A comprehensive search of PubMed, Embase, Cochrane, Scopus, CNKI, Wanfang, and ClinicalKey databases was conducted for studies on the prognosis of TB in rectal cancer after neoadjuvant therapy from the inception of the databases to January 2023, and the final literature included was determined using predefined criteria. Quality assessment of the studies included, extraction of general and prognostic information from them, and meta-analyses were carried out progressively.
A total of 11 studies were included, and the results of the meta-analysis showed that high-grade tumor budding (TB-1) increased the risk of poor 5-year disease-free survival (HR = 1.75, 95% CI 1.38-2.22, P < 0.00001), 5-year overall survival (HR = 1.77, 95% CI 1.21-2.59, P = 0.003), local recurrence (OR = 4.15, 95% CI 1.47-11.75, P = 0.007), and distant metastasis (OR = 5.36, 95% CI 2.51-11.44, P < 0.0001) in patients with rectal cancer after neoadjuvant therapy. TB-1 was significantly associated with poor differentiation and lymphatic, perineural, and venous invasion.
Tumor budding is significantly correlated with unfavorable prognosis and poor pathological characteristics following neoadjuvant therapy for rectal cancer. We anticipate more high-quality, prospective studies in the future to confirm our findings.
PROSPERO CRD42022377564.
方法:对PubMed的全面搜索,Embase,科克伦,Scopus,CNKI,万方,和ClinicalKey数据库从数据库开始到2023年1月进行了新辅助治疗后直肠癌中TB预后的研究,最终纳入的文献使用预定义的标准确定.对研究的质量评估包括,从他们中提取一般和预后信息,并逐步进行荟萃分析。
结果:共纳入11项研究,meta分析结果显示,高级别肿瘤出芽(TB-1)增加了5年无病生存率低的风险(HR=1.75,95%CI1.38-2.22,P<0.00001),5年总生存率(HR=1.77,95%CI1.21-2.59,P=0.003),局部复发(OR=4.15,95%CI1.47-11.75,P=0.007),直肠癌患者新辅助治疗后发生远处转移(OR=5.36,95%CI2.51~11.44,P<0.0001)。TB-1与分化差和淋巴管显著相关,神经周,和静脉侵入。
结论:直肠癌新辅助治疗后,肿瘤出芽与不良预后和不良病理特征显著相关。我们期待更多的高品质,未来的前瞻性研究证实了我们的发现。
背景:PROSPEROCRD42022377564.