Evidence map›Paper›PMID 28466127›Full record

SynthesisClinical neuroradiology2018

Incidence of Tumour Progression and Pseudoprogression in High-Grade Gliomas: a Systematic Review and Meta-Analysis.

Abdul W Abbasi, Henriette E Westerlaan, Gea A Holtman, Kamal M Aden, Peter Jan van Laar, Anouk van der Hoorn

Abstract readMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Clinical neuroradiology, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 89 papers, 8 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
89citing papers in PubMed, 8 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

89 citing papers in PubMed, 8 syntheses or guidelines pooled it.

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29 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Abdul W AbbasiUniversity Medical Center Groningen, Department of Radiology, University of Groningen, Hanzeplein 1, 30.001, 9700 RB, Groningen, The Netherlands.
Henriette E WesterlaanUniversity Medical Center Groningen, Department of Radiology, University of Groningen, Hanzeplein 1, 30.001, 9700 RB, Groningen, The Netherlands.
Gea A HoltmanUniversity Medical Center Groningen, Department of General Practice, University of Groningen, Groningen, The Netherlands.
Kamal M AdenUniversity Medical Center Groningen, Department of Radiology, University of Groningen, Hanzeplein 1, 30.001, 9700 RB, Groningen, The Netherlands.
Peter Jan van LaarUniversity Medical Center Groningen, Department of Radiology, University of Groningen, Hanzeplein 1, 30.001, 9700 RB, Groningen, The Netherlands.
Anouk van der HoornUniversity Medical Center Groningen, Department of Radiology, University of Groningen, Hanzeplein 1, 30.001, 9700 RB, Groningen, The Netherlands. a.van.der.hoorn@umcg.nl.ORCID http://orcid.org/0000-0003-4649-327X

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundHigh-grade gliomas are the most common primary brain tumours. Pseudoprogression describes the false appearance of radiation-induced progression on MRI. A distinction should be made from true tumour progression to correctly plan treatment. However, there is wide variation of reported pseudoprogression. We thus aimed to establish the incidence of pseudoprogression and tumour progression in high-grade glioma patients with a systematic review and meta-analysis.

methodsWe searched PubMed, Embase and Web of Science on the incidence of pseudoprogression and tumour progression in adult high-grade glioma patients from 2005, the latest on 8 October 2014. Histology or imaging follow-up was used as reference standard. Extracted data included number of patients with worsening of imaging findings on T1 postcontrast or T2/FLAIR, pseudoprogression and tumour progression. Study quality was assessed. Heterogeneity was tested with I

resultsWe identified 73 studies. MRI progression occurred in 2603 patients. Of these, 36% (95% confidence interval [CI] 33-40%) demonstrated pseudoprogression, 60% (95%CI 56-64%) tumour progression and unknown outcome was present in the remaining 4% of the patients (range 1-37%).

conclusionThis meta-analysis demonstrated for the first time a notably high pooled incidence of pseudoprogression in patients with a form of progression across the available literature. This highlighted the full extent of the problem of the currently conventional MRI-based Response Assessment in Neuro-Oncology (RANO) criteria for treatment evaluation in high-grade gliomas. This underscores the need for more accurate treatment evaluation using advanced imaging to improve diagnostic accuracy and therapeutic approach.

Indexed as

Disease ProgressionAdultBrain NeoplasmsChemoradiotherapyGliomaHumansIncidenceMagnetic Resonance ImagingHigh-grade gliomasIncidenceMeta-analysisPseudoprogressionTreatment response assessment

Identifiers

PMID28466127
PMCPMC6105173

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.