Findings

What do systematic reviews say?

20 questions · 23 findings · 11 reviews

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No studies found 7 · 30.4%GRADE not reported 0 · 0%Very low 3 · 13%Low 6 · 26.1%Moderate 6 · 26.1%High 1 · 4.3%

Surgery vs primary endocrine therapy

Survival ‐ overall · Women (70 years plus) with operable primary breast cancer

Surgery showed no clear difference in survival ‐ overall compared with primary endocrine therapy (low certainty).

1 finding from 1 review

Surgery versus primary endocrine therapy for operable primary breast cancer in elderly women (70 years plus) 2014 · Cochrane Headline outcomes only
HR 0.98 [0.81, 1.2]
3 studies · 495 participants
Low

Surgery +/- radiotherapy + (adjuvant) chemotherapy vs Surgery +/- radiotherapy alone (observation or adjuvant radiotherapy only)

Overall survival, post-surgery chemotherapy vs surgery alone (no radiotherapy) · People receiving curative-intent treatment for oral cavity and oropharyngeal (squamous cell) cancer

Surgery +/- radiotherapy + (adjuvant) chemotherapy showed no clear difference in overall survival, adjuvant chemotherapy vs observation alone… compared with surgery +/- radiotherapy alone (observation or adjuvant radiotherapy… (moderate certainty).

1 finding from 1 review

Interventions for the treatment of oral cavity and oropharyngeal cancer: chemotherapy 2021 · Cochrane All outcomes
HR 0.95 [0.73, 1.22]
5 studies · 353 participants
Moderate

Surgery plus whole brain radiotherapy (WBRT) vs stereotactic radiosurgery

Overall survival · people with single or solitary brain metastasis

It is very uncertain whether surgery plus whole brain radiotherapy (WBRT) changes overall survival compared with stereotactic radiosurgery (very low certainty).

1 finding from 1 review

Surgery versus stereotactic radiotherapy for people with single or solitary brain metastasis 2018 · Cochrane Headline outcomes only
HR 0.92 [0.48, 1.77]
1 study · 64 participants
Very low

Surgery plus whole brain radiotherapy (WBRT) vs stereotactic radiosurgery plus WBRT

Overall survival · people with single or solitary brain metastasis

Surgery plus whole brain radiotherapy (WBRT) showed no clear difference in overall survival compared with stereotactic radiosurgery plus WBRT (low certainty).

1 finding from 1 review

Surgery versus stereotactic radiotherapy for people with single or solitary brain metastasis 2018 · Cochrane Headline outcomes only
HR 0.53 [0.2, 1.42]
1 study · 21 participants
Low

Induction chemotherapy plus locoregional treatment (radiotherapy and/or surgery) vs Locoregional treatment (radiotherapy and/or surgery) alone

Overall survival, induction platinum + 5-fluorouracil prior to surgery vs surgery alone · People receiving curative-intent treatment for oral cavity and oropharyngeal (squamous cell) cancer

Induction chemotherapy plus locoregional treatment (radiotherapy… showed no clear difference in overall survival, induction platinum + 5-fluorouracil prior to… compared with locoregional treatment (radiotherapy and/or surgery) alone (low certainty).

1 finding from 1 review

Interventions for the treatment of oral cavity and oropharyngeal cancer: chemotherapy 2021 · Cochrane All outcomes
HR 1.06 [0.71, 1.60]
1 study · 198 participants
Low

iMRI image‐guided surgery vs surgery

Overall survival · high‐grade glioma

The review found no eligible studies for this question.

2 findings from 2 reviews · compare the 2 reviews

Intraoperative imaging technology to maximise extent of resection for glioma: a network meta‐analysis 2021 · Cochrane Headline outcomes only
no estimate extracted
Studies not reported
No studies found
Intraoperative imaging technology to maximise extent of resection for glioma 2018 · Cochrane Headline outcomes only
no estimate extracted
Studies not reported
No studies found

5‐ALA image‐guided surgery vs surgery

Overall survival · high‐grade glioma

The review found no eligible studies for this question.

2 findings from 2 reviews · compare the 2 reviews

Intraoperative imaging technology to maximise extent of resection for glioma: a network meta‐analysis 2021 · Cochrane Headline outcomes only
no estimate extracted
Studies not reported
No studies found
Intraoperative imaging technology to maximise extent of resection for glioma 2018 · Cochrane Headline outcomes only
no estimate extracted
Studies not reported
No studies found

Neoadjuvant chemotherapy prior to interval surgery (NACT) vs surgery followed by chemotherapy (PDS)

Overall survival ( · women with advanced ovarian epithelial cancer

Neoadjuvant chemotherapy prior to interval surgery (NACT) showed no clear difference in overall survival ( compared with surgery followed by chemotherapy (PDS) (high certainty).

1 finding from 1 review

Neoadjuvant chemotherapy before surgery versus surgery followed by chemotherapy for initial treatment in advanced… 2021 · Cochrane Headline outcomes only
HR 0.96 [0.86, 1.08]
4 studies · 2000 participants
High

Neuronavigation image‐guided surgery vs surgery

Overall survival · high‐grade glioma

The review found no eligible studies for this question.

2 findings from 2 reviews · compare the 2 reviews

Intraoperative imaging technology to maximise extent of resection for glioma: a network meta‐analysis 2021 · Cochrane Headline outcomes only
no estimate extracted
Studies not reported
No studies found
Intraoperative imaging technology to maximise extent of resection for glioma 2018 · Cochrane Headline outcomes only
no estimate extracted
Studies not reported
No studies found

Minimally invasive surgery vs Standard therapy alone (radiotherapy or chemoradiotherapy)

Overall survival · patients with small‐volume primary oropharyngeal carcinoma

The review found no eligible studies for this question.

1 finding from 1 review

Minimally invasive surgery versus radiotherapy/chemoradiotherapy for small‐volume primary oropharyngeal carcinoma 2016 · Cochrane Headline outcomes only
no estimate extracted
Studies not reported
No studies found

Ultra‐radical (extensive) surgery vs surgery

Survival (overall and disease‐ specific) · women with stage IIIc or IV ovarian cancer

It is very uncertain whether ultra‐radical (extensive) surgery changes survival (overall and disease‐ specific) compared with standard surgery (very low certainty).

1 finding from 1 review

Ultra‐radical (extensive) surgery versus standard surgery for the primary cytoreduction of advanced epithelial ovarian… 2022 · Cochrane Headline outcomes only
HR 0.6 [0.43, 0.82]
2 studies · 397 participants
Very low

Radiosurgery alone vs WBRT and radiosurgery

Overall survivalNo. of participants: 2631(8 RCTs) · patients with newly diagnosed multiple brain metastases

Radiosurgery alone showed no clear difference in overall survivalNo. of participants: 403(3 RCTs) compared with WBRT and radiosurgery (moderate certainty).

1 finding from 1 review

Whole brain radiotherapy for the treatment of newly diagnosed multiple brain metastases 2018 · Cochrane Headline outcomes only
HR 1 [0.8, 1.25]
Studies not reported
Moderate

Surgery plus endocrine therapy vs primary endocrine therapy

Survival ‐ overall · Women (70 years plus) with operable primary breast cancer

Surgery plus endocrine therapy showed no clear difference in survival ‐ overall compared with primary endocrine therapy (low certainty).

1 finding from 1 review

Surgery versus primary endocrine therapy for operable primary breast cancer in elderly women (70 years plus) 2014 · Cochrane Headline outcomes only
HR 0.86 [0.73, 1]
3 studies · 1076 participants
Low

Whole brain radiation therapy (WBRT) + stereotactic radiosurgery (SRS) vs WBRT

Overall survival · Patients with brain metastases

Whole brain radiation therapy (WBRT) + stereotactic radiosurgery (SRS) showed no clear difference in overall survival compared with WBRT (moderate certainty).

1 finding from 1 review

Whole brain radiation therapy (WBRT) alone versus WBRT and radiosurgery for the treatment of brain metastases 2017 · Cochrane Headline outcomes only
HR 0.82 [0.65, 1.02]
2 studies · 358 participants
Moderate

Breast surgery plus systemic treatment vs systemic treatment

Overall survival at 2 years · people with metastatic breast cancer

It is very uncertain whether breast surgery plus systemic treatment changes overall survival at 2 years compared with systemic treatment (very low certainty).

1 finding from 1 review

Breast surgery for metastatic breast cancer 2018 · Cochrane Headline outcomes only
HR 0.83 [0.53, 1.31]
2 studies · 624 participants
Very low

Surgery +/- radiotherapy + (adjuvant) chemotherapy vs Surgery +/- radiotherapy alone (observation or adjuvant radiotherapy only)

Overall survival, adjuvant concomitant chemoradiotherapy vs post-surgery radiotherapy alone · People receiving curative-intent treatment for oral cavity and oropharyngeal (squamous cell) cancer

Surgery +/- radiotherapy + (adjuvant) chemotherapy probably leads to lower overall survival, adjuvant concurrent chemoradiation vs adjuvant… compared with surgery +/- radiotherapy alone (observation or adjuvant radiotherapy… (moderate certainty).

1 finding from 1 review

Interventions for the treatment of oral cavity and oropharyngeal cancer: chemotherapy 2021 · Cochrane All outcomes
HR 0.84 [0.72, 0.98]
4 studies · 1097 participants
Moderate

Whole brain radiation therapy (WBRT) + stereotactic radiosurgery (SRS) vs WBRT

Overall survivalNo. of participants: 2631(8 RCTs) · patients with newly diagnosed multiple brain metastases

WBRT and radiosurgery showed no clear difference in overall survivalNo. of participants: 358(2 RCTs) compared with WBRT (moderate certainty).

1 finding from 1 review

Whole brain radiotherapy for the treatment of newly diagnosed multiple brain metastases 2018 · Cochrane Headline outcomes only
HR 0.61 [0.27, 1.39]
Studies not reported
Moderate

Induction chemotherapy plus locoregional treatment (radiotherapy and/or surgery) vs Locoregional treatment (radiotherapy and/or surgery) alone

Overall survival, induction platinum + 5-fluorouracil prior to radiotherapy vs radiotherapy alone · People receiving curative-intent treatment for oral cavity and oropharyngeal (squamous cell) cancer

1 finding from 1 review

Interventions for the treatment of oral cavity and oropharyngeal cancer: chemotherapy 2021 · Cochrane All outcomes
HR 0.85 [0.70, 1.04]
5 studies · 7427 participants
Moderate

Induction chemotherapy plus locoregional treatment (radiotherapy and/or surgery) vs Locoregional treatment (radiotherapy and/or surgery) alone

Overall survival, induction cisplatin + 5-fluorouracil prior to concurrent chemoradiation (cisplatin) vs concurrent chemoradiation (cisplatin) · People receiving curative-intent treatment for oral cavity and oropharyngeal (squamous cell) cancer

Induction chemotherapy plus locoregional treatment (radiotherapy… showed no clear difference in overall survival, induction cisplatin + 5-fluorouracil prior to… compared with locoregional treatment (radiotherapy and/or surgery) alone (low certainty).

1 finding from 1 review

Interventions for the treatment of oral cavity and oropharyngeal cancer: chemotherapy 2021 · Cochrane All outcomes
HR 0.71 [0.37, 1.35]
2 studies · 389 participants
Low

Induction chemotherapy plus locoregional treatment (radiotherapy and/or surgery) vs Locoregional treatment (radiotherapy and/or surgery) alone

Overall survival, induction cisplatin + 5-fluorouracil + docetaxel prior to concurrent chemoradiation (cisplatin) vs concurrent chemoradiation (cisplatin) · People receiving curative-intent treatment for oral cavity and oropharyngeal (squamous cell) cancer

Induction chemotherapy plus locoregional treatment (radiotherapy… showed no clear difference in overall survival, induction cisplatin + 5-fluorouracil + docetaxel… compared with locoregional treatment (radiotherapy and/or surgery) alone (low certainty).

1 finding from 1 review

Interventions for the treatment of oral cavity and oropharyngeal cancer: chemotherapy 2021 · Cochrane All outcomes
HR 1.08 [0.80, 1.44]
3 studies · 760 participants
Low