Abstract：
OBJECTIVE:To perform a systematic review and meta-analysis of randomized controlled trials (RCTs) evaluating risk-benefit for adjuvant postoperative treatments in high-risk renal cell carcinoma by assessing reported disease-free survival (DFS), overall survival (OS), toxicity, and quality of life. METHODS:A literature search was performed in PubMed, Embase, Web of Science, and Cochrane Central Register of Controlled Trials to identify relevant RCTs (from database inception through May 15, 2018). The results of the ATLAS trial were published while writing this manuscript, and the manuscript was updated accordingly. A generic variance-weighted random effects model was used to derive estimates for efficacy and common adverse effects. Heterogeneity was assessed using the Cochran Q statistic and was quantified using the I2 test. RESULTS:Adjuvant therapy with tyrosine kinase inhibitors compared with placebo was observed to have a DFS hazard ratio [HR] of 0.92 (95% CI, 0.83-1.01) and an OS HR of 1.01 (95% CI, 0.89-1.15) (4 RCTs; 4417 patients). Analysis of DFS for sunitinib compared with placebo (n=1909) in the adjuvant setting detected an HR of 0.90 (95% CI, 0.67-1.19). Increased risk of grade 3 or 4 adverse events (relative risk [RR]=2.6; 95% CI, 2.28-2.97), diarrhea (RR=9.89; 95% CI, 4.22-23.14), fatigue (RR=3.11; 95% CI, 1.86-5.18), hypertension (RR=3.63; 95% CI, 2.99-4.41), and palmar/plantar dysesthesia (RR=2.70; 95% CI, 2.47-2.96) was observed. CONCLUSION:Adjuvant vascular endothelial growth factor tyrosine kinase inhibitors in high-risk renal cell carcinoma did not improve OS or DFS, and there was a significant increased risk of toxicity in greater than half of the patients, leading to a decline in quality of life.
journal_name
Mayo Clin Procjournal_title
Mayo Clinic proceedingsauthors
Riaz IB,Faridi W,Husnain M,Malik SU,Sipra QUAR,Gondal FR,Xie H,Yadav S,Kohli Mdoi
10.1016/j.mayocp.2019.01.045subject
Has Abstractpub_date
2019-08-01 00:00:00pages
1524-1534issue
8eissn
0025-6196issn
1942-5546pii
S0025-6196(19)30217-4journal_volume
94pub_type
杂志文章,meta分析abstract：:This discussion concerns an overview of our considerations of the adrenergic nervous system with respect to those areas of the nervous system that provide direct sensory input to the brain in control of arterial pressure; those brain centers that also participate in regulating arterial pressure; certain neurohumoral c...
journal_title：Mayo Clinic proceedings
pub_type： 杂志文章,评审
doi：
更新日期：1977-06-01 00:00:00
abstract：OBJECTIVE:To determine the risk of hospitalization and death in relation to preexisting depression and anxiety among patients with cardiovascular disease (CVD). PATIENTS AND METHODS:The cohort consisted of 799 Olmsted County, MN, residents diagnosed with CVD (myocardial infarction or heart failure) from January 1, 197...
journal_title：Mayo Clinic proceedings
pub_type： 杂志文章
doi：10.4065/mcp.2011.0148
更新日期：2011-11-01 00:00:00
abstract：OBJECTIVE:To assess long-term secular trends in the utilization of bilateral compared with unilateral orchiectomy in the community. PATIENTS AND METHODS:This population-based descriptive study reviewed medical records of all Olmsted County, Minnesota, men undergoing orchiectomy between 1956 and 2000. RESULTS:Over the...
journal_title：Mayo Clinic proceedings
pub_type： 杂志文章
doi：10.4065/76.12.1199
更新日期：2001-12-01 00:00:00
abstract：:A 56-year-old man sought medical assistance because of recurrent nonconvulsive status epilepticus without a history of prior seizure activity. Examination of the cerebrospinal fluid disclosed leptomeningeal cancer. To our knowledge, the association of partial complex status epilepticus and leptomeningeal cancer has no...
journal_title：Mayo Clinic proceedings
pub_type： 杂志文章
doi：10.1016/s0025-6196(12)62337-4
更新日期：1987-09-01 00:00:00
abstract：:Humanism and the humanities open the way to communication, to a better professional and political performance, and to a better image of the profession in the eyes of its "real" public. They also offer to individual physicians a richer life, a greater understanding of their own achievements, a protection against isolat...
journal_title：Mayo Clinic proceedings
pub_type： 杂志文章
doi：10.1016/s0025-6196(12)60703-4
更新日期：1993-09-01 00:00:00
abstract：:The sensitivity of an indirect fluorescent antibody (IFA) test (screening test) for the detection of antibodies to cytomegalovirus (CMV) was examined by using 128 serum specimens and quaternary aminoethyl (QAE)-Sephadex A50 column chromatography to separate IgM from IgG class antibodies. Of these 128 rheumatoid factor...
journal_title：Mayo Clinic proceedings
pub_type： 杂志文章
doi：10.1016/s0025-6196(12)65437-8
更新日期：1987-05-01 00:00:00
abstract：OBJECTIVE:To determine how all-cause hospitalizations within 12 months preceding an index heart failure (HF) hospitalization affect risk stratification for 30-day all-cause readmission. PATIENTS AND METHODS:Early readmission of inpatients with HF is challenging to predict, yet this outcome is used to compare hospital ...
journal_title：Mayo Clinic proceedings
pub_type： 杂志文章
doi：10.1016/j.mayocp.2013.12.018
更新日期：2014-05-01 00:00:00
abstract：:It is now generally accepted that vitamin D deficiency is a worldwide health problem that affects not only musculoskeletal health but also a wide range of acute and chronic diseases. However, there remains cynicism about the lack of randomized controlled trials to support the association studies regarding the nonskele...
journal_title：Mayo Clinic proceedings
pub_type： 杂志文章
doi：10.1016/j.mayocp.2013.05.011
更新日期：2013-07-01 00:00:00
abstract：OBJECTIVE:To report the third known and documented occurrence of malignant disease as a complication of immunosuppression associated with low-dose methotrexate therapy for rheumatoid arthritis. MATERIAL AND METHODS:We present a case report of a 64-year-old woman with rheumatoid arthritis who had received low-dose meth...
journal_title：Mayo Clinic proceedings
pub_type： 杂志文章,评审
doi：10.1016/s0025-6196(12)61065-9
更新日期：1994-03-01 00:00:00
abstract：OBJECTIVE:To determine whether N-acetylcysteine rinse was safe and could improve thickened secretions and dry mouth during and after radiotherapy. PATIENTS AND METHODS:We designed a prospective pilot double-blind, placebo-controlled randomized clinical trial (Alliance MC13C2). Adult patients (age ≥18 years) were enrol...
journal_title：Mayo Clinic proceedings
pub_type： 杂志文章,随机对照试验
doi：10.1016/j.mayocp.2019.03.031
更新日期：2019-09-01 00:00:00
abstract：OBJECTIVE:To assess whether amiodarone, as part of a strategy to achieve sinus rhythm, is safe and effective compared with a placebo or rate control drug in patients with persistent atrial fibrillation (AF) of more than 30 days' duration. METHODS:Randomized controlled trials comparing amiodarone with a placebo or rate...
journal_title：Mayo Clinic proceedings
pub_type： 杂志文章,meta分析
doi：10.1016/S0025-6196(11)61140-3
更新日期：2009-03-01 00:00:00
abstract：:Tobacco use is a global pandemic. The most common pharmacological treatments of tobacco use and dependence include nicotine replacement therapy and nonnicotine medications. Bupropion sustained release (SR) is the only first-line nonnicotine medication recommended by the US Public Health Service Clinical Practice Guide...
journal_title：Mayo Clinic proceedings
pub_type： 杂志文章,评审
doi：10.4065/78.8.1020
更新日期：2003-08-01 00:00:00
abstract：:Herein we review the symptoms, physical findings, and test results in 131 patients with acoustic neurinoma. The earliest symptoms are unilateral hearing loss, tinnitus, and dysequilibrium. As the disease progresses, facial numbness, facial weakness, and headaches become more prominent. Physical findings other than hea...
journal_title：Mayo Clinic proceedings
pub_type： 杂志文章
doi：
更新日期：1983-11-01 00:00:00
abstract：OBJECTIVE:To assess the effects of glutathione on pain-free walking distance (PFWD) and hemodynamic parameters in patients with peripheral artery disease. PATIENTS AND METHODS:Forty patients with Fontaine stage II peripheral artery disease who were seen between September 2000 and March 2001 at the vascular laboratory ...
journal_title：Mayo Clinic proceedings
pub_type： 临床试验,杂志文章,随机对照试验
doi：10.4065/77.8.754
更新日期：2002-08-01 00:00:00
abstract：:Fibromyalgia is the currently preferred term for widespread musculoskeletal pain, typically accompanied by other symptoms such as fatigue, memory problems, and sleep and mood disturbances, for which no alternative cause can be identified. Earlier there was some doubt about whether there was an "organic basis" for thes...
journal_title：Mayo Clinic proceedings
pub_type： 杂志文章,评审
doi：10.1016/j.mayocp.2015.03.014
更新日期：2015-05-01 00:00:00
abstract：:Atherosclerosis is a diffuse, systemic disease that affects the coronary, cerebral, and peripheral arterial trees. Disruption of atherosclerotic plaques leads to thrombus formation and arterial occlusion. This unpredictable and potentially life-threatening atherothrombotic sequence underlies clinical events such as an...
journal_title：Mayo Clinic proceedings
pub_type： 杂志文章,评审
doi：10.4065/81.1.59
更新日期：2006-01-01 00:00:00
abstract：OBJECTIVE:To record long-term follow-up data on patients with chronic idiopathic meningitis. DESIGN:We retrospectively reviewed the outcome of 49 patients who were examined at the Mayo Clinic between 1978 and 1990. MATERIAL AND METHODS:For all patients, symptoms, signs, laboratory values, results of imaging studies, ...
journal_title：Mayo Clinic proceedings
pub_type： 杂志文章
doi：10.1016/s0025-6196(12)62246-0
更新日期：1994-06-01 00:00:00
abstract：:Two-dimensional echocardiography is useful for the immediate diagnosis of acute myocardial infarction when diagnostic electrocardiographic changes are absent. The technique is also helpful in distinguishing myocardial infarction from other conditions that may clinically or electrocardiographically mimic infarction. Th...
journal_title：Mayo Clinic proceedings
pub_type： 杂志文章
doi：10.1016/s0025-6196(12)61526-2
更新日期：1987-01-01 00:00:00
abstract：OBJECTIVE:The current study was undertaken to assess the frequency of excessive enteric protein loss and protein-losing enteropathy in the relatively early period after the Fontan operation. DESIGN:Protein excretion was determined in 26 of 27 consecutive patients who underwent the Fontan procedure between January and ...
journal_title：Mayo Clinic proceedings
pub_type： 杂志文章
doi：10.1016/s0025-6196(12)61035-0
更新日期：1994-02-01 00:00:00
abstract：:The source of the membranous materials that accumulate in distal axons of rats intoxicated with p-bromophenylacetylurea (BPAU) was studied by electron microscopy. 35S-Methionine was injected into the ventral horn of the spinal cord at 2, 14, and 35 days after injection of BPAU. Three days later, samples of the deep pe...
journal_title：Mayo Clinic proceedings
pub_type： 杂志文章
doi：10.1016/s0025-6196(12)61550-x
更新日期：1992-04-01 00:00:00
abstract：:Drugs that target G protein-coupled receptors (GPCRs) represent the primary treatment strategy for patients with acute and chronic pain; however, there is substantial individual variability in both the efficacy and adverse effects associated with these drugs. Variability in drug responses is due, in part, to individua...
journal_title：Mayo Clinic proceedings
pub_type： 杂志文章,评审
doi：10.1016/j.mayocp.2015.06.010
更新日期：2015-08-01 00:00:00
abstract：OBJECTIVE:To evaluate the association between coffee consumption and mortality from all causes and from cardiovascular disease. PATIENTS AND METHODS:Data from the Aerobics Center Longitudinal Study representing 43,727 participants with 699,632 person-years of follow-up were included. Baseline data were collected by an...
journal_title：Mayo Clinic proceedings
pub_type： 杂志文章
doi：10.1016/j.mayocp.2013.06.020
更新日期：2013-10-01 00:00:00
abstract：:Traditional treatments for men with localized prostate cancer have included both surgical removal and radiation therapy, with their potential adverse effects on patient quality of life. Thus, there has been increasing interest in the development of minimally invasive procedures that use various technologies to deliver...
journal_title：Mayo Clinic proceedings
pub_type： 杂志文章,评审
doi：10.4065/79.12.1547
更新日期：2004-12-01 00:00:00
abstract：:Type 2 diabetes mellitus is a heterogeneous disorder characterized by 2 pathogenic defects, impaired insulin secretion and insulin resistance. The resultant hyperglycemia causes microvascular and macrovascular complications that increase morbidity and mortality in patients with diabetes mellitus. Optimum glycemic cont...
journal_title：Mayo Clinic proceedings
pub_type： 杂志文章,评审
doi：
更新日期：2001-06-01 00:00:00
abstract：OBJECTIVE:To determine the frequency of fetal urinary tract anomalies and to characterize the types of such abnormalities detected on ultrasonography and the outcome of affected patients during a 15-year period at our institution. DESIGN:We retrospectively reviewed the findings on maternal prenatal ultrasound examinat...
journal_title：Mayo Clinic proceedings
pub_type： 杂志文章
doi：10.4065/70.6.526
更新日期：1995-06-01 00:00:00
abstract：OBJECTIVE:To obtain pilot prospective data regarding the efficacy and tolerability of gabapentin for alleviating hot flashes. PATIENTS AND METHODS:This prospective single-arm clinical trial was conducted between July 26, 2001, and November 30, 2001. Patients underwent a baseline week and then 4 weeks of gabapentin tre...
journal_title：Mayo Clinic proceedings
pub_type： 临床试验,杂志文章
doi：10.4065/77.11.1159
更新日期：2002-11-01 00:00:00
abstract：:The sympathetic nervous system plays a key role in regulating arterial blood pressure in humans. This review provides an overview of sympathetic neural control of the circulation and discusses the changes that occur in various disease states, including hypertension, heart failure, and obstructive sleep apnea. It focus...
journal_title：Mayo Clinic proceedings
pub_type： 杂志文章,评审
doi：10.1016/S0025-6196(11)60492-8
更新日期：2009-09-01 00:00:00
abstract：OBJECTIVE:To determine the effect of psychologic distress, measured with a commonly used screening questionnaire, on 6-month morbidity and rehospitalization costs in coronary patients. DESIGN:Psychologic distress was determined by screening with the Symptom Checklist-90--Revised (SCL-90-R) self-report inventory during...
journal_title：Mayo Clinic proceedings
pub_type： 杂志文章
doi：10.4065/70.8.734
更新日期：1995-08-01 00:00:00
abstract：:An unusual case of a capillary hemangioma of the filum terminale is presented. The successful removal returned the patient to an asymptomatic state. ...
journal_title：Mayo Clinic proceedings
pub_type： 杂志文章
doi：
更新日期：1975-03-01 00:00:00
abstract：OBJECTIVE:To describe the advantages, disadvantages, practical considerations, and future developments of transcutaneous drug delivery. MATERIALS AND METHODS:The physiochemical properties of the drug preparation that are factors in the effectiveness of transcutaneous transport are drug stability or volatility, use of ...
journal_title：Mayo Clinic proceedings
pub_type： 杂志文章,评审
doi：10.4065/70.6.581
更新日期：1995-06-01 00:00:00
