Association between nut consumption and cancer risk: a meta-analysis.

This study aims to conduct a meta-analysis and dose-response analysis of the relationship between nut intake and cancer risk and mortality. Electronic databases were searched. A meta-analysis was conducted to calculate the pooled effect sizes (ESs) with the corresponding 95% CIs, and a dose-response analysis was performed. A random-effects model was used in the statistical analysis. Two independent reviewers completed the full-text screening, data extraction, and quality assessment. We included 17 articles in the present meta-analysis. Total nuts intake was revealed to be significantly associated with reduced cancer risk (ES: 0.9; 95% CI: 0.86-0.95; P < 0.001) and cancer mortality (ES: 0.88; 95% CI: 0.85-0.92, P < 0.001), especially lung cancer risk (ES: 0.86; 95% CI: 0.81-0.91, P < 0.001) and gastric cancer risk (ES: 0.79; 95% CI: 0.68-0.91, P = 0.001). Moreover, a 10 g/d increment of tree nuts consumption was associated with a 20% cancer mortality reduction (ES: 0.80; 95% CI: 0.71-0.89; P < 0.0001). Nuts intake is significantly associated with the reduction of cancer risk and mortality. Especially, nuts intake is significantly associated with reduced lung cancer risk and gastric cancer risk. Noticeably, a 10 g/d increase in tree nuts intake is related to a 20% reduction in overall cancer mortality.

Metformin has no Significant Anticancer Effect on Patients with Advanced or Unresectable Cancer: A Systematic Review and Meta-analysis.

BACKGROUND: At present, the antitumor effect of metformin is controversial. Previous meta-analyses included observational studies, of which the results can be influenced by many confounders, affecting the result of meta-analyses and weakening the strength of evidence. Therefore, we conducted a meta-analysis to confirm the effect of metformin use on patients with advanced or unresectable cancers, including randomized clinical trials (RCTs). METHODS: We searched for RCTs in accordance with the inclusion and exclusion criteria. A meta-analysis was conducted to combine hazard ratios (HRs) or risk ratios (RRs) and their 95% confidence intervals (CIs) using a random-effects model. RESULTS: Finally, 7 eligible RCTs were included in the meta-analysis. Overall, the combined results revealed that treatment with metformin did not improve the overall survival (OS) of patients (HR, 1.12; 95% CI, 0.91-1.37, p>0.05), and there was no clear evidence that metformin use was related to improved progression-free survival (PFS) (HR, 1.17; 95% CI, 0.97-1.40; p>0.05). The pooled RR for grade III or IV adverse events was 0.92 (95% CI, 0.52- 1.60; p>0.05), indicating that the use of metformin was not significantly related to increased toxicity. CONCLUSION: Metformin does not significantly improve the survival of patients with advanced or unresectable cancer, regardless of cancer type and region.

Association of active immunotherapy with outcomes in cancer patients with COVID-19: a systematic review and meta-analysis.

BACKGROUND: During the COVID-19 pandemic, there are growing concerns about the safety of administering immunotherapy in cancer patients with COVID-19. However, current clinical guidelines provided no clear recommendation. METHODS: Studies were searched and retrieved from electronic databases. The meta-analysis was performed by employing the generic inverse-variance method. A random-effects model was used to calculate the unadjusted odds ratios (ORs) and adjusted ORs with the corresponding 95% CIs. RESULTS: This meta-analysis included 20 articles with 6,042 cancer patients diagnosed with COVID-19. According to the univariate analysis, the acceptance of immunotherapy within 30 days before COVID-19 diagnosis did not increase the mortality of cancer patients (OR: 0.92; 95% CI: 0.68-1.25; P=0.61). Moreover, after adjusting for confounders, the adjusted OR for mortality was 0.51, with borderline significance (95% CI: 0.25-1.01; P=0.053). Similarly, the univariate analysis showed that the acceptance of immunotherapy within 30 days before COVID-19 diagnosis did not increase the risk of severe/critical disease in cancer patients (OR: 1.07; 95% CI: 0.78-1.47; P=0.66). No significant between-study heterogeneity was found in these analyses. CONCLUSIONS: Accepting immunotherapy within 30 days before the diagnosis of COVID-19 was not significantly associated with a higher risk of mortality or severe/critical disease of infected cancer patients. Further prospectively designed studies with large sample sizes are required to evaluate the present results.

Diagnostic efficacy of PET-CT, CT, and MRI in preoperative assessment of mandibular invasion caused by head and neck cancer: A systematic review and meta-analysis.

OBJECTIVE: This study aims to conduct a systematic review and meta-analysis of the performance of PET-CT, CT, and MRI in diagnosing mandible invasion induced by head and neck cancer (HNC). MATERIALS AND METHODS: The MEDLINE, Embase, Science Direct, CNKI and CQVIP databases were searched from inception until August 1, 2020. Then, a meta-analysis was conducted to calculate the combined diagnostic values with the corresponding 95% CIs. Two independent researchers completed the full text screening, data abstraction, and risk assessment. RESULTS: This meta-analysis included 53 studies (N = 2 946 participants). For the pooled sensitivity (SEN), MRI (SEN: 0.88, 95% CI: 0.81-0.93) was found to have a significantly higher SEN (P = 0.0045), when compared to CT (SEN: 0.77, 95% CI: 0.71-0.82), while compared with PET-CT (SEN: 0.88, 95% CI: 0.64-0.97), the SEN was approximately equal (P > 0.05). The analysis revealed that the combined specificity (SPE) of MRI (SPE: 0.83, 95% CI: 0.74-0.89) and PET-CT (SPE: 0.81, 95% CI: 0.57-0.93) was lower than that of CT (SPE: 0.87, 95% CI: 0.83-0.90), but there was no statistical significance among these (P > 0.05). The comparison of the area under curve (AUC) reflected that PET-CT, CT and MRI have approximately equal summary diagnostic power in detecting mandibular invasion (P > 0.05). CONCLUSION: The findings suggest that compared with CT, MRI is significantly superior for higher SEN in diagnosing mandibular invasion. The SEN of MRI and PET-CT were approximately equal. For the summary of diagnostic power, more prospective clinical trials that directly compare these three methods are needed in the future.