Characteristics of prospective studies on blood α- and γ-tocopherol levels and risk of prostate cancer.

<p>Abbreviations: BMI: body mass index, T:tertile, Q:quartile/quintile, SD: standard deviation. * Derived from the slogan of a campaign, “Give us a CLUE to cancer.”</p

Blood α-Tocopherol, γ-Tocopherol Levels and Risk of Prostate Cancer: A Meta-Analysis of Prospective Studies

<div><p>Background</p><p>Epidemiological studies that have examined the association of blood α-tocopherol and γ-tocopherol (the principal bioactive form of vitamin E) levels with the risk of prostate cancer have yielded inconsistent results. In addition, a quantitative assessment of published studies is not available.</p><p>Methods and Findings</p><p>In this meta-analysis, relevant studies were sought by a search of the PubMed and Embase databases for articles published up to October 2013, with no restrictions. Bibliographies from retrieved articles also were scoured to find further eligible studies. Prospective studies that reported adjusted relative risk (RR) estimates with 95% confidence intervals (CIs) for the association between blood tocopherol levels and the risk of prostate cancer were included. Nine nested case–control studies involving approximately 370,000 participants from several countries were eligible. The pooled RRs of prostate cancer for the highest versus lowest category of blood α-tocopherol levels were 0.79 (95% CI: 0.68–0.91), and those for γ-tocopherol levels were 0.89 (95% CI: 0.71–1.12), respectively. Significant heterogeneity was present among the studies in terms of blood γ-tocopherol levels (<i>p</i> = 0.008) but not in terms of blood α-tocopherol levels (<i>p</i> = 0.33). The risk of prostate cancer decreased by 21% for every 25-mg/L increase in blood α-tocopherol levels (RR: 0.79; 95% CI: 0.69–0.91).</p><p>Conclusions</p><p>Blood α-tocopherol levels, but not γ-tocopherol levels, were inversely associated with the risk of prostate cancer in this meta-analysis.</p></div

Dose–response relationship between blood α-tocopherol levels and relative risk of prostate cancer.

<p>Blood α-tocopherol levels were modeled with a linear trend in a random-effects meta-regression model. The solid line represents point estimates of association between blood α-tocopherol levels and prostate cancer risk; dashed lines are 95% confidence intervals (CIs).</p

Adjusted relative risks of prostate cancer for the highest vs. lowest categories of blood α- and γ-tocopherol levels.

<p>Adjusted relative risks of prostate cancer for the highest vs. lowest categories of blood α- and γ-tocopherol levels.</p

Methodological quality assessment based on the NOS.^a

a<p>Assessed with the 9-star Newcastle-Ottawa Scale(NOS).</p>b<p>Adequate definition of cases(0,1star).</p>c<p>Consecutive or obviously representative series of cases (0,1).</p>d<p>Selection of controls: Community controls (0,1).</p>e<p>Definition of controls: No history of disease (endpoint) (0,1).</p>f<p>Study controls for the most important factor or any additional factor(0,1,2).</p>g<p>Secure record (eg surgical records) (0,1).</p>h<p>Same method of ascertainment for cases and controls(0,1).</p>i<p>Same non-response rate for both groups(0,1).</p>j<p>Total: minimum equals 1; maximum equals 9 stars.</p

Is Anterior Cervical Discectomy and Fusion Superior to Corpectomy and Fusion for Treatment of Multilevel Cervical Spondylotic Myelopathy? A Systemic Review and Meta-Analysis

<div><p>Objective</p><p>Both anterior cervical discectomy with fusion (ACDF) and anterior cervical corpectomy with fusion (ACCF) are used to treat cervical spondylotic myelopathy (CSM), however, there is considerable controversy as to whether ACDF or ACCF is the optimal treatment for this condition. To compare the clinical outcomes, complications, and surgical trauma between ACDF and ACCF for the treatment of CSM, we conducted a meta-analysis.</p><p>Methods</p><p>We conducted a comprehensive search in MEDLINE, EMBASE, PubMed, Google Scholar and Cochrane databases, searching for relevant controlled trials up to July 2013 that compared ACDF and ACCF for the treatment of CSM. We performed title and abstract screening and full-text screening independently and in duplicate. A random effects model was used for heterogeneous data; otherwise, a fixed effect model was used to pool data, using mean difference (MD) for continuous outcomes and odds ratio (OR) for dichotomous outcomes.</p><p>Results</p><p>Of 2157 citations examined, 15 articles representing 1372 participants were eligible. Overall, there were significant differences between the two treatment groups for hospital stay (M = −5.60, 95% CI = −7.09 to −4.11), blood loss (MD = −151.35, 95% CI = −253.22 to −49.48), complications (OR = 0.50, 95% CI = 0.35 to 0.73) and increased lordosis of C2–C7 (MD = 3.70, 95% CI = 0.96 to 6.45) and fusion segments angles (MD = 3.38, 95% CI = 2.54 to 4.22). However, there were no significant differences in the operation time (MD = −9.34, 95% CI = −42.99 to 24.31), JOA (MD = 0.24, 95% CI = −0.10 to 0.57), VAS (MD = −0.06, 95% CI = −0.81 to 0.70), NDI (MD = −1.37, 95% CI  = −3.17 to 0.43), Odom criteria (OR = 0.88, 95% CI = 0.60 to 1.30) or fusion rate (OR = 1.17, 95% CI = 0.34 to 4.11).</p><p>Conclusions</p><p>Based on this meta-analysis, although complications and increased lordosis are significantly better in the ACDF group, there is no strong evidence to support the routine use of ACDF over ACCF in CSM.</p></div