Anterior approach versus conventional liver resection for hepatocellular carcinoma

Wang, Quan; Zheng, Bin; Ma, Ben; Yang, Kehu

doi:10.1002/14651858.cd010545

Cited by 2 publications

(2 citation statements)

References 58 publications

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“…TSA was performed with a desire to maintain an overall 5% risk of type I error, being the standard in most meta-analyses and systematic reviews. In addition, the required information size was calculated (an alpha error of 5%, a beta error of 20%) [ 16 , 26 – 27 ]. Theoretically, If the trial sequential monitoring boundary is crossed before the required information size is reached, firm evidence may be established.…”

Section: Methodsmentioning

confidence: 99%

Preoperative short-course radiotherapy and long-course radiochemotherapy for locally advanced rectal cancer: Meta-analysis with trial sequential analysis of long-term survival data

Wang

Zheng

et al. 2018

PLoS ONE

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Background and purposeThe role of preoperative short-course radiotherapy (SCRT) in rectal cancer treatment, when compared to long-course radiochemotherapy (LCRT), is still controversial. Thus the meta-analysis with trial sequential analysis (TSA) was performed to evaluate the long-term survival of SCRT and LCRT as therapeutic regimens for locally advanced rectal cancer.Material and methodsPubMed, Embase, and the Cochrane Central Register of Controlled Trials were searched up to August 2017 for eligible studies. Hazard ratios (HRs) or odds ratios (ORs) of overall survival (OS), disease free survival (DFS) and local recurrence (LR) with the corresponding 95% confidence intervals (CIs) were calculated and TSA was applied.Results11 studies with 1984 patients were included. There was no significant difference in OS (HR = 0.92, 95% CI: 0.75–1.13, p = 0.44), DFS (HR = 0.94, 95% CI: 0.79–1.12, p = 0.50) and LR (OR = 0.73, 95% CI: 0.49–1.08, p = 0.11) between SCRT and LCRT groups. TSA suggested firm evidence for lacking on average a -10% relative risk reduction (RRR) in 4-year OS but no statistical significance in 4-year DFS.ConclusionsPreoperative SCRT is as effective as LCRT for locally advanced colorectal cancer in long-term survival. SCRT could be preferential while facing long waiting lists or lacking medical resource.

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Section: Methodsmentioning

confidence: 99%

Preoperative short-course radiotherapy and long-course radiochemotherapy for locally advanced rectal cancer: Meta-analysis with trial sequential analysis of long-term survival data

Wang

Zheng

et al. 2018

PLoS ONE

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“…Meta‐analysis IS considerations and TSMBs may provide a valuable tool for guarding against false‐positive results and premature dissemination of marginal or useless interventions . We calculated the required IS (RIS) with an alpha error of 5% and a beta error of 20% . If the TSMB is crossed before the RIS is reached, reliable results may be established.…”

Section: Methodsmentioning

confidence: 99%

A comparison of open, laparoscopic and robotic total mesorectal excision: trial sequential analysis and network meta‐analysis

et al. 2019

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Aim Total mesorectal excision (TME) for rectal cancer can be achieved by employing open (OpTME), laparoscopic (LaTME) and robotic (RoTME) approaches but which of these has the best outcome? The aim of present study is to identify the most effective technique for rectal cancer by comparing all outcomes. Methods Randomized controlled trials (RCTs) which compared at least two TME strategies were identified by literature search of electronic databases of articles published to June 2018. Network meta‐analysis with trial sequential analysis was performed using a frequentist approach with random‐effects meta‐analysis. Data collection and analysisWe conducted a systematic search of PubMed, EmBase, the Cochrane Library, CNKI, and Web of Science. Titles and abstracts of the retrieved publications were independently and blindly assessed by two authors. Results Twenty‐two RCTs with 4882 rectal cancer patients were included in this analysis. The trial sequential analysis demonstrated that the cumulative Z‐curve crossed either the traditional boundary or the trial sequential monitoring boundaries, suggesting that OpTME resulted in a more complete TME specimen than LaTME (relative risk 1.05, 95% confidence interval 1.01–1.08). Network meta‐analysis showed there was no significant difference in the other comparisons. Based on the P score of completeness of the TME specimen and circumferential resection margin positivity, the best technique was OpTME, followed by RoTME and then LaTME. However, this order was reversed when complications and mortality were considered. RoTME led to better lymph node harvest. Conclusions Although OpTME may give better pathological specimens, minimally invasive techniques may have advantages when considering lymph node harvest, complications and mortality. More RCTs are needed to determine which technique actually gives the best chance of survival.

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Anterior approach versus conventional liver resection for hepatocellular carcinoma

Cited by 2 publications

References 58 publications

Preoperative short-course radiotherapy and long-course radiochemotherapy for locally advanced rectal cancer: Meta-analysis with trial sequential analysis of long-term survival data

Preoperative short-course radiotherapy and long-course radiochemotherapy for locally advanced rectal cancer: Meta-analysis with trial sequential analysis of long-term survival data

A comparison of open, laparoscopic and robotic total mesorectal excision: trial sequential analysis and network meta‐analysis

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