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Surgical resection versus biopsy in the treatment of primary central nervous system lymphoma: a systematic review and meta-analysis
PURPOSE: Despite the improvement in treatment and prognosis of primary central nervous system lymphoma (PCNSL) over the last decades, the 5-year survival rate is approximately 30%; thus, new therapeutic approaches are needed to improve patient survival. The study’s aim was to evaluate the role of su...
Autores principales: | , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Springer US
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9758097/ https://www.ncbi.nlm.nih.gov/pubmed/36449256 http://dx.doi.org/10.1007/s11060-022-04200-7 |
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author | Chojak, Rafał Koźba-Gosztyła, Marta Polańska, Karolina Rojek, Marta Chojko, Aleksandra Bogacz, Rafał Skorupa, Natalia Więcław, Jakub Czapiga, Bogdan |
author_facet | Chojak, Rafał Koźba-Gosztyła, Marta Polańska, Karolina Rojek, Marta Chojko, Aleksandra Bogacz, Rafał Skorupa, Natalia Więcław, Jakub Czapiga, Bogdan |
author_sort | Chojak, Rafał |
collection | PubMed |
description | PURPOSE: Despite the improvement in treatment and prognosis of primary central nervous system lymphoma (PCNSL) over the last decades, the 5-year survival rate is approximately 30%; thus, new therapeutic approaches are needed to improve patient survival. The study’s aim was to evaluate the role of surgical resection of PCNSL. METHODS: Primary outcomes were the overall survival (OS) and progression-free survival (PFS) of patients with PCNSL who underwent surgical resection versus biopsy alone. The meta-analysis was conducted to calculate pooled hazard ratios (HRs) under a random-effects model for the time-to-event variables. The odds ratios (ORs) were calculated for binary, secondary outcome parameters. RESULTS: Seven studies (n = 1046) were included. We found that surgical resection was associated with significantly better OS (HR 0.63 [95% CI 0.51–0.77]) when compared with biopsy. PFS was also significantly improved (HR 0.64 [95% CI 0.49–0.85]) in patients who underwent resection compared with those who underwent biopsy. The heterogeneity for OS and PFS was low (I2 = 7% and 24%, respectively). We also found that patients who underwent biopsy more often had multiple (OR 0.38 [95% CI 0.19–0.79]) or deep-seated (OR 0.20 [95% CI 0.12–0.34]) lesions compared with those who underwent surgical resection. There were no significant differences in chemotherapy or radiotherapy use or the occurrence of postoperative complications between the two groups. CONCLUSION: In selected patients, surgical resection of PCNSL is associated with significantly better overall survival and progression-free survival compared with biopsy alone. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s11060-022-04200-7. |
format | Online Article Text |
id | pubmed-9758097 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Springer US |
record_format | MEDLINE/PubMed |
spelling | pubmed-97580972022-12-18 Surgical resection versus biopsy in the treatment of primary central nervous system lymphoma: a systematic review and meta-analysis Chojak, Rafał Koźba-Gosztyła, Marta Polańska, Karolina Rojek, Marta Chojko, Aleksandra Bogacz, Rafał Skorupa, Natalia Więcław, Jakub Czapiga, Bogdan J Neurooncol Review PURPOSE: Despite the improvement in treatment and prognosis of primary central nervous system lymphoma (PCNSL) over the last decades, the 5-year survival rate is approximately 30%; thus, new therapeutic approaches are needed to improve patient survival. The study’s aim was to evaluate the role of surgical resection of PCNSL. METHODS: Primary outcomes were the overall survival (OS) and progression-free survival (PFS) of patients with PCNSL who underwent surgical resection versus biopsy alone. The meta-analysis was conducted to calculate pooled hazard ratios (HRs) under a random-effects model for the time-to-event variables. The odds ratios (ORs) were calculated for binary, secondary outcome parameters. RESULTS: Seven studies (n = 1046) were included. We found that surgical resection was associated with significantly better OS (HR 0.63 [95% CI 0.51–0.77]) when compared with biopsy. PFS was also significantly improved (HR 0.64 [95% CI 0.49–0.85]) in patients who underwent resection compared with those who underwent biopsy. The heterogeneity for OS and PFS was low (I2 = 7% and 24%, respectively). We also found that patients who underwent biopsy more often had multiple (OR 0.38 [95% CI 0.19–0.79]) or deep-seated (OR 0.20 [95% CI 0.12–0.34]) lesions compared with those who underwent surgical resection. There were no significant differences in chemotherapy or radiotherapy use or the occurrence of postoperative complications between the two groups. CONCLUSION: In selected patients, surgical resection of PCNSL is associated with significantly better overall survival and progression-free survival compared with biopsy alone. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s11060-022-04200-7. Springer US 2022-11-30 2022 /pmc/articles/PMC9758097/ /pubmed/36449256 http://dx.doi.org/10.1007/s11060-022-04200-7 Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . |
spellingShingle | Review Chojak, Rafał Koźba-Gosztyła, Marta Polańska, Karolina Rojek, Marta Chojko, Aleksandra Bogacz, Rafał Skorupa, Natalia Więcław, Jakub Czapiga, Bogdan Surgical resection versus biopsy in the treatment of primary central nervous system lymphoma: a systematic review and meta-analysis |
title | Surgical resection versus biopsy in the treatment of primary central nervous system lymphoma: a systematic review and meta-analysis |
title_full | Surgical resection versus biopsy in the treatment of primary central nervous system lymphoma: a systematic review and meta-analysis |
title_fullStr | Surgical resection versus biopsy in the treatment of primary central nervous system lymphoma: a systematic review and meta-analysis |
title_full_unstemmed | Surgical resection versus biopsy in the treatment of primary central nervous system lymphoma: a systematic review and meta-analysis |
title_short | Surgical resection versus biopsy in the treatment of primary central nervous system lymphoma: a systematic review and meta-analysis |
title_sort | surgical resection versus biopsy in the treatment of primary central nervous system lymphoma: a systematic review and meta-analysis |
topic | Review |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9758097/ https://www.ncbi.nlm.nih.gov/pubmed/36449256 http://dx.doi.org/10.1007/s11060-022-04200-7 |
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