)
Meta-Analysis Review
Red blood cell distribution width (RDW), a parameter that used to differentiate the type of anemia for several decades, recent studies suggest it was a prognostic factor in various types of cancer patients. However, the prognostic value of RDW in cancer patients remains controversial. Here, we performed a meta-analysis and systematic review to evaluate the prognostic value of RDW in cancer patients. Relevant studies were picked out from the databases of Web of Science, Embase, Pubmed and Cochrane Library. A total of 16 papers with 4267 patients were included in this meta-analysis, and the combined results indicated that elevated RDW was associated with poor over survival (OS) (HR = 1.47, 95%CI:1.29-1.66), poor cancer-specific survival (CSS) (HR = 1.46, 95%CI:1.08-1.85), poor disease-free survival (DFS) (HR = 1.91, 95%CI:1.27-2.56), poor event-free survival (EFS) (HR = 2.98, 95%CI:0.57-5.39) and poor progress-free survival (PFS) (HR = 3.21, 95%CI:0.33-6.75) after treatment. Furthermore, the similar results were observed in subgroup analysis stratified by cancer type, cutoff value of RDW, sample size and ethnicity. In conclusion, this meta-analysis demonstrated that RDW may be a potential prognostic marker in patients with cancer, and high RDW may also be associated with poor outcomes.
Topics: Erythrocyte Indices; Humans; Neoplasms; Prognosis
PubMed: 27926498
DOI: 10.18632/oncotarget.13784 -
The Journal of Urology Oct 2021Sarcopenia, an age-related loss of muscle mass and function, may predict adverse outcomes for patients with urological cancers. However, the clinical implications and...
PURPOSE
Sarcopenia, an age-related loss of muscle mass and function, may predict adverse outcomes for patients with urological cancers. However, the clinical implications and significance of sarcopenic obesity are not well understood. We systematically reviewed data on the prevalence and prognostic impact of sarcopenic obesity for patients with renal cell carcinoma, urothelial carcinoma and prostate cancer undergoing treatment.
MATERIALS AND METHODS
We searched EMBASE®, PubMed®/MEDLINE® and Scopus® for relevant original articles and abstracts published between January 2010 and February 2021. Primary outcomes were overall survival (OS), cancer-specific survival (CSS) and progression-free survival. The secondary outcome was the prevalence of sarcopenic obesity.
RESULTS
A total of 15 studies comprising 3,866 patients were included. Of the 10 studies that evaluated survival outcomes, the association between sarcopenic obesity and survival was mixed. One of 10 studies showed a significant association of sarcopenic obesity with OS (HR 0.7, 95% CI 0.51-0.98; p=0.04). One additional study showed reported a trend for shorter OS (p=0.05) associated with sarcopenic obesity. Others reported that it is an adverse prognostic factor for CSS (HR 5.0, 95% CI 1.4-16.7; p=0.01). All other studies did not demonstrate that sarcopenic obesity was of prognostic relevance with regard to OS, CSS and progression-free survival. Overall, its mean prevalence was 27% (range 11-63).
CONCLUSIONS
There is considerable heterogeneity in methods used to define sarcopenic obesity in the literature, and current data are limited. Future studies are needed to further understand the relationship of obesity and sarcopenia on the clinical trajectory of patients with urological cancer.
Topics: Body Composition; Comorbidity; Humans; Obesity; Prevalence; Prognosis; Progression-Free Survival; Risk Assessment; Risk Factors; Sarcopenia; Urologic Neoplasms
PubMed: 34032495
DOI: 10.1097/JU.0000000000001873 -
International Journal of Infectious... Dec 2013To determine prognostic factors for mortality in neonates with tetanus and to assess the associations between prognostic factors and neonatal tetanus (NT) mortality. (Meta-Analysis)
Meta-Analysis Review
OBJECTIVES
To determine prognostic factors for mortality in neonates with tetanus and to assess the associations between prognostic factors and neonatal tetanus (NT) mortality.
METHODS
Five databases were searched for studies on prognostic factors and NT mortality published up to April 2013 to identify studies relevant to this review. Prognostic factors of interest were birth weight, age at onset of symptoms, age at presentation, delay in presentation, and duration of hospitalization. Odds ratios (ORs) for prognostic factors and mortality were estimated by random effects models and stratified analyses for all studies.
RESULTS
Sixteen studies including a total of 4535 neonates were included in the analysis: nine from Africa, five from Asia, and two from Europe. The prognostic factors identified consistently in the studies were birth weight, age at onset of symptoms, and age at presentation. Of the 16 studies, only one assessed all three prognostic factors, five studies assessed two prognostic factors, and 10 studies assessed one prognostic factor. Neonates with a low birth weight were more likely to have an increased odds of NT death (OR 2.09, 95% confidence interval (CI) 1.29-3.37) than normal weight neonates. This mortality risk was exacerbated for low birth weight neonates with age at onset≤6 days (OR 6.80, 95% CI 2.42-19.11). Age at onset≤5-7 days was associated with an increased odds of NT death.
CONCLUSIONS
Low birth weight predicted an increased odds of death by NT. Age at onset≤5-7 days to diagnosis is crucial in determining survival among neonates with tetanus.
Topics: Age of Onset; Confounding Factors, Epidemiologic; Hospital Mortality; Humans; Infant Mortality; Infant, Low Birth Weight; Infant, Newborn; Odds Ratio; Prognosis; Publication Bias; Risk Factors; Tetanus
PubMed: 24145010
DOI: 10.1016/j.ijid.2013.05.016 -
International Journal of Surgery... Jul 2019Many reports have shown that the prognostic nutritional index (PNI) is associated with the progression of malignant tumors. We comprehensively evaluated the prognostic... (Meta-Analysis)
Meta-Analysis
BACKGROUND AND AIMS
Many reports have shown that the prognostic nutritional index (PNI) is associated with the progression of malignant tumors. We comprehensively evaluated the prognostic significance of the PNI in patients with gynecological cancer.
METHODS
We identified relevant studies by searching PubMed, Embase, the Cochrane Library, and the Web of Science. The hazard ratio (HR) and odds ratio (OR) with 95% confidence interval (CI) were used to explore the correlation between PNI and overall survival (OS), progression-free survival (PFS), and the characteristics of gynecological cancer. All analyses were performed using Review Manager ver. 5.2 software.
RESULTS
We included nine studies with 2373 patients. The PNI correlated closely with the OS and PFS of gynecological cancer; the pooled HRs were respectively 2.66 (95% CI 1.56-4.55) and 2.43 (95% CI 2.07-2.86) on univariate analysis (UVA) and 1.88 (95% CI 1.10-3.20) and 1.92 (95% CI 1.52-2.44) on multivariate analysis (MVA).
CONCLUSIONS
The PNI is significantly associated with the prognosis of patients with gynecological cancer, and may, in fact, be independently prognostic.
Topics: Disease Progression; Female; Genital Neoplasms, Female; Humans; Multivariate Analysis; Nutrition Assessment; Nutritional Status; Odds Ratio; Prognosis; Proportional Hazards Models
PubMed: 31185310
DOI: 10.1016/j.ijsu.2019.05.018 -
Journal of Oral Pathology & Medicine :... May 2016Several mTOR pathway proteins are involved in the regulation of cellular anabolism, growth, proliferation, and survival. Activated proteins in the mTOR pathway are... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Several mTOR pathway proteins are involved in the regulation of cellular anabolism, growth, proliferation, and survival. Activated proteins in the mTOR pathway are deregulated in multiple types of cancers and could influence prognosis. However, it is unclear whether deregulation of mTOR pathway proteins serves a prognostic role in patients with head and neck cancer (HNC). Furthermore, proteins in the mTOR pathway may be important targets for anticancer therapy. The aim of this study was to summarize existing cohort studies to determine whether immunoexpression of mTOR pathway proteins are important prognostic factors for survival in patients with HNC.
MATERIALS AND METHODS
A systematic review was performed using the Cochrane, Lilacs, PubMed, ScienceDirect, Scopus, and Web of Science databases (up to 23 January 2015). A meta-analysis was conducted to measure the frequency of protein expression in head and neck cancer patient samples and the prognostic value of mTOR pathway proteins for overall survival (OS) and disease-free survival (DFS).
RESULTS
Twelve studies were included in our final analysis. The meta-analysis revealed that the frequency of overall expression of mTOR pathway proteins was 74.42% (CI: 63.3 to 84.0, P < 0.001, n = 2016 samples). The survival meta-analysis showed a pooled hazard ratio for OS and DFS of 1.44 (95% confidence interval [95% CI] 1.14-1.73) and 1.18 (95% CI 0.71-1.64), respectively.
CONCLUSION
This systematic review and meta-analysis support evidence that mTOR pathway proteins can be used as predictive markers for survival in patients with HNC because their expression was significantly associated with poor OS and short DFS.
Topics: Biomarkers, Tumor; Carcinoma, Squamous Cell; Cohort Studies; Disease-Free Survival; Head and Neck Neoplasms; Humans; Metabolic Networks and Pathways; Prognosis; Squamous Cell Carcinoma of Head and Neck; Survival Analysis; TOR Serine-Threonine Kinases
PubMed: 26661562
DOI: 10.1111/jop.12390 -
European Journal of Cancer (Oxford,... May 2015Early tumour shrinkage (ETS), defined as a reduction of at least 20% in tumour size at first reassessment, has been recently investigated retrospectively in first-line... (Meta-Analysis)
Meta-Analysis Review
PURPOSE
Early tumour shrinkage (ETS), defined as a reduction of at least 20% in tumour size at first reassessment, has been recently investigated retrospectively in first-line trials of metastatic colorectal cancer (CRC), and appears to be associated with better outcomes. We have performed a systematic review and meta-analysis of published trials to evaluate the prognostic value of ETS in CRC in terms of overall survival (OS) and progression-free survival (PFS).
MATERIAL AND METHODS
An electronic search of the PubMed, SCOPUS, EMBASE, the Web of Science, and the Cochrane Central Register of Controlled Trial databases identified trials that compared outcomes of patients with or without ETS during first-line chemotherapy for metastatic CRC. The OS, reported as a hazard ratio (HR) with a 95% confidence interval (CI), was the primary outcome measure; the correlation coefficient (R) between ETS with median OS was also estimated.
RESULTS
Twenty-one trials from 10 publications were analysed. Overall, patients with ETS were associated with a better OS (HR, 0.58; 95% CI, 0.53 to 0.64; P<0.00001) and PFS (HR, 0.57; 95% CI, 0.47-0.69; P<0.00001) compared with patients who were early non-responders. However, ETS was poorly correlated with OS in terms of surrogacy (R=0.37; 95% CI - 0.31-0.78; P=0.28).
CONCLUSIONS
ETS is a good prognostic factor but an inappropriate surrogate for predicting outcome in CRC patients. These findings support ETS as prognostic tool in ascertaining earlier non-responders; however, its role as a surrogate end-point deserves further evaluation.
Topics: Antineoplastic Combined Chemotherapy Protocols; Biomarkers, Tumor; Colorectal Neoplasms; Humans; Neoadjuvant Therapy; Predictive Value of Tests; Prognosis; Survival Analysis; Time Factors; Treatment Outcome; Tumor Burden
PubMed: 25794604
DOI: 10.1016/j.ejca.2015.02.011 -
Human Reproduction (Oxford, England) Oct 2023Is spontaneous collapse (SC) by human blastocysts a prognostic factor in IVF treatment? (Meta-Analysis)
Meta-Analysis
STUDY QUESTION
Is spontaneous collapse (SC) by human blastocysts a prognostic factor in IVF treatment?
SUMMARY ANSWER
SC in human blastocyst is associated with reduced euploid embryo and pregnancy rates.
WHAT IS KNOWN ALREADY
SC of the human blastocyst is a phenomenon that was revealed relatively recently following the clinical application of time-lapse monitoring in IVF laboratories. The ploidy and clinical prognosis of affected blastocysts are still poorly understood, with inconsistent reports. Systematic reviews and meta-analyses on this topic are currently absent in the literature but its potential as a marker of embryo viability holds great clinical value. In this study, we aimed to comprehensively evaluate the potential of SC as a prognostic factor in regard to ploidy status, and pregnancy, live birth and miscarriage rates.
STUDY DESIGN, SIZE, DURATION
A systematic review and meta-analysis were performed according to PRISMA guidelines, with a protocol registered with PROSPERO (CRD42022373749). A search of MEDLINE, EMBASE, and the Cochrane Library for relevant studies was carried out on 10 October 2022, using key words relevant to 'blastocyst collapse' and 'time-lapse imaging'.
PARTICIPANTS/MATERIALS, SETTING, METHODS
Two independent reviewers systematically screened and evaluated each study in terms of participants, exposure, comparator, and outcomes (PECO). The Quality In Prognosis Studies tool was used for quality assessment. Data were extracted according to Cochrane methods. Pregnancy, live birth, ploidy, or miscarriage data were summarized by risk ratios (RRs) or odds ratios and their 95% CIs. All meta-analyses were performed with random-effects models.
MAIN RESULTS AND THE ROLE OF CHANCE
Following removal of duplicates, a total of 196 records were identified by the initial search. After screening according to PECO, 19 articles were included for further eligibility assessment. For meta-analysis, seven retrospective cohort studies were eventually included. After data pooling, the incidence of blastocyst SC was 37.0% (2516/6801) among seven studies (ranging from 17.4% to 56.2%). SC was associated with significantly lower clinical pregnancy rates (two studies, n = 736; RR = 0.77, 95% CI = 0.62-0.95; I2 = 30%), ongoing pregnancy rates (five studies, n = 2503; RR = 0.66, 95% CI = 0.53-0.83; I2 = 60%), and reduced euploidy rates (three studies, n = 3569; RR = 0.70, 95% CI = 0.59-0.83; I2 = 69%). Nevertheless, live birth rates (two studies, n = 816; RR = 0.76, 95% CI = 0.55-1.04; I2 = 56%) and miscarriage rate (four studies, n = 1358; RR = 1.31, 95% CI = 0.95-1.80; I2 = 0%) did not differ between blastocysts with or without SC. There was, however, significant heterogeneity between the studies included for evaluation of ongoing pregnancy rates (I2 = 60%, P = 0.04), live birth rates (I2 = 56%, P = 0.13), and ploidy rates (I2 = 69%, P = 0.04). Subgroup analyses were conducted according to different definitions of SC, number of collapse events, and whether the transferred blastocyst had undergone preimplantation genetic testing for aneuploidy; with inconclusive findings across subgroups.
LIMITATIONS, REASONS FOR CAUTION
All studies in the meta-analysis were retrospective with varying levels of heterogeneity for different outcomes. Not all studies had accounted for potential confounding factors, therefore only unadjusted data could be used in the main meta-analysis. Studies employed slightly different strategies when defining blastocyst SC. Standardization in the definition for SC is needed to improve comparability between future studies.
WIDER IMPLICATIONS OF THE FINDINGS
Our results indicate that blastocyst SC has negative implications for a pregnancy. Such blastocysts should be given a low ranking when selecting from a cohort for intrauterine transfer. Blastocyst SC should be considered as a contributing variable when building blastocyst algorithms to predict pregnancy or live birth.
STUDY FUNDING/COMPETING INTEREST(S)
There is no external funding to report. All authors report no conflict of interest.
REGISTRATION NUMBER
PROSPERO 2022 CRD42022373749.
Topics: Pregnancy; Female; Humans; Retrospective Studies; Abortion, Spontaneous; Prognosis; Pregnancy Rate; Live Birth; Blastocyst
PubMed: 37581900
DOI: 10.1093/humrep/dead166 -
Medicina (Kaunas, Lithuania) Jan 2023: Postoperative pancreatic fistula (POPF) is one of the most challenging complications after pancreatic resections, associated with prolonged hospital stay and high... (Review)
Review
: Postoperative pancreatic fistula (POPF) is one of the most challenging complications after pancreatic resections, associated with prolonged hospital stay and high mortality. Early identification of pancreatic fistula is necessary for the treatment to be effective. Several prognostic factors have been identified, although it is unclear which one is the most crucial. Some studies show that post-pancreatectomy hypophosphatemia may be associated with the development of POPF. The aim of this systematic review was to determine whether postoperative hypophosphatemia can be used as a prognostic factor for postoperative pancreatic fistula. : The systematic literature review was performed according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses recommendations (PRISMA) and was registered in the International Prospective Register of Systematic Reviews (PROSPERO). The PubMed, ScienceDirect, and Web of Science databases were systematically searched up to the 31st of January 2022 for studies analyzing postoperative hypophosphatemia as a prognostic factor for POPF. Data including study characteristics, patient characteristics, operation type, definitions of postoperative hypophosphatemia and postoperative pancreatic fistula were extracted. : Initially, 149 articles were retrieved. After screening and final assessment, 3 retrospective studies with 2893 patients were included in this review. An association between postoperative hypophosphatemia and POPF was found in all included studies. Patients undergoing distal pancreatectomy were more likely to develop severe hypophosphatemia compared to patients undergoing proximal pancreatectomy. Serum phosphate levels on postoperative day 4 (POD 4) and postoperative day 5 (POD 5) remained significantly lower in patients who developed leak-related complications showing a slower recovery of hypophosphatemia from postoperative day 3 (POD 3) through postoperative day 7 (POD 7). Moreover, body mass index (BMI) higher than 30 kg/m, soft pancreatic tissue, abnormal white blood cell count on postoperative day 3 (POD 3), and shorter surgery time were associated with leak-related complications (LRC) and lower phosphate levels. : Early postoperative hypophosphatemia might be used as a prognostic biomarker for early identification of postoperative pancreatic fistula. However, more studies are needed to better identify significant cut-off levels of postoperative hypophosphatemia and development of hypophosphatemia in the postoperative period.
Topics: Humans; Pancreatic Fistula; Prognosis; Retrospective Studies; Hypophosphatemia; Postoperative Complications; Phosphates; Postoperative Period; Risk Factors
PubMed: 36837475
DOI: 10.3390/medicina59020274 -
Sleep May 2024Sleep problems are common in individuals with low back pain (LBP) and sleep restriction seems to be associated with impaired pain processing. Our objective was to... (Meta-Analysis)
Meta-Analysis
Sleep problems are common in individuals with low back pain (LBP) and sleep restriction seems to be associated with impaired pain processing. Our objective was to investigate whether sleep is associated with future LBP outcomes (i.e. pain intensity, disability, and recovery) in adults. We conducted a systematic review of prospective cohort studies and secondary analyses of randomized controlled trials (registration-PROSPERO CRD42022370781). In December 2022, we searched the MEDLINE, Embase, CINAHL, and PsycINFO databases. Fourteen studies, totaling 19 170 participants were included. Thirteen studies were rated as having high risk of bias (QUIPS tool). We used vote-counting and meta-analysis approaches to synthesize the data. We found associations between baseline sleep with future pain intensity, recovery, and between changes in sleep with changes in pain intensity, changes in disability, and recovery. We further synthesized outcomes as "overall LBP improvement" outcomes. Baseline poor sleep was moderately associated with non-improvement in LBP in the long-very long term (OR 1.55, 95% CI: 1.39 to 1.73; three studies providing unadjusted effect sizes), and non-improvement in sleep was largely associated with non-improvement in LBP in the short-moderate term (OR 3.45, 95% CI: 2.54 to 4.69; four studies providing unadjusted effect sizes). We found no association between baseline sleep with future disability and overall LBP improvement in the short-moderate term. Therefore, sleep may be a prognostic factor for pain intensity and recovery from LBP. All findings were supported by low to very low-quality evidence. Better-conducted studies are needed to strengthen our certainty about the evidence.
Topics: Low Back Pain; Humans; Randomized Controlled Trials as Topic; Prognosis; Prospective Studies; Sleep Wake Disorders; Sleep
PubMed: 38300526
DOI: 10.1093/sleep/zsae023 -
Breast (Edinburgh, Scotland) Jun 2016Despite some published papers analyzing the prognostic role of forkhead-box A1 (FOXA1) in breast cancer, it has not yet been considered as an established prognostic... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Despite some published papers analyzing the prognostic role of forkhead-box A1 (FOXA1) in breast cancer, it has not yet been considered as an established prognostic factor in clinical practice. The present meta-analysis evaluated the prognostic value of FOXA1 in breast cancer.
METHODS
PubMed, Web of Science and Embase databases were searched for relevant published literature that evaluated the correlation between FOXA1 and breast cancer. Either a fixed or random effect model was applied to estimate the pooled hazard ratio (HR) for FOXA1 prognosis in breast cancer.
RESULT
A total of nine articles comprising 6386 breast cancer patients met the inclusion criteria. Among these nine studies, five studies and four studies investigated the prognostic association with disease-free survival (DFS), and overall survival (OS), respectively. Meta-analysis results suggested that high FOXA1 expression was positively associated with DFS (pooled HR: 0.43, 95% CI: 0.23-0.81; P < 0.05) and OS (pooled HR: 0.39, 95% CI: 0.26-0.60; P < 0.05) in breast cancer patients. No publication bias was discovered by Begg's test in this meta-analysis.
CONCLUSION
The results from this meta-analysis indicated that elevated FOXA1 expression level was associated with better outcome in breast cancer.
Topics: Adult; Aged; Biomarkers, Tumor; Breast Neoplasms; Disease-Free Survival; Female; Hepatocyte Nuclear Factor 3-alpha; Humans; Middle Aged; Prognosis; Proportional Hazards Models
PubMed: 27212698
DOI: 10.1016/j.breast.2016.02.009