Objectives To identify the association between night shift work and the risk of various cancers with a comprehensive perspective and to explore sex differences in this association. Methods We searched PubMed, Embase, and Web of Science for studies on the effect of night shift work on cancer, including case-control, cohort, and nested case-control studies. We computed risk estimates with 95% confidence intervals (CIs) in a random or fixed effects model and quantified heterogeneity using the I 2 statistic. Subgroup, metaregression, and sensitivity analyses were performed to explore potential sources of heterogeneity. Contour-enhanced funnel plots and the trim and fill method were used together to analyze bias. Linear dose–response analysis was used to quantitatively estimate the accumulative effect of night shift work on the risk of cancer. Results Fifty-eight studies were eligible for our meta-analysis, including 5,143,838 participants. In the random effects model, the pooled odds ratio (OR) of cancers was 1.15 (95% CI = 1.08–1.22, P < 0.001; I 2 = 76.2%). Night shift work increased the cancer risk in both men (OR = 1.14, 95% CI = 1.05–1.25, P = 0.003) and women (OR = 1.12, 95% CI = 1.04–1.20, P = 0.002). Subgroup analyses showed that night shift work positively increased the risk of breast (OR = 1.22, 95% CI = 1.08–1.38), prostate (OR = 1.26, 95% CI = 1.05–1.52), and digestive system (OR = 1.15, 95% CI = 1.01–1.32) cancers. For every 5 years of night shift work, the cancer risk increased by 3.2% (OR = 1.032, 95% CI = 1.013–1.051). Conclusion This is the first meta-analysis identifying the positive association between night shift work and the risk of cancer and verifying that there is no sex difference in the effect of night shift work on cancer risk. Cancer risk increases with cumulative years of night shift work.

This study was performed to identify the prognostic impact of lymphovascular invasion (LVI) in patients with upper urinary tract urothelial carcinoma (UTUC) after radical nephroureterectomy (RNU). A systematic search in PubMed, Embase, and the Cochrane Library was performed to identify relevant studies. The outcomes of interest, including progression-free survival (PFS), cancer-specific survival (CSS), and overall survival (OS), were extracted, and the pooled hazard ratios (HRs) and 95% confidence intervals (CIs) were used for effect size estimation. Subgroup, metaregression, and sensitivity analyses were performed to explore potential origins of heterogeneity. Publication bias was estimated by Egger’s linear regression and funnel plot. Our meta-analysis included a total of 27 studies involving 17,453 patients. The pooled HRs were statistically significant for PFS (HR=1.73, 95%CI=1.41–2.11), CSS (HR=1.87, 95%CI=1.54–2.27), and OS (HR=1.56, 95%CI=1.29–1.87), with high heterogeneity (I2=77.8%, 70.3%, and 59.2%, respectively). Four studies explored the prognostic value of LVI in patients with advanced tumor stages (T3–T4). The fixed effects model (I2=33.9%) showed that the pooled HR was 1.64 (95%CI=1.35–1.99) for CSS. Egger’s plots showed no significant publication bias (PFS: P=0.443, CSS: P=0.096, and OS: P=0.894). Our meta-analysis demonstrated that LVI is a poor prognostic factor for UTUC and is strongly associated with disease recurrence, cancer-specific mortality, and overall mortality.

PurposeThis study aimed to evaluate the prognostic impact of lymphovascular invasion (LVI) in patients treated with radical nephroureterectomy (RNU) for upper urinary tract urothelial carcinoma (UTUC).Materials and MethodsWe collected data from 180 patients who were treated with RNU from 2005 to 2013 at our institution. The Kaplan-Meier method with log-rank test and Cox proportional hazards regression models were used for univariate and multivariate analyses.ResultsLVI was present in 28 patients (15.6%), which was associated with higher pathological tumor stage (p<0.001), tumor necrosis (p=0.012), lymph node metastasis (p=0.017) and multifocality (p=0.012). On multivariate analysis, LVI was an independent prognostic factor of recurrence-free survival [RFS: hazard ratio (HR)=2.954; 95% confidence interval (CI)=1.539–5.671; p=0.001] and cancer-specific survival (CSS: HR=3.530; 95% CI=1.701–7.325; p=0.001) in all patients. In patients with node-negative UTUC, LVI was also a significant predictor of RFS (HR=3.732; 95% CI 1.866–7.464; p<0.001) and CSS (HR=3.825; 95% CI=1.777–8.234; p=0.001).ConclusionLVI status was an independent predictor in patients with UTUC who underwent RNU. The estimate of LVI could help physicians identify high-risk patients and make a better medication regimen of adjuvant chemotherapy.

Background: To investigate the pathological risk of prostate cancer (PCa) according to the obesity and metabolic status of Chinese patients undergoing radical prostatectomy. Materials and Methods: We performed a retrospective cross-sectional study of 1016 patients with PCa who underwent radical prostatectomy and whose metabolic status and body mass index were examined. Multivariate logistic regression analysis was performed to examine the relationship between different metabolic obesity phenotypes and the pathological outcomes of PCa. Results: Among 1016 men, 551 (54.2%), 106 (10.4%), 238 (23.4%), and 121 (11.9%) were assigned to the metabolically healthy and normal weight (MHNW) group, metabolically abnormal but normal weight (MANW) group, metabolically healthy but overweight or obese (MHO) group, and metabolically abnormal and overweight or obese (MAO) group, respectively. Compared with the MHNW group, the MAO group had a significantly greater risk of a higher prostatectomy Gleason score [odds ratio (OR), 1.907; 95% confidence interval (95% CI), 1.144-3.182], pathological stage (OR, 1.606; 95% CI, 1.035-2.493), and seminal vesicle invasion (OR, 1.673; 95% CI, 1.041-2.687). In contrast, the ORs were not increased in the MHO or MANW group. In the context of normal weight, metabolic disorders were associated with lymph node involvement. The metabolic status and body mass index were not associated with extracapsular extension or surgical margins in any of the four groups. Conclusion: The MAO phenotype is associated with aggressive PCa, including a higher prostatectomy Gleason score, pathological stage, and seminal vesicle invasion and might also be associated with disease progression. Obesity and metabolic disorders act synergistically to increase the pathological risk of PCa.