Clinical Outcome Following Prolonged Neoadjuvant Chemotherapy and Delayed Surgery in Osteosarcoma Patients: An Evidence-based Clinical Review.

BACKGROUND: The incidence of osteosarcoma reached 16.8 cases annually at dr. Cipto Mangunkusumo Hospital in 1995-2008. Previous studies suggested that prolonged neoadjuvant chemotherapy followed by delayed surgery improves the clinical outcome. Prolonged neoadjuvant chemotherapy followed by delayed surgery commonly occurs in Indonesia, as diagnostic imaging and surgery waiting list will delay the surgery. The aim of this study is to observe the survival rate and the event-free survival rate of osteosarcoma patients with prolonged neoadjuvant chemotherapy and delayed surgery. METHODS: This review included randomized controlled trials (RCTs), cohort studies, retrospective cohort studies, clinical trials, and reviews. Literature search was conducted through MEDLINE (PubMed search engine), Cochrane Central Register of Controlled Trial, and Scopus. The studies were screened and selected according to inclusion criteria by author and contributors independently. RESULTS: Six studies were included in the qualitative synthesis of this study. Overall survival rate, event-free survival rate, histological response and recurrence as well as neoadjuvant chemotherapy duration, cycle and regiment were assessed in this study. CONCLUSION: Prolonged neoadjuvant chemotherapy and delayed surgery results in 5-years survival rate of 43.2% to 96.6% and 5-years event-free survival rate of 35.7% to 86.4%.

Birds of primary and secondary forest and shrub habitats in the peat swamp of Berbak National Park, Sumatra.

Background: Tropical lowland rainforests are threatened by deforestation and degradation worldwide. Relatively little research has investigated the degradation of the forests of South-east Asia and its impact on biodiversity, and even less research has focused on the important peat swamp forests of Indonesia, which experienced major losses through severe fires in 2015. Methods: We acoustically sampled the avifauna of the Berbak National Park in 2013 in 12 sites split in three habitats: primary swamp forest, secondary swamp forest, and shrub swamp, respectively representing non-degraded, previously selectively logged, and burned habitats. We analysed the species richness, abundance, vocalisation activity, and community composition across acoustic counts, sites, feeding guilds and IUCN Red List categories. We also analysed community-weighted means of body mass, wing length, and distribution area. Results: The avifauna in the three habitats was remarkably similar in richness, abundance and vocalisation activity, and communities mainly differed due to a lower prevalence of understory insectivores (Old-World Babblers, Timaliidae) in shrub swamp. However primary forest retained twice as many conservation-worthy species as shrub swamp, which harboured heavier, probably more mobile species, with larger distributions than those of forest habitats. Conclusions: The National Park overall harboured higher bird abundances than nearby lowland rainforests. Protecting the remaining peat swamp forest in this little-known National Park should be a high conservation priority in the light of the current threats coming from wildlife trade, illegal logging, land use conversion, and man-made fires.