Prognostic value of lymph node micrometastasis in esophageal cancer: A systematic review and meta-analysis
ObjectiveWhether lymph node micrometastasis (LNM) increases the risk in esophageal cancer patients remains controversial. We conducted a systematic review and meta-analysis to explore the prognosis value of LNM in esophageal cancer patients.MethodsTwo reviewers independently searched electronic data...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2023-01-01
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| Series: | Frontiers in Oncology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fonc.2022.1025855/full |
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| author | Jing Yang Jing Yang Jing Yang Qianqian Liu Qianqian Liu Qianqian Liu Yuping Bai Yuping Bai Yuping Bai Haitong Zhao Tingting He Tingting He Tingting He Ziru Zhao Ziru Zhao Ziru Zhao Min Huang Min Huang Min Huang Mengyuan Jiang Mengyuan Jiang Mengyuan Jiang Rui Zhang Rui Zhang Rui Zhang Min Zhang Min Zhang |
| author_facet | Jing Yang Jing Yang Jing Yang Qianqian Liu Qianqian Liu Qianqian Liu Yuping Bai Yuping Bai Yuping Bai Haitong Zhao Tingting He Tingting He Tingting He Ziru Zhao Ziru Zhao Ziru Zhao Min Huang Min Huang Min Huang Mengyuan Jiang Mengyuan Jiang Mengyuan Jiang Rui Zhang Rui Zhang Rui Zhang Min Zhang Min Zhang |
| author_sort | Jing Yang |
| collection | DOAJ |
| description | ObjectiveWhether lymph node micrometastasis (LNM) increases the risk in esophageal cancer patients remains controversial. We conducted a systematic review and meta-analysis to explore the prognosis value of LNM in esophageal cancer patients.MethodsTwo reviewers independently searched electronic databases, including PubMed, Embase, and the Cochrane Library, for eligible citations until February 2022. We calculated pooled estimates of the hazards ratio with a random-effects model. The certainty of evidence was determined by the Grade of Recommendations Assessment, Development, and Evaluation (GRADE) method. A sensitivity analysis was performed to assess the stability. Publication bias was assessed using funnel plots and Egger’s test. We also performed subgroup analysis to explore the source of heterogeneity.ResultsA total of 16 studies, with 1,652 patients, were included. The overall survival (OS) was significantly increased with LNM negativity compared with LNM positivity (HR 1.95; 95% CI, 1.53–2.49; P < 0.001; I2 = 0.0%, P = 0.930; certainty of evidence: low). Relapse-free survival (RFS) was significantly increased with LNM negativity compared with LNM positivity (HR 3.39; 95% CI, 1.87–6.16; P < 0.001; I2 = 50.18%, P = 0.060; certainty of evidence: moderate). No significant difference was observed in recurrence between the two groups (certainty of evidence: low). Sensitivity analysis revealed a stable trend. In addition, the funnel plot and Egger’s test did not show significant publication bias.ConclusionLNM positivity worsens the prognosis in esophageal cancer, and the evidence for RFS is moderate. Future relevant high-quality studies are warranted to validate our results further and provide a reference for guidelines.Systematic review registrationhttps://www.crd.york.ac.uk/prospero, identifier (CRD42022321768). |
| first_indexed | 2024-04-11T01:05:15Z |
| format | Article |
| id | doaj.art-6420a68d400546489372a0fa58814f1c |
| institution | Directory Open Access Journal |
| issn | 2234-943X |
| language | English |
| last_indexed | 2024-04-11T01:05:15Z |
| publishDate | 2023-01-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Oncology |
| spelling | doaj.art-6420a68d400546489372a0fa58814f1c2023-01-04T13:11:10ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2023-01-011210.3389/fonc.2022.10258551025855Prognostic value of lymph node micrometastasis in esophageal cancer: A systematic review and meta-analysisJing Yang0Jing Yang1Jing Yang2Qianqian Liu3Qianqian Liu4Qianqian Liu5Yuping Bai6Yuping Bai7Yuping Bai8Haitong Zhao9Tingting He10Tingting He11Tingting He12Ziru Zhao13Ziru Zhao14Ziru Zhao15Min Huang16Min Huang17Min Huang18Mengyuan Jiang19Mengyuan Jiang20Mengyuan Jiang21Rui Zhang22Rui Zhang23Rui Zhang24Min Zhang25Min Zhang26School of Basic Medicine, Gansu University of Traditional Chinese Medicine, Lanzhou, Gansu, ChinaDepartment of Pathology, Gansu Provincial Hospital, Lanzhou, Gansu, ChinaDepartment of Pathology, The 940th Hospital of Joint Logistics Support Force of Chinese People´s Liberation Army, Lanzhou, ChinaSchool of Basic Medicine, Gansu University of Traditional Chinese Medicine, Lanzhou, Gansu, ChinaDepartment of Pathology, Gansu Provincial Hospital, Lanzhou, Gansu, ChinaDepartment of Pathology, The 940th Hospital of Joint Logistics Support Force of Chinese People´s Liberation Army, Lanzhou, ChinaSchool of Basic Medicine, Gansu University of Traditional Chinese Medicine, Lanzhou, Gansu, ChinaDepartment of Pathology, Gansu Provincial Hospital, Lanzhou, Gansu, ChinaThe Department of Pathology, Hainan Provincial Hospital, Haikou, Hainan, ChinaEvidence Based Social Science Research Center, School of Public Health, Lanzhou University, Lanzhou, ChinaSchool of Basic Medicine, Gansu University of Traditional Chinese Medicine, Lanzhou, Gansu, ChinaDepartment of Pathology, Gansu Provincial Hospital, Lanzhou, Gansu, ChinaDepartment of Pathology, The 940th Hospital of Joint Logistics Support Force of Chinese People´s Liberation Army, Lanzhou, ChinaSchool of Basic Medicine, Gansu University of Traditional Chinese Medicine, Lanzhou, Gansu, ChinaDepartment of Pathology, Gansu Provincial Hospital, Lanzhou, Gansu, ChinaDepartment of Pathology, The 940th Hospital of Joint Logistics Support Force of Chinese People´s Liberation Army, Lanzhou, ChinaSchool of Basic Medicine, Gansu University of Traditional Chinese Medicine, Lanzhou, Gansu, ChinaDepartment of Pathology, Gansu Provincial Hospital, Lanzhou, Gansu, ChinaDepartment of Pathology, The 940th Hospital of Joint Logistics Support Force of Chinese People´s Liberation Army, Lanzhou, ChinaSchool of Basic Medicine, Gansu University of Traditional Chinese Medicine, Lanzhou, Gansu, ChinaDepartment of Pathology, Gansu Provincial Hospital, Lanzhou, Gansu, ChinaDepartment of Pathology, The 940th Hospital of Joint Logistics Support Force of Chinese People´s Liberation Army, Lanzhou, ChinaSchool of Basic Medicine, Gansu University of Traditional Chinese Medicine, Lanzhou, Gansu, ChinaDepartment of Pathology, Gansu Provincial Hospital, Lanzhou, Gansu, ChinaDepartment of Pathology, The 940th Hospital of Joint Logistics Support Force of Chinese People´s Liberation Army, Lanzhou, ChinaSchool of Basic Medicine, Gansu University of Traditional Chinese Medicine, Lanzhou, Gansu, ChinaDepartment of Pathology, Gansu Provincial Hospital, Lanzhou, Gansu, ChinaObjectiveWhether lymph node micrometastasis (LNM) increases the risk in esophageal cancer patients remains controversial. We conducted a systematic review and meta-analysis to explore the prognosis value of LNM in esophageal cancer patients.MethodsTwo reviewers independently searched electronic databases, including PubMed, Embase, and the Cochrane Library, for eligible citations until February 2022. We calculated pooled estimates of the hazards ratio with a random-effects model. The certainty of evidence was determined by the Grade of Recommendations Assessment, Development, and Evaluation (GRADE) method. A sensitivity analysis was performed to assess the stability. Publication bias was assessed using funnel plots and Egger’s test. We also performed subgroup analysis to explore the source of heterogeneity.ResultsA total of 16 studies, with 1,652 patients, were included. The overall survival (OS) was significantly increased with LNM negativity compared with LNM positivity (HR 1.95; 95% CI, 1.53–2.49; P < 0.001; I2 = 0.0%, P = 0.930; certainty of evidence: low). Relapse-free survival (RFS) was significantly increased with LNM negativity compared with LNM positivity (HR 3.39; 95% CI, 1.87–6.16; P < 0.001; I2 = 50.18%, P = 0.060; certainty of evidence: moderate). No significant difference was observed in recurrence between the two groups (certainty of evidence: low). Sensitivity analysis revealed a stable trend. In addition, the funnel plot and Egger’s test did not show significant publication bias.ConclusionLNM positivity worsens the prognosis in esophageal cancer, and the evidence for RFS is moderate. Future relevant high-quality studies are warranted to validate our results further and provide a reference for guidelines.Systematic review registrationhttps://www.crd.york.ac.uk/prospero, identifier (CRD42022321768).https://www.frontiersin.org/articles/10.3389/fonc.2022.1025855/fullesophageal cancerlymph node micrometastasisprognosismeta-analysissystematic review |
| spellingShingle | Jing Yang Jing Yang Jing Yang Qianqian Liu Qianqian Liu Qianqian Liu Yuping Bai Yuping Bai Yuping Bai Haitong Zhao Tingting He Tingting He Tingting He Ziru Zhao Ziru Zhao Ziru Zhao Min Huang Min Huang Min Huang Mengyuan Jiang Mengyuan Jiang Mengyuan Jiang Rui Zhang Rui Zhang Rui Zhang Min Zhang Min Zhang Prognostic value of lymph node micrometastasis in esophageal cancer: A systematic review and meta-analysis Frontiers in Oncology esophageal cancer lymph node micrometastasis prognosis meta-analysis systematic review |
| title | Prognostic value of lymph node micrometastasis in esophageal cancer: A systematic review and meta-analysis |
| title_full | Prognostic value of lymph node micrometastasis in esophageal cancer: A systematic review and meta-analysis |
| title_fullStr | Prognostic value of lymph node micrometastasis in esophageal cancer: A systematic review and meta-analysis |
| title_full_unstemmed | Prognostic value of lymph node micrometastasis in esophageal cancer: A systematic review and meta-analysis |
| title_short | Prognostic value of lymph node micrometastasis in esophageal cancer: A systematic review and meta-analysis |
| title_sort | prognostic value of lymph node micrometastasis in esophageal cancer a systematic review and meta analysis |
| topic | esophageal cancer lymph node micrometastasis prognosis meta-analysis systematic review |
| url | https://www.frontiersin.org/articles/10.3389/fonc.2022.1025855/full |
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