Synthetic Retinoid Interventions and Outcomes in People with Cancer or Potentially Malignant Disorders of the Upper Aerodigestive Tract: A Systematic Review and Meta-analysis

Abstract

Background & Aims: Retinoids may have a role in the chemoprevention of potentially malignant disorders of the upper aerodigestive tract. Therefore, we conducted a systematic review of randomised controlled trials to examine the effect of synthetic retinoid interventions in people with cancer or potentially malignant disorders of the upper digestive tract. Methods: We searched five electronic databases and reference lists to locate all eligible trials and analysed trial quality. Outcome measures were all-cause and cancer mortality, disease-free survival, second primary cancer, cancer and potentially malignant disorder recurrence and progression to cancer. Results of individual trials were combined by use of random-effects meta-analyses. Results & Conclusions: We identified 17 15 trials, eightnine in people with upper aerodigestive tract cancer and seven eight in people with potentially malignant disorders, respectively. The results provide little evidence that retinoids have a beneficial effect on disease-free survival (OR=0.74, 95% CI =0.51, 1.09), all cause mortality (OR = 1.28, 95% confidence interval [CI] =1.00 to 1.65), disease-free survival (OR=0.74, 95% CI =0.51, 1.09), recurrence of cancer (OR = 1.47, 95% CI = 0.95, 2.26), development of second primary cancers (OR = 0.96, 95% CI = 0.76, 1.20) or the progression to malignancy (OR = 0.69, 95% CIs = 0.22, 2.15). There was even a suggestion of harm for some outcomes. There was also a suggestion that retinoids may decrease the recurrence of potentially malignant disorders (OR = 0.22, 95% CIs = 0.03, 1.34). For now there is no evidence to support the use of retinoids in people with upper aerodigestive tract cancer.