ABSTRACT
Background: Patients with ductal adenocarcinoma of the body and tail of the pancreas usually remain asymptomatic until late in the course of the disease, and the survival of such patients depends on multiple factors, which may affect the therapeutic approach and patient survival. Hence, the aim of this study was to investigate such risk factors by pooling various available studies. Methods: A systematic review was conducted according to PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines between January 1, 2007, and December 31, 2016, using the following databases: Medline, Scopus, the Cochrane Library, and Google Scholar. Studies were selected according to the predesigned eligibility criteria, and information was extracted for demographics, clinical features, and survival outcomes. Data were pooled using fixed- or random-effects models. Results: Sixteen studies were included (5,660 patients) with a median age of 64.8 years and a median survival of 28.5 (range 13–38) months. Identified significant factors for overall survival were higher age (hazard ratio [HR] = 1.211), men (HR = 1.182), presence of lymph node metastasis (HR = 1.964), multivisceral resection (HR = 1.947), N stage (1 versus 0; HR = 1.601), surgical margin (R0 versus No R0; HR = 0.519) and tumor size (>3 cm; HR = 1.890). Conclusion: The pooled results of this study revealed several risk factors for overall survival in patients with left-sided pancreatic cancer.
ABSTRACT
OBJECTIVE@#Accumulation of estrogenic compounds and other carcinogens in normal breast tissues contributes to unpredictable breast cancer incidence during adolescence and throughout life. To assess the role of parabens in this phenomenon, the paraben content of adjacent normal-malignant breast tissues is measured in women with breast cancer living in Isfahan Province, Iran.@*METHODS@#Adjacent normal-malignant breast tissue samples were obtained from 53 subjects. The parabens including methyl-paraben (MePB), ethyl-paraben (EtPB), propyl-paraben (PrPB), and butylparaben (BuPB) were extracted from the sample supernatant and then subjected to gas chromatography analysis.@*RESULTS@#Some risk factors for breast cancer were stimulated by parabens in adjacent malignant-normal breast tissues among young and middle-aged women with breast cancer. We observed a significant association for dose-response pattern of MePB [OR = 98.34 (11.43-185.2), P = 0.027] for both ER+ and PR+ women and MePB [OR = 164.3 (CI: 112.3-216.3), P < 0.001] for HER2+ women than women with negative receptors. The risk of 95-fold increase in MePB dose and 164-fold increase in ΣPBs dose were significant for women with hereditary breast cancer in first-degree relatives.@*CONCLUSION@#These results may promote future epidemiology studies and strategies to improve women's lifestyle and consume paraben-free products.