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Adjuvant chemotherapy for small intestine adenocarcinoma

Adenocarcinoma of the small intestine is an infrequently encountered tumour and, as such, knowledge of its clinical and pathological characteristics is limited. No suitable evidence was found to determine the role of adjuvant chemotherapy, when compared with placebo or any other or no adjuvant treatment, in the management of adenocarcinoma of the small intestine.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2015

Surgery or radiotherapy for early cervical cancer of the adenocarcinoma type

Early‐stage cervical cancer of the common type, squamous cell carcinoma, has the same prognosis after primary surgery or radiotherapy. For cervical cancer of the glandular cell type (adenocarcinoma) we recommend surgery. Second best alternative for patients unfit for surgery is chemoradiation. For patients with suspected positive lymph nodes, chemoradiation is probably the first choice.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2013

Chemotherapy before surgery in patients with adenocarcinoma of the esophagus, the gastroesophageal junction, and the stomach

This systematic review uses the data of individual patients from eight and published data from another six randomized controlled trials. We found that the administration of chemotherapy before surgery leads to longer survival in patients with adenocarcinoma of the esophagus, the junction between esophagus and stomach, and the stomach. The findings suggest that patients whose tumor is in the junction between esophagus and stomach and younger patients benefit most from the chemotherapy. Moreover, the addition of radiation to the chemotherapy seems to yield an additional advantage to patients, at least in tumors of the esophagus and the junction between esophagus and stomach. Chemotherapy before surgery does not increase the risk of suffering a complication during or after surgery.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2013

Comparing the time taken to give paclitaxel (an anticancer drug) in advanced adenocarcinoma

Paclitaxel is derived from Yews (a type of tree), and can be used to treat for several cancers such as lung, womb, ovary and breast. It was initially given by a long infusion (injection) over 24 hours, with premedication to avoid any allergic reactions. It was also thought this method would be more active against tumours. Six randomised trials were included in this review, which found that short (three hour) infusions are more convenient and caused significantly fewer adverse (side) effects (i.e. decreased white blood cell counts, fever, infection or sore mouth). With short‐infusion paclitaxel there is no obvious loss of effectiveness when compared with longer infusions, although further clinical trials are needed to be sure of this.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2015

Standard vs extended lymphadenectomy associated with pancreaticoduodenectomy for periampullary adenocarcinoma: a meta-analysis

Bibliographic details: Chen ST, Qiu JG, Yuan HC, Jiang H, Wu H.  Standard vs extended lymphadenectomy associated with pancreaticoduodenectomy for periampullary adenocarcinoma: a meta-analysis. World Chinese Journal of Digestology 2013; 21(34): 3887-3893 Available from: http://www.wjgnet.com/1009-3079/21/3887.asp

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2013

Imaging tests for the diagnosis and staging of pancreatic adenocarcinoma

Bibliographic details: Treadwell JR, Mitchell MD, Eatmon K, Jue J, Zafar H, Teitelbaum U, Schoelles K.  Imaging tests for the diagnosis and staging of pancreatic adenocarcinoma. Rockville, MD, USA: Agency for Healthcare Research and Quality. Comparative Effectiveness Review; 141. 2014 Available from: http://effectivehealthcare.ahrq.gov/index.cfm/search-for-guides-reviews-and-reports/?productid=1620&pageaction=displayproduct

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2014

Diagnostic accuracy of imaging modalities in the evaluation of vascular invasion in pancreatic adenocarcinoma: a meta-analysis

Bibliographic details: Li AE, Li BT, Ng BH, McCormack S, Vedelago J, Clarke S, Pavlakis N, Samra J.  Diagnostic accuracy of imaging modalities in the evaluation of vascular invasion in pancreatic adenocarcinoma: a meta-analysis. World Journal of Oncology 2013; 4(2): 74-82 Available from: http://www.wjon.org/index.php/wjon/article/view/657

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2013

Use of the levonorgestrel intrauterine system for endometrial protection in women with breast cancer on adjuvant tamoxifen

Tamoxifen is commonly used by women to reduce the risk of breast cancer recurrence. Tamoxifen can also cause abnormal changes to the lining of the womb (endometrium), including polyps and cancer. Mirena is a uterine device that releases the progesterone‐like synthetic hormone levonorgestrel into the endometrium and causes marked endometrial suppression. This review suggests that Mirena can reduce the risk of endometrial polyps over a one‐year period in women taking adjuvant tamoxifen following breast cancer. Larger studies are necessary to assess the effects of Mirena in preventing endometrial hyperplasia and cancer.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2010

Treatment of Barrett's oesophagus

One of the two main types of oesophageal (gullet) cancer, oesophageal adenocarcinoma, is rapidly increasing in incidence in the western world. The prognosis for patients treated for oesophageal adenocarcinoma is appalling with fewer than 15% of individuals surviving beyond five years. Barrett’s oesophagus has been identified as the pre‐cancerous stage of adenocarcinoma. It is recognised that Barrett's oesophagus develops as a complication of acid and bile reflux which commonly, but not inevitably, leads to heartburn symptoms. In response to these injurious agents, the normal squamous lining of the oesophagus is replaced by a columnar lining resembling the lining of the intestine. This intestinal subtype has the highest risk of malignancy and the term Barrett's oesophagus is used only for this subtype in many areas of the world, and in most research publications. Barrett's oesophagus can gradually progress to adenocarcinoma through a series of stages called dysplasia which can be identified in biopsies examined under the microscope.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2013

Screening for oesophageal cancer

Oesophageal cancer is a common cause of cancer related death in the world. The prognosis in the advanced stages is unfavourable, but the early oesophageal cancers are asymptomatic and curable, and usually go undetected until they have spread beyond the oesophageal wall. Endoscopy with iodine staining or cytologic examination are two common screening tests for early oesophageal cancer. These screening tests were started in the 1970s, but the true benefit is inconsistent and is uncertain due to lead‐time bias, which is the amount of time by which the diagnosis is advanced by the screening procedure; and length‐time bias, where screening is more likely to detect slow‐growing disease rather than altering the person's duration of life. This review intended to determine the efficacy of the two screening tests for oesophageal cancer. We identified 3482 studies but none were RCTs of screening. Several non‐comparative studies showed that the screening tests may increase the incidence of reported oesophageal cancer and improve the survival results after a screening test, but these results could indicate bias rather than a true causative effect. Therefore, there is a strong need for randomised controlled trials (RCTs), especially long‐term RCTs, to determine the efficacy, cost‐effectiveness, and any adverse effects of screening for oesophageal cancer.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2012

Amifostine for salivary glands in high‐dose radioactive iodine treated differentiated thyroid cancer

Thyroid cancer is the most common malignancy of the endocrine system consisting of several subtypes like papillary carcinoma (accounting for 80% of cases) and follicular carcinoma (accounting for 11% of cases). These are collectively referred to as 'differentiated thyroid cancer'. Treatment with radioactive iodine after surgery (ablation of the thyroid gland or 'thyroidectomy') is important for the detection of metastatic disease and for the destruction of the remaining thyroid tissue with microscopic cancer. After radioactive iodine treatment, adverse effects may happen in the salivary glands and cause salivary gland swelling and pain, usually involving the parotid. The symptoms may develop immediately after a therapeutic dose of radioactive iodine or months later and progress in intensity with time. Secondary complications reported include dry mouth ('xerostomia') and taste alterations.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2009

Endoscopic skull base/sinonasal adenocarcinoma surgery: what evidence exists?

BACKGROUND: This study reviewed the published outcomes literature on endoscopic or endoscopic-assisted treatment of sinonasal and skull base adenocarcinoma (SSBA). A systematic literature review was performed.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2010

Is adjuvant 5-FU-based chemoradiotherapy for resectable pancreatic adenocarcinoma beneficial: a meta-analysis of an unanswered question

The objective of this study was to determine the effect, if any, on survival of adjuvant 5-FU-based chemoradiotherapy following pancreaticoduodenectomy for pancreatic carcinoma. A systematic review of the published literature was undertaken. Survival estimates were derived from published reports. Five prospective studies (4 level I, 1 level II) with a total of 607 (229 surgery only; 378 surgery-adjuvant) patients followed for survival met selection criteria. Two-year survival ranged from 15%-37% in the surgery only group and 37%-43% in the surgery and adjuvant groups. The survival advantage (absolute difference) ranged from 3%-27% and no individual study achieved statistical significance (5%). Although clinical heterogeneity existed in surgery-alone control groups with regard to trial date, no statistical heterogeneity was detected (P = 0.459, chi2 test), allowing pooling of survival data. Using a fixed effects model, the summary estimate showed an absolute 2-year survival benefit with adjuvant therapy of 12% (95% CI, 3%-21%, P = 0.011). Trials after 1997 (n = 3) indicated a survival benefit of 8% to patients receiving adjuvant therapy (95% CI, -3-18%, P = 0.145). The result was not statistically significant, and there was no evidence of heterogeneity (P = 0.626, chi2 test). Summary estimates were unchanged when the analysis was performed with a random effects model. 5-FU based chemotherapy with radiotherapy given after resection imparts a small overall survival benefit of 2 years. The benefit of 5-FU-based adjuvant therapy, however, has declined in recent years, and its significance remains unproven in the context of current diagnostic and surgical practice.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2006

Standard with extended pancreaticoduodenectomy for adenocarcinoma of the head of the pancreas: a meta-analysis

OBJECTIVE: To compare standard with extended pancreaticoduodenectomy for adenocarcinoma of the head of the pancreas: a meta-analysis of randomized controlled trials and prospective studies.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2007

Neoadjuvant therapy in pancreatic adenocarcinoma: a meta-analysis of phase II trials

BACKGROUND: Neoadjuvant treatment has proven beneficial for many gastrointestinal (GI) malignancies, but no phase III trials have been completed examining this approach in pancreatic cancer. This meta-analysis examines the best available phase II trials using neoadjuvant treatment for resectable and borderline/unresectable pancreatic adenocarcinoma.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2011

Efficacy of oral or intrauterine device-delivered progestin in patients with complex endometrial hyperplasia with atypia or early endometrial adenocarcinoma: a meta-analysis and systematic review of the literature

OBJECTIVES: To investigate the efficacy of progestin treatment to achieve pathological complete response (pCR) in patients with complex atypical endometrial hyperplasia (CAH) or early endometrial adenocarcinoma (EC).

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2012

Nonsteroidal anti-inflammatory drugs and esophageal inflammation - Barrett's esophagus - adenocarcinoma sequence: a meta-analysis

The incidence of esophageal adenocarcinoma has markedly increased in the last few decades and Barrett's esophagus is regarded as the precursor lesion of this cancer. The aim of the study was to quantify the adenocarcinoma risk associated with nonsteroidal anti-inflammatory drug use and to determine at which stage chemoprevention with this drug is the most effective in esophageal inflammation - Barrett's esophagus - adenocarcinoma sequence. A literature search was performed to identify studies published between 1998 and 2009 for relevant risk estimates. Fixed and random effect meta-analytical techniques were conducted for aspirin, nonaspirin nonsteroidal anti-inflammatory drugs, and all nonsteroidal anti-inflammatory drugs. Four cohort and 10 case-control studies were included. Use of aspirin and nonaspirin nonsteroidal anti-inflammatory drugs in normal population was associated with a reduced risk of adenocarcinoma (odds ratio [OR]: 0.73, 95% confidence interval [CI]: 0.65-0.83; OR: 0.84, 95% CI: 0.72-0.98, respectively). The use of all nonsteroidal anti-inflammatory drugs was associated with a reduced risk of adenocarcinoma (relative risk [RR]: 0.64, 95% CI: 0.42-0.96) in Barrett's esophagus patients. However, no obvious dose-effect relationships were found. In addition, we discovered a reverse association between drugs use and adenocarcinoma risk in people without a history of upper gastrointestinal tract disorders (OR: 0.57, 95% CI: 0.43-0.77, P= 0.12). Our meta-analyses suggest a protective effect of nonsteroidal anti-inflammatory drugs on the risk of adenocarcinoma. Our results also suggest that the drugs might act after the formation of Barrett's epithelium in the esophageal inflammation - Barrett's esophagus - adenocarcinoma sequence.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2011

Should extended lymphadenectomy be performed for adenocarcinoma of the head of the pancreas? A meta-analysis and systematic review

BACKGROUND AND AIM: Although some retrospective studies have recommended that pancreaticoduodenectomy with extended lymphadenectomy might improve the survival of patients with adenocarcinoma of the head of the pancreas, the procedure remains controversial.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2013

Proximal gastrectomy versus total gastrectomy for adenocarcinoma of esophagogastric junction: a meta-analysis

OBJECTIVE: To compare the efficacy of proximal gastrectomy(PG) and total gastrectomy(TG) for adenocarcinoma of esophagogastric junction.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2014

Standard and extended lymphadenectomy for adenocarcinoma of the pancreatic head: a meta-analysis and systematic review

BACKGROUND AND AIM: Although some retrospective studies have recommended that pancreaticoduodenectomy with extended lymphadenectomy might improve the survival of patients with adenocarcinoma of the head of the pancreas, the procedure remains controversial.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2014

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