Platinum-based adjuvant therapy was efficient for triple-negative breast cancer: a meta-analysis from randomized controlled trials.

Triple-negative breast cancer (TNBC) is the most aggressive breast cancer. Neoadjuvant chemotherapy was widely accepted for treating TNBC. This systematic review and meta-analysis aimed to evaluate the efficacy, safety, and survival benefit of platinum-based adjuvant therapy (PBAT) in treating TNBC. The keywords were searched in Medline, Embase, Pubmed, and Cochrane Library database up to July 24, 2022. All the randomized control trials (RCTs) comparing PBAT and non-PBAT in treating TNBC were included in our study. The pathological complete remission (pCR) and complications were compared by odds ratio (OR) and 95% confidence intervals (CIs). The overall survival (OS) and relapse-free survival (RFS) were compared by hazard ratio (HR) and 95% CIs. A total of 19 RCTs were included in our meta-analysis, among which 2,501 patients were treated with PBAT and 2,290 with non-PBAT. The patients treated with PBAT combined a significantly higher pCR rate compared to those patients treated with non-PBAT (49.8% versus 36.4%, OR = 1.27, 95%CI = 1.14-1.43, P < 0.001). Besides, patients treated with PBAT had a significantly better RFS (HR = 0.78, 95%CI = 0.63-0.95, P = 0.016), but not in OS (HR = 0.84, P = 0.304). Although the occurrence of neutropenia and nausea were slightly different between the PBAT group (51.5% and 24.4%) and the non-PBAT group (47.0% and 29.4%), the complications were acceptable in the two treatments groups. Our results demonstrated that TNBC patients treated with PBAT could achieve a higher pCR rate and better RFS benefit without a higher complication rate.Highlights Platinum-based adjuvant therapy provided a higher pCR rate for TNBC.Platinum-based adjuvant therapy prolonged the RFS but without prolongingthe OS.Neutropenia and nausea rate was different between group PBAT and non-PBAT.

Elevated plasma visfatin levels correlate with conversion of laparoscopic cholecystectomy to open surgery in acute cholecystitis.

Visfatin correlates with inflammation and its levels in peripheral blood are associated with some inflammatory diseases. This study aimed to assess the relationship between plasma visfatin levels and conversion of laparoscopic cholecystectomy to open surgery in acute cholecystitis. One hundred and forty-six acute cholecystitis patients and 146 sex- and age-matched healthy controls were recruited and their plasma visfatin levels were determined using an enzyme immunoassay. 17 patients (11.6%) underwent conversion. Plasma visfatin levels were statistically significantly elevated in all patients (97.2±41.8ng/mL), those with (161.4±71.3ng/mL) or without conversion (88.7±26.9ng/mL), compared to controls (40.3±13.3ng/mL, all P<0.001). A linear regression analysis showed that plasma visfatin levels were positively associated with plasma C-reactive protein levels (t=0.510, P<0.001). A logistic-regression analysis showed that age [odds ratio (OR) 1.160, 95% confidence interval (CI) 1.011-1.332, P=0.035] and plasma visfatin levels (OR 1.035, 95% CI 1.005-1.066, P=0.022) appeared to be the independent predictors of conversion. A receiver operating characteristic curve analysis found that plasma visfatin levels predicted conversion with high area under curve (AUC) (AUC, 850; 95% CI, 0.781-0.903). The AUC of the visfatin concentration was similar to that of age (AUC, 0.738; 95% CI, 0.659-0.807) (P=0.188). Visfatin improved the AUC of age to 0.914 (95% CI, 0.856-0.954) (P=0.011) using a combined logistic-regression model. Thus, high plasma levels of visfatin are associated with systemic inflammation, and may independently predict conversion of laparoscopic cholecystectomy to open surgery in acute cholecystitis.