Evidence mapping and quality assessment of systematic reviews on therapeutic interventions for oral cancer

Meisser Madera Anaya,1–3 Juan Victor Ariel Franco,4 Mónica Ballesteros,2 Ivan Solà,2,3 Gerard Urrútia Cuchí,2,3 Xavier Bonfill Cosp2,3,5 1Department of Research, Faculty of Dentistry, University of Cartagena, Cartagena, Colombia; 2Iberoamerican Cochrane Centre, Institute of Biomedical Research Sant Pau (IIB Sant Pau), Barcelona, Spain; 3Department of Public Health and Clinical Epidemiology, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain; 4Department of Research, Cochrane Argentina, Instituto Universitario Hospital Italiano, Buenos Aires, Argentina; 5CIBER de Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain Purpose: This evidence mapping aims to describe and assess the quality of available evidence in systematic reviews (SRs) on treatments for oral cancer. Materials and methods: We followed the methodology of Global Evidence Mapping. Searches in MEDLINE, EMBASE, Epistemonikos and The Cochrane Library were conducted to identify SRs on treatments for oral cancer. The methodological quality of SRs was assessed using the Assessing the Methodological Quality of Systematic Reviews-2 tool. We organized the results according to identified Population–Intervention–Comparison–Outcome (PICO) questions and presented the evidence mapping in tables and a bubble plot. Results: Fifteen SRs met the eligibility criteria, including 118 individual reports, of which 55.1% were randomized controlled clinical trials. Ten SRs scored “Critically low” methodological quality. We extracted 30 PICOs focusing on interventions such as surgery, radiotherapy, chemotherapy, targeted therapy and immunotherapy; 18 PICOs were for resectable oral cancer, of which 8 were reported as beneficial. There were 12 PICOs for unresectable oral cancer, of which only 2 interventions were reported as beneficial. Conclusion: There is limited available evidence on treatments for oral cancer. The methodological quality of most included SRs scored “Critically low”. The main beneficial treatment reported by authors for patients with resectable oral cancer is surgery alone or in combination with radiotherapy or chemotherapy. Evidence about the benefits of the treatments for unresectable oral cancer is lacking. These findings highlight the need to address future research focused on new treatments and knowledge gaps in this field, and increased efforts are required to improve the methodology quality and reporting process of SRs on treatments for oral cancer. Keywords: mouth neoplasms, oral carcinoma, buccal tumor, evidence synthesis, evidence-based medicin