Traditional and cumulative meta‑analysis: Chemoradiotherapy followed by surgery versus surgery alone for resectable esophageal carcinoma

Feng, Hao; Zhao, Ye; Jing, Tao; Ma, Jian-Xing; Zhao, Yajing; Zhang, Jianhua; Wang, Cheng; Li, Bin

doi:10.3892/mco.2017.1534

Cited by 3 publications

(3 citation statements)

References 32 publications

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“…For the most prevalent chronic diseases including hypertension, diabetes, COPD, coronary heart disease, cerebrovascular disease, and cancer, we conducted the cumulative meta-analysis according to the season of admission of the patients and the increasing sample size of the included studies within each season. A cumulative meta-analysis is helpful to assess the dynamics of how the summary results change with a newly added study ( 26 ). R 4.0.3 (The R Foundation for Statistical Computing, Vienna, Austria) was used to conduct a cumulative meta-analysis.…”

Section: Methodsmentioning

confidence: 99%

Chronic Diseases as a Predictor for Severity and Mortality of COVID-19: A Systematic Review With Cumulative Meta-Analysis

Geng

Bao

et al. 2021

Front. Med.

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Introduction: Given the ongoing coronavirus disease 2019 (COVID-19) pandemic and the consequent global healthcare crisis, there is an urgent need to better understand risk factors for symptom deterioration and mortality among patients with COVID-19. This systematic review aimed to meet the need by determining the predictive value of chronic diseases for COVID-19 severity and mortality.Methods: We searched PubMed, Embase, Web of Science, and Cumulative Index to Nursing and Allied Health Complete to identify studies published between December 1, 2019, and December 31, 2020. Two hundred and seventeen observational studies from 26 countries involving 624,986 patients were included. We assessed the risk of bias of the included studies and performed a cumulative meta-analysis.Results: We found that among COVID-19 patients, hypertension was a very common condition and was associated with higher severity, intensive care unit (ICU) admission, acute respiratory distress syndrome, and mortality. Chronic obstructive pulmonary disease was the strongest predictor for COVID-19 severity, admission to ICU, and mortality, while asthma was associated with a reduced risk of COVID-19 mortality. Patients with obesity were at a higher risk of experiencing severe symptoms of COVID-19 rather than mortality. Patients with cerebrovascular disease, chronic liver disease, chronic renal disease, or cancer were more likely to become severe COVID-19 cases and had a greater probability of mortality.Conclusions: COVID-19 patients with chronic diseases were more likely to experience severe symptoms and ICU admission and faced a higher risk of mortality. Aggressive strategies to combat the COVID-19 pandemic should target patients with chronic diseases as a priority.

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Section: Methodsmentioning

confidence: 99%

Chronic Diseases as a Predictor for Severity and Mortality of COVID-19: A Systematic Review With Cumulative Meta-Analysis

Geng

Bao

et al. 2021

Front. Med.

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“…A recent meta-analysis of 22 randomized trials also reported improved survival with neoadjuvant therapy versus esophagectomy alone for patients with locally advanced esophageal cancer, but more for adenocarcinoma than squamous-cell carcinoma. 33 However, response to neoadjuvant therapy is unpredictable and low—29% in CROSS—and survival of complete responders is worse than that of patients undergoing esophagectomy for early-stage cancers, the hysteresis effect of down-staging. 5…”

Section: Discussionmentioning

confidence: 99%

Precision Surgical Therapy for Adenocarcinoma of the Esophagus and Esophagogastric Junction

Rice

Lü

Ishwaran

et al. 2019

Journal of Thoracic Oncology

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Introduction: To facilitate initial clinical decision whether to use esophagectomy alone or neoadjuvant therapy in surgical care for individual patients with adenocarcinoma of the esophagus and esophagogastric junction—information not available from randomized trials—a machine-learning analysis was performed using worldwide real-world data on patients undergoing different therapies for this rare adenocarcinoma. Methods: Using random forest technology in a sequential analysis, we 1) identified eligibility for each of 4 therapies among 13,365 patients: esophagectomy alone (n=6,649), neoadjuvant therapy (n=4,706), esophagectomy and adjuvant therapy (n=998), and neoadjuvant and adjuvant therapy (n=1,022); 2) performed survival analyses incorporating interactions of patient and cancer characteristics with therapy; 3) determined optimal therapy as that predicted to maximize lifetime within 10 years (restricted mean survival time, RMST) for each patient; and 4) compared lifetime gained from optimal versus actual therapies. Results: Actual therapy was optimal in 61% of those receiving esophagectomy alone; neoadjuvant therapy was optimal for 36% receiving neoadjuvant therapy. Many patients were predicted to benefit from postoperative adjuvant therapy. Total RMST for actual therapy received was 58,825 years. Had patients received optimal therapy, total RMST was predicted to be 62,982 years, a 7% gain. Conclusions: Average treatment effect for adenocarcinoma of the esophagus yields only crude evidence-based therapy guidelines. However, patient response to therapy is widely variable, and survival after data-driven predicted optimal therapy often differs from actual therapy received. Therapy must address an individual patient’s cancer and clinical characteristics to provide precision surgical therapy for adenocarcinoma of the esophagus and esophagogastric junction.

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“…25 A cumulative meta-analysis can be performed multiple times; not only can it obtain summary results and provide a comparison of the dynamic results, but also it can assess the impact of newly added studies on the overall conclusions. 26 For example, initial observational studies and systematic reviews and meta-analyses suggested that frozen embryo transfer was better for mothers and babies; however, recent primary studies have begun to challenge these conclusions. 27 Maheshwari et al 27 therefore conducted a cumulative meta-analysis Following the basic meta-analysis principles to analyze the incidences of adverse events of studies to investigate whether these conclusions have remained consistent over time and found that the decreased risks of harmful outcomes associated with pregnancies conceived from frozen embryos have been consistent in terms of direction and magnitude of effect over several years, with an increasing precision around the point estimates.…”

Section: Cumulative Meta-analysismentioning

confidence: 99%

A brief introduction of meta‐analyses in clinical practice and research

Zhang

Zhong

et al. 2021

The Journal of Gene Medicine

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With the explosive growth of medical information, it is almost impossible for healthcare providers to review and evaluate all relevant evidence to make the best clinical decisions. Meta-analyses, which summarize all existing evidence and quantitatively synthesize individual studies, have become the best available evidence for informing clinical practice. This article introduces the common methods, steps, principles, strengths and limitations of meta-analyses and aims to help healthcare providers and researchers obtain a basic understanding of meta-analyses in clinical practice and research.

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Traditional and cumulative meta‑analysis: Chemoradiotherapy followed by surgery versus surgery alone for resectable esophageal carcinoma

Cited by 3 publications

References 32 publications

Chronic Diseases as a Predictor for Severity and Mortality of COVID-19: A Systematic Review With Cumulative Meta-Analysis

Chronic Diseases as a Predictor for Severity and Mortality of COVID-19: A Systematic Review With Cumulative Meta-Analysis

Precision Surgical Therapy for Adenocarcinoma of the Esophagus and Esophagogastric Junction

A brief introduction of meta‐analyses in clinical practice and research

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