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      Risk factors for metachronous esophageal squamous cell carcinoma after endoscopic or surgical resection of esophageal carcinoma: a systematic review and meta-analysis

      systematic-review

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          Abstract

          Background

          early-stage esophageal carcinoma (EC) patients lack typical clinical signs and symptoms and are often diagnosed and treated at a late stage, leading to a poor prognosis and a high incidence of metachronous esophageal squamous cell carcinoma (MESCC) and second primary carcinoma (SPC). The aims of the review were to identify and quantify risk factors for MESCC and analysis location of SPC in postoperative patients with EC; to predict incidence of MESCC over follow-up time.

          Methods

          an electronic search of studies reporting potential risk factors, the incidence of MESCC, and the location of SPC were performed on PubMed, Web of Science, Cochrane Library, Embase, and Scopus from inception to 10 November 2022. The Newcastle-Ottawa scale was used to assess the study quality, and the qualitative strength of evidence rating of all items was provided. The meta-regression model was used to predict the incidence of MESCC over follow-up time, the location distribution of SPC was presented using clustered column chart, while the publication bias was assessed using funnel plots and Egger’s test.

          Results

          smoking, age, history of multiple other cancer, and Lugol-voiding lesions (LVLs) were determined to be the risk factors of MESCC. LVLs were qualitatively determined as “definite” and the history of multiple other cancer as “likely.” The overall pooled MESCC incidence was 20.3% (95% CI: 13.8% to 26.8%), with an increase of 0.20% for each additional year of follow-up. The head and neck were the most common locations for SPC, followed by the esophagus.

          Conclusion

          timely investigating the age of patients, previous history of cancer and monitoring the number of LVLs in the first 5 years after operation are of great significance to identify high-risk populations of MESCC for timely medical care. Education and behavior correction about smoking are advocated. Tumor markers should be regularly detected in the head and neck, esophagus, and stomach. Endoscopic resection was associated with a higher incidence of MESCC, which provided a reference for doctors to choose the removal method.

          Systematic review registration

          https://www.crd.york.ac.uk/PROSPERO/, identifier CRD42022377030.

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          Most cited references37

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          Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement

          David Moher and colleagues introduce PRISMA, an update of the QUOROM guidelines for reporting systematic reviews and meta-analyses
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            The PRISMA 2020 statement: An updated guideline for reporting systematic reviews

            The Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) statement, published in 2009, was designed to help systematic reviewers transparently report why the review was done, what the authors did, and what they found. Over the past decade, advances in systematic review methodology and terminology have necessitated an update to the guideline. The PRISMA 2020 statement replaces the 2009 statement and includes new reporting guidance that reflects advances in methods to identify, select, appraise, and synthesise studies. The structure and presentation of the items have been modified to facilitate implementation. In this article, we present the PRISMA 2020 27-item checklist, an expanded checklist that details reporting recommendations for each item, the PRISMA 2020 abstract checklist, and the revised flow diagrams for original and updated reviews.
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              Esophageal cancer: Risk factors, screening and endoscopic treatment in Western and Eastern countries.

              Esophageal cancer is one of the most unknown and deadliest cancers worldwide, mainly because of its extremely aggressive nature and poor survival rate. Esophageal cancer is the 6(th) leading cause of death from cancer and the 8(th) most common cancer in the world. The 5-year survival is around 15%-25%. There are clear differences between the risk factors of both histological types that affect their incidence and distribution worldwide. There are areas of high incidence of squamous cell carcinoma (some areas in China) that meet the requirements for cost-effectiveness of endoscopy for early diagnosis in the general population of those areas. In Europe and United States the predominant histologic subtype is adenocarcinoma. The role of early diagnosis of adenocarcinoma in Barrett's esophagus remains controversial. The differences in the therapeutic management of early esophageal carcinoma (high-grade dysplasia, T1a, T1b, N0) between different parts of the world may be explained by the number of cancers diagnosed at an early stage. In areas where the incidence is high (China and Japan among others) early diagnoses is more frequent and has led to the development of endoscopic techniques for definitive treatment that achieve very effective results with a minimum number of complications and preserving the functionality of the esophagus.
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                Author and article information

                Contributors
                Journal
                Front Oncol
                Front Oncol
                Front. Oncol.
                Frontiers in Oncology
                Frontiers Media S.A.
                2234-943X
                14 September 2023
                2023
                : 13
                : 1241572
                Affiliations
                [1] 1 Department of Social Medicine and Health Management, School of Public Health, Lanzhou University , Lanzhou, China
                [2] 2 The First Clinical Medical College, Lanzhou University , Lanzhou, China
                [3] 3 Department of Gastroenterology, The First Hospital of Lanzhou University , Lanzhou, China
                [4] 4 Key Laboratory for Gastrointestinal Diseases of Gansu Province, The First Hospital of Lanzhou University , Lanzhou, China
                [5] 5 Talent Service Center, Gansu Provincial Health Commission , Lanzhou, China
                Author notes

                Edited by: Reza Alizadeh-Navaei, Mazandaran University of Medical Sciences, Iran

                Reviewed by: Danial Shamshirian, Shahid Beheshti University of Medical Sciences, Iran; Saeid Heidari-Soureshjani, Shahrekord University of Medical Sciences, Iran

                *Correspondence: Xiaohui Wang, wangxiaohui@ 123456lzu.edu.cn
                Article
                10.3389/fonc.2023.1241572
                10540085
                37781208
                501fa5b7-dd3b-497e-b3a1-9c746e1950c5
                Copyright © 2023 Du, Bao, Liang, Zhao, Zhao, Xu and Wang

                This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

                History
                : 16 June 2023
                : 21 August 2023
                Page count
                Figures: 6, Tables: 6, Equations: 0, References: 37, Pages: 16, Words: 6595
                Categories
                Oncology
                Systematic Review
                Custom metadata
                Gastrointestinal Cancers: Gastric and Esophageal Cancers

                Oncology & Radiotherapy
                metachronous esophageal squamous cell carcinoma,esophageal carcinoma,risk factors,second primary carcinoma,meta-analysis

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