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Meta-Analysis
. 2022 Aug 20;12(1):14221.
doi: 10.1038/s41598-022-18545-6.

Topical pharmacotherapy for ocular surface squamous neoplasia: systematic review and meta-analysis

Kincső Kozma  1 , Zsuzsa Réka Dömötör  2 , Adrienne Csutak  1 , László Szabó  3 , Péter Hegyi  3   4   5 , Bálint Erőss  3   4   5 , Zsuzsanna Helyes  6   7 , Zsolt Molnár  3   4   8   9 , Fanni Dembrovszky  3 , Eszter Szalai  10
Affiliations
Meta-Analysis

Topical pharmacotherapy for ocular surface squamous neoplasia: systematic review and meta-analysis

Kincső Kozma et al. Sci Rep. .

Abstract

Ocular surface squamous neoplasia (OSSN) has different treatment modalities. Although surgical excision has been the gold standard therapeutic option, topical pharmacotherapy agents such as 5-fluorouracil (5-FU), interferon alfa-2b (IFN) and mitomycin-C (MMC) are also commonly used. The protocol was registered (CRD42021224961). Comprehensive literature research was carried out to compare topical pharmacotherapy (5-FU or IFN or MMC) to surgical excision regarding clinical success (tumor resolution), recurrence and complications in patients undergoing treatment for OSSN. From 7859 records, 7 articles were included in the qualitative and 4 in the quantitative synthesis. The outcomes of surgical excision and topical pharmacotherapy were comparable in the included articles. There were no significant differences between surgical excision and topical pharmacotherapy regarding the clinical success [odds ratio (OR): 0.785; confidence interval (CI): 0.130-4.736, P = 0.792)] and tumor recurrence (OR: 0.746; CI: 0.213-2.609; P = 0.646). The most common side effect of the different therapeutic options was dry eye. The highest rate of dry eye symptoms was reported after surgical excision (in 59%). Topical pharmacotherapy with all the 3 agents is as effective and well-tolerable as surgical excision in terms of tumor resolution, recurrence rate and side effects in all OSSN patients suggesting similar long-term clinical benefits.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Figure 1
Figure 1
PRISMA (preferred reporting items for systematic reviews and meta-analyses) flowchart showing the different phases of this systematic review and meta-analysis.
Figure 2
Figure 2
Forest plot of studies measuring clinical success of different treatment modalities of OSSN. The clinical success of each study and the 95% confidence intervals (CIs) are presented. The diamond at the bottom represents the overall clinical success for all studies.
Figure 3
Figure 3
Funnel plot of studies assessing clinical success of different treatment modalities of OSSN.
Figure 4
Figure 4
Forest plot of studies measuring tumor recurrence of different treatment modalities in OSSN. The recurrence rate of each study and the 95% confidence intervals (CIs) are presented. The diamond at the bottom represents the overall recurrence rate for all studies.
Figure 5
Figure 5
Funnel plot of studies assessing tumor recurrence of different treatment modalities in OSSN.
See this image and copyright information in PMC

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