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Lane C, Rabbani R, Linton J, Taylor SM, Viallet N. Systematic review and meta-analysis of transoral laser microsurgery in hypopharyngeal carcinoma. Laryngoscope Investig Otolaryngol 2020; 5:66-73. [PMID: 32128432 PMCID: PMC7042655 DOI: 10.1002/lio2.351] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2019] [Revised: 12/15/2019] [Accepted: 12/31/2019] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Transoral laser microsurgery has been suggested as an alternative treatment modality for hypopharyngeal carcinoma. The purpose of this study is to systematically review the oncologic and functional outcomes of patients with hypopharyngeal carcinoma when treated with primary transoral laser microsurgery. METHODS A comprehensive literature search was performed using PRISMA methodology on OVID MEDLINE and EMBASE. Meta-analysis was completed for oncological outcomes. RESULTS Six studies reported quality of life outcomes five reported oncologic outcomes. A median of 95% (range 0.83-0.98) patients achieving gastrostomy independence, a median of 3% (range 0%-6%) were tracheostomy dependent, and a median of 97% (Range 0.89-1.0) were able to preserve their larynx. Pooled five-year overall survival was 54% (CI, 0.50-0.58, I2 = 29%), pooled disease-specific survival was 72% (CI, 0.68-0.77, I2 = 46%), and pooled local control rate was 78% (CI, 0.72-0.85, I2 = 69%). CONCLUSION Systematic review supports improvements in functional outcomes and oncologic outcomes with transoral laser microsurgery.
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Affiliation(s)
- Ciaran Lane
- Department of Otolaryngology ‐ Head and Neck SurgeryUniversity of ManitobaWinnipegCanada
| | - Rasheda Rabbani
- George & Fay Yee Center for Healthcare Innovation, Max Rady College of Medicine, Rady Faculty of Health SciencesUniversity of ManitobaWinnipegManitobaCanada
- Community Health Sciences, Max Rady College of Medicine, Rady Faculty of Health SciencesUniversity of ManitobaWinnipegManitobaCanada
| | - Janice Linton
- Neil John Maclean Health SciencesUniversity of Manitoba LibrariesWinnipegManitobaCanada
| | - S. Mark Taylor
- Division of Otolaryngology‐Head and Neck SurgeryDalhousie UniversityHalifax Regional MunicipalityNova ScotiaCanada
| | - Norbert Viallet
- Department of Otolaryngology ‐ Head and Neck SurgeryUniversity of ManitobaWinnipegCanada
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Ebrahim S, Montoya L, Kamal El Din M, Sohani ZN, Agarwal A, Bance S, Saquib J, Saquib N, Ioannidis JPA. Randomized trials are frequently fragmented in multiple secondary publications. J Clin Epidemiol 2016; 79:130-139. [PMID: 27387965 DOI: 10.1016/j.jclinepi.2016.05.016] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2015] [Revised: 04/19/2016] [Accepted: 05/06/2016] [Indexed: 10/21/2022]
Abstract
OBJECTIVE To assess the frequency and features of secondary publications of randomized controlled trials (RCTs). STUDY DESIGN AND SETTING For 191 RCTs published in high-impact journals in 2009, we searched for secondary publications coauthored by at least one same author of the primary trial publication. We evaluated the probability of having secondary publications, characteristics of the primary trial publication that predict having secondary publications, types of secondary analyses conducted, and statistical significance of those analyses. RESULTS Of 191 primary trials, 88 (46%) had a total of 475 secondary publications by 2/2014. Eight trials had >10 (up to 51) secondary publications each. In multivariable modeling, the risk of having subsequent secondary publications increased 1.32-fold (95% CI 1.05-1.68) per 10-fold increase in sample size, and 1.71-fold (95% CI 1.19-2.45) in the presence of a design article. In a sample of 197 secondary publications examined in depth, 193 tested different hypotheses than the primary publication. Of the 193, 43 tested differences between subgroups, 85 assessed predictive factors associated with an outcome of interest, 118 evaluated different outcomes than the original article, 71 had differences in eligibility criteria, and 21 assessed different durations of follow-up; 176 (91%) presented at least one analysis with statistically significant results. CONCLUSIONS Approximately half of randomized trials in high-impact journals have secondary publications published with a few trials followed by numerous secondary publications. Almost all of these publications report some statistically significant results.
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Affiliation(s)
- Shanil Ebrahim
- Stanford Prevention Research Center, Department of Medicine, Stanford University, 1265 Welch Road, Stanford, CA 94305, USA; Meta-Research Innovation Center at Stanford (METRICS), School of Medicine, Stanford University, 1265 Welch Road, Stanford, CA 94305, USA; Department of Clinical Epidemiology & Biostatistics, McMaster University, 1200 Main Street West, Hamilton, Ontario L8S 4K1, Canada; Department of Anesthesia, McMaster University, 1200 Main Street West, Hamilton, Ontario L8S 4K1, Canada; Prevention Lab and Systematic Overviews through advancing Research Technology (SORT), SickKids Research Institute, Hospital for Sick Children, 555 University Avenue, Toronto, Ontario M5G 1X8, Canada
| | - Luis Montoya
- Department of Trauma and Orthopaedics, University Health Network, 399 Bathurst Street, Toronto, Ontario M5T 2S8, Canada
| | - Mostafa Kamal El Din
- Department of Clinical Epidemiology & Biostatistics, McMaster University, 1200 Main Street West, Hamilton, Ontario L8S 4K1, Canada
| | - Zahra N Sohani
- Department of Clinical Epidemiology & Biostatistics, McMaster University, 1200 Main Street West, Hamilton, Ontario L8S 4K1, Canada; Population Genomics Program, Faculty of Health Sciences, McMaster University, 1200 Main Street West, Hamilton, Ontario L8S 4K1, Canada; Faculty of Medicine, 1 King's College Circle, University of Toronto, Toronto, Ontario M5S 1A8, Canada
| | - Arnav Agarwal
- Faculty of Medicine, 1 King's College Circle, University of Toronto, Toronto, Ontario M5S 1A8, Canada
| | - Sheena Bance
- Department of Applied Psychology and Human Development, Ontario Institute for Studies in Education, 252 Bloor Street West, Toronto, Ontario M5S 1V6, Canada
| | - Juliann Saquib
- Department of Family and Community Medicine, Qassim University, Buraydah, Saudi Arabia
| | - Nazmus Saquib
- College of Medicine, Sulaiman AlRajhi Colleges, Al Bukayriyah, Saudi Arabia
| | - John P A Ioannidis
- Stanford Prevention Research Center, Department of Medicine, Stanford University, 1265 Welch Road, Stanford, CA 94305, USA; Meta-Research Innovation Center at Stanford (METRICS), School of Medicine, Stanford University, 1265 Welch Road, Stanford, CA 94305, USA; Department of Health Research and Policy, Stanford University School of Medicine, 150 Governor's Ln, Stanford, CA 94305, USA; Department of Statistics, Stanford University School of Humanities and Sciences, Building 1, Main Quad, Stanford, CA 94305, USA.
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