ObjectiveTo systematically review the effect of laparoscopy versus laparotomy for borderline ovarian tumors (BOTs) on postoperative recurrence. MethodsWe searched PubMed, The Cochrane Library (Issue 11, 2015), EMbase, Web of Science, CNKI, WanFang Data and CBM databases from inception to Nov. 2015, to collect relevant clinical studies comparing laparoscopy and laparotomy for BOTs. Two reviewer independently screened literature, extracted data and assessed the risk of bias of include studies by using NOS scale. Then, meta-analysis was performed by using RevMan 5.3 software. ResultsNineteen cohort studies were included. The scores of NOS scale showed that 10 studies were < 7 points, while the other 9 studies were≥7 points. The results of meta-analysis showed that: the recurrence rate of tumor (OR=1.75, 95%CI 1.05 to 2.91, P=0.03) in the laparoscopy group was higher than that in the laparotomy group, but no significant differences were found in further subgroup analysis according to type of operations (conservative surgery: OR=1.22, 95%CI 0.71 to 2.08, P=0.47; non-conservative surgery: OR=4.38, 95% CI 0.85 to 22.68, P=0.08). The diameter of tumor in the laparoscopy group was significant smaller than that in the laparotomy group (MD=-6.88, 95% CI-8.15 to-5.61, P < 0.000 01), and the rate of rupture of tumor in the laparoscopy group was significant higher than that in the laparotomy group (OR=3.99, 95% CI 2.54 to 6.26, P < 0.000 01). ConclusionCurrent evidence shows, compared with laparotomy, laparoscopy has similar effect on postoperative recurrence and smaller diameter of tumor, but laparoscopy could increase the rate of rupture of tumor. Due to the limited quality and sample size of included studies, more high quality and large sample size studies are need to prove the above conclusion.
Indirect comparison refers to a comparison of different healthcare interventions using data from separate studies, and is often used because of a lack of, or insufficient evidence from head-to-head comparative trials. We aimed to summarize the definition, fundamental theory, type, relevant statistical contents, and to clarify some question on how to use indirect comparison, in order to attract more researchers' attention and promote methodological development of indirect comparison.
ObjectiveTo analyze the retrieval status of master and doctoral dissertations entitled systematic review/meta-analysis (SR/MA) in China. MethodsThe China Dissertation Database was searched for master and doctoral dissertations entitled SR/MA from 1980 to March 2015. Two reviewers independently extracted the basic characteristics of included dissertations, the name of retrieval databases, retrieval strategies and the method of screening literature. Then related data were analysed by Stata 12.0 software. ResultsA total of 1 639 master and doctoral dissertations entitled SR/MA were included for data analysis. Among them, 1 259 (79.5%) retrieved both Chinese databases and English databases, 107 (6.5%) retrieved Chinese databases alone, and the other 237 (14.5%) retrieved English databases alone. 1 137 (69.4%) retrieved two or more Chinese databases, while 1 316 (80.3%) retrieved two or more English databases. The most commonly retrieved Chinese databases were CNKI, VIP, CBM, and WanFang Data; while the most frequently retrieved English databases were PubMed, The Cochrane Library, EMbase and Ovid. 89.9% reported the duration of search time, 73.4% reported manual retrieval, 68.6% reported reference retrieval, 23.3% reported conference retrieval, 23.3% reported using search engine and 26.8% reported contact with experts and authors. 45.8% reported their steps of screening papers, 37.5% provided a flow screening chart, and only 14.9% reported the number of papers from each database. ConclusionThe current study suggests that the retrieved databases of master and doctoral dissertations entitled SR/MA in China are still not enough. We suggest the authors of dissertations on SR/MA retrieve at least 3 common databases, reference, engines, conference paper at the same time, and improve information on search strategy and paper screening methods.
ObjectiveTo systematically evaluate the efficacy, cosmetic outcome and adverse reaction of hypofractionation radiotherapy (HRT) versus conventional radiotherapy (CRT) for early stage breast cancer after breast conserving surgery. MethodsThe databases including CNKI, CBM, VIP, PubMed, EMbase and The Cochrane Library (Issue 1, 2015) were searched from the inception to May 2015 to collect the randomized controlled trials (RCTs) related to HRT versus CRT for early stage breast cancer after breast conserving surgery. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Then, meta-analysis was performed using RevMan 5.2 software. ResultsSix RCTs involving 8 240 patients were included. Meta-analyses results showed, there were no statistical differences between the HRT group and the CRT group in local-regional recurrence rate (5 year: RR=1.01, 95%CI 0.73 to 1.40, P=0.94; 10 year: RR=1.04, 95%CI 0.86 to 1.26, P=0.67), mortality (5 year: RR=0.95, 95%CI 0.85 to 1.08, P=0.45; 10 year: RR=0.97, 95%CI 0.86 o 1.09, P=0.61), photographic breast appearance (RR=0.98, 95%CI 0.91 to 1.05, P=0.56), the incidence of lung fibrosis (5 year: RR=1.07, 95%CI 0.66 to 1.72, P=0.78; 10 year: RR=1.05, 95%CI 0.62 to 1.77, P=0.86), the incidence of rib fracture (5 year: RR=1.00, 95%CI 0.60 to 1.68, P=0.99; 10 year: RR=1.19, 95%CI 0.70 to 2.00, P=0.52), and the incidence of ischemic of heart (5 year: RR=0.88, 95%CI 0.54 to 1.45, P=0.62; 10 year: RR=0.86, 95%CI 0.54 to 1.37, P=0.53). ConclusionHRT could provide similar tumor control as CRT without serious toxicity. Meanwhile HRT is superior to CRT in terms of patient convenience and costs, it should be promoted as adjuvant treatment for early stage breast cancer after breast conserving surgery.
ObjectiveTo investigate the current status of systematic reviews/meta-analyses (SRs/MAs) registered in PROSPERO by Chinese authors, in order to provide references for improving the registration rate and quality, and finally improve the quality of SRs/MAs. MethodsWe searched PROSPERO (http://www.crd.york.ac.uk/crdweb/) from inception to December 31, 2014, to identify SRs/MAs registered by Chinese authors. Two reviewers independently screened records and extracted data. Excel 2013 was used for data input and management, and Stata 12.0 software was used for statistical analysis (Stata Corp., College Station, TX, USA). ResultsA total of 322 SRs/MAs were included. There was an increasing trend in registration number by year, and 60.6% was registered in 2014. The type of SRs/MAs was mainly the interventional (n=247, 76.7%). These SRs/MAs were related to 21 systematic diseases, and cancer ranked the top one (65, 20.2%). The authors distributed in 26 provinces, and majority of authors' institutes were "Evidence-Based Medicine Center". More than half (56.2%) of SRs/MAs were supported by fundings, but only 39.8% of SRs/MAs were performed cooperatively by two or more institutes. ConclusionThere is a rapid increase in numbers of SRs/MAs registered in PROSPERO by Chinese authors, but the absolute number is still small. The problems include the weakness of cooperative consciousness and lake of awareness in registering SRs/MAs.