The aim of this study was to determine the clinical features, treatment factors, and prognosis of patients with multiple primary malignant tumors (MPMTs). In total, 161 patients with MPMTs at our hospital (The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, Shaanxi, China) were analyzed in this study. We found that among 161 patients with MPMTs, 78 (48.4%) patients had synchronous tumors and 83 (51.6%) patients had metachronous tumors. Most clinical and pathological features were similar in both groups. Most patients with MPMTs were men and older patients (>50 years old), and adenocarcinoma was the most frequent pathology type. The most frequent location of all MPMTs was the digestive system. The leading tumor association was between digestive–digestive tumors, also. However, patients with synchronous tumors and MPMTs of the digestive system showed a shorter survival time. In the metachronous cancer group, the median interval time was 60 months, and a short interval time (≤60 months) was associated with a shorter survival time. In addition, survival time was increased in the younger age group (≤50 years old) and in patients who accepted surgery-based comprehensive therapy. However, only interval time (≤60 months) was an independent prognostic factor associated with survival for the metachronous cancer group. Therefore, careful surveillance and follow-up are especially important in these patients.

Probiotics are recommended to supplement triple therapy in pediatrics, and the effectiveness of triple therapy is associated with specific probiotic supplementation.

AIM:To evaluate the role of probiotics in the standard triple Helicobacter pylori therapy. METHODS:In this meta-analysis, we investigated the efficacy of probiotics in a standard triple H. pylori therapy in adults. Searches were mainly conducted in MEDLINE/PubMed, EMBASE, and the Cochrane Central Register of Controlled Trials. Fourteen studies met our criteria, and the quality of these studies was assessed using the Jadad scale. We used STATA version 12.0 to extract data and to calculate the odds ratios (ORs), which are presented with the corresponding 95% confidence intervals (CIs). The data are presented as forest plots. RESULTS:The pooled ORs for the eradication rates calculated by intention-to-treat analysis and perprotocol analysis in the probiotic group vs the control group were 1.67 (95%CI: 1.38-2.02) and 1.68 (95%CI: 1.35-2.08), respectively, using the fixed-effects model. The sensitivity of the Asian studies was greater than that of the Caucasian studies (Asian: OR = 1.78, 95%CI: 1.40-2.26; Caucasian: OR = 1.48, 95%CI: 1.06-2.05). The pooled OR for the incidence of total adverse effects was significantly lower in the probiotic group (OR = 0.49, 95%CI: 0.26-0.94), using the random effects model, with significant heterogeneity (I 2 = 85.7%). The incidence of diarrhea was significantly reduced in the probiotic group (OR = 0.21, 95%CI: 0.06-0.74), whereas the incidence of taste disorders, metallic taste, vomiting, nausea, and epigastric pain did not differ significantly between the probiotic group and the control group. CONCLUSION:Supplementary probiotic preparations during standard triple H. pylori therapy may improve the eradication rate, particularly in Asian patients, and the incidence of total adverse effects. and rational search strategy, inclusion criteria, and statistical analyses, we found that supplementary probiotic preparations given during standard triple H. pylori therapy conferred a higher eradication rate, particularly in Asian patients, and a lower incidence of total adverse effects, particularly diarrhea. META-ANALYSIS

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