Department of Oral and Maxillofacial Surgery/ Oral Pathology, Amsterdam UMC and Academic Centre for Dentistry Amsterdam (ACTA), Vrije Universiteit Amsterdam, Cancer Center Amsterdam, Amsterdam, The Netherlands.
Department of Anatomy, Faculty of Medicine, Hasanuddin University, Makassar, Indonesia.
Sci Rep. 2023 May 25;13(1):8445. doi: 10.1038/s41598-023-32190-7.
Multiple treatment approaches have been undertaken to reduce the incidence of recurrence in solid/multicystic ameloblastoma (SMA), both conservative and radical. A network meta-analysis (NMA) was conducted to assess and compare the effectiveness of these various treatment approaches concurrently. This study was reported based on the Preferred Reporting Items for Systematic Reviews for Network Meta-Analysis (PRISMA-NMA) statement. PubMed (MEDLINE), ScienceDirect, Scopus, and Web of Science were searched until August 10, 2021. The NMA was conducted using the STATA program. Of 1153 records identified in the search, seven observational studies with 180 patients were included. Six different treatment approaches were identified. Segmental resection ranked highest for reducing the recurrence rate with the highest SUCRA score (77.7), followed by curettage with cryotherapy (66.9) and marginal resection (49.3). Network inconsistencies and publication bias appeared to be absent. According to the Confidence in Network Meta-Analysis (CINeMa) method, the evidence's certainty was low for all comparisons due to imprecision and within-study bias. In conclusion, this study is the first NMA in the field of ameloblastoma. Segmental resection seemed to be the most effective treatment approach for minimizing recurrence in SMA patients. Nevertheless, weak certainty of evidence makes that the results must be regarded with caution.
已采取多种治疗方法来降低实体/多囊性成釉细胞瘤(SMA)的复发率,包括保守和激进的方法。本研究进行了一项网络荟萃分析(NMA),以评估和比较这些不同治疗方法的有效性。本研究根据系统评价网络荟萃分析的首选报告项目(PRISMA-NMA)声明进行报告。截至 2021 年 8 月 10 日,检索了 PubMed(MEDLINE)、ScienceDirect、Scopus 和 Web of Science。使用 STATA 程序进行 NMA。在搜索中确定了 1153 条记录,其中包括 7 项观察性研究,共 180 名患者。确定了六种不同的治疗方法。节段切除术在降低复发率方面排名最高,具有最高的 SUCRA 评分(77.7),其次是冷冻刮除术(66.9)和边缘切除术(49.3)。网络不一致和发表偏倚似乎不存在。根据置信度网络荟萃分析(CINeMa)方法,由于不精确和研究内偏倚,所有比较的证据确定性都较低。总之,这是成釉细胞瘤领域的第一项 NMA。节段切除术似乎是降低 SMA 患者复发率的最有效治疗方法。然而,证据的确定性较低,因此必须谨慎看待这些结果。