Probiotics Evaluation in Oncological Surgery: A Systematic Review of 36 Randomized Controlled Trials Assessing 21 Diverse Formulations.

Cogo, E; Elsayed, M; Liang, V; Cooley, K; Guerin, C; Psihogios, A; Papadogianis, P

Probiotics Evaluation in Oncological Surgery: A Systematic Review of 36 Randomized Controlled Trials Assessing 21 Diverse Formulations.

Cogo, E Elsayed, M Liang, V Cooley, K

Guerin, C Psihogios, A Papadogianis, P

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Publisher:: Multimed Inc.
Publication Type:: Journal Article
Citation:: Current Oncology, 2021, 28, (6), pp. 5192-5214
Issue Date:: 2021-12-07

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Field	Value	Language
dc.contributor.author	Cogo, E
dc.contributor.author	Elsayed, M
dc.contributor.author	Liang, V
dc.contributor.author	Cooley, K https://orcid.org/0000-0001-7960-6504
dc.contributor.author	Guerin, C
dc.contributor.author	Psihogios, A
dc.contributor.author	Papadogianis, P
dc.date.accessioned	2022-01-06T03:26:03Z
dc.date.available	2021-12-03
dc.date.available	2022-01-06T03:26:03Z
dc.date.issued	2021-12-07
dc.identifier.citation	Current Oncology, 2021, 28, (6), pp. 5192-5214
dc.identifier.issn	1198-0052
dc.identifier.issn	1718-7729
dc.identifier.uri	http://hdl.handle.net/10453/152733
dc.description.abstract	BACKGROUND: Objectives were to evaluate probiotics safety and efficacy in oncological surgery. METHODS: Systematic review methodology guided by Cochrane, PRISMA, SWiM, and CIOMS. Protocol registered on PROSPERO (CRD42018086168). RESULTS: 36 RCTs (on 3305 participants) and 6 nonrandomized/observational studies were included, mainly on digestive system cancers. There was evidence of a beneficial effect on preventing infections, with 70% of RCTs' (21/30) direction of effect favoring probiotics. However, five RCTs (17%) favored controls for infections, including one trial with RR 1.57 (95% CI: 0.79, 3.12). One RCT that changed (balanced) its antibiotics protocol after enrolling some participants had mortality risk RR 3.55 (95% CI: 0.77, 16.47; 7/64 vs. 2/65 deaths). The RCT identified with the most promising results overall administered an oral formulation of Lactobacillus acidophilus LA-5 + Lactobacillus plantarum + Bifidobacterium lactis BB-12 + Saccharomyces boulardii. Methodological quality appraisals revealed an overall substantial risk-of-bias, with only five RCTs judged as low risk-of-bias. CONCLUSIONS: This large evidence synthesis found encouraging results from most formulations, though this was contrasted by potential harms from a few others, thus validating the literature that "probiotics" are not homogeneous microorganisms. Given microbiome developments and infections morbidity, further high-quality research is warranted using those promising probiotics identified herein.
dc.format	Electronic
dc.language	eng
dc.publisher	Multimed Inc.
dc.relation.ispartof	Current Oncology
dc.relation.isbasedon	10.3390/curroncol28060435
dc.rights	info:eu-repo/semantics/restrictedAccess
dc.subject	1112 Oncology and Carcinogenesis
dc.subject.classification	Oncology & Carcinogenesis
dc.title	Probiotics Evaluation in Oncological Surgery: A Systematic Review of 36 Randomized Controlled Trials Assessing 21 Diverse Formulations.
dc.type	Journal Article
utslib.citation.volume	28
utslib.location.activity	Switzerland
utslib.for	1112 Oncology and Carcinogenesis
pubs.organisational-group	/University of Technology Sydney
pubs.organisational-group	/University of Technology Sydney/Faculty of Health
pubs.organisational-group	/University of Technology Sydney/Faculty of Health/Public Health
utslib.copyright.status	in_progress	*
pubs.consider-herdc	false
dc.date.updated	2022-01-06T03:25:55Z
pubs.issue	6
pubs.publication-status	Published
pubs.volume	28
utslib.citation.issue	6

Abstract:

BACKGROUND: Objectives were to evaluate probiotics safety and efficacy in oncological surgery. METHODS: Systematic review methodology guided by Cochrane, PRISMA, SWiM, and CIOMS. Protocol registered on PROSPERO (CRD42018086168). RESULTS: 36 RCTs (on 3305 participants) and 6 nonrandomized/observational studies were included, mainly on digestive system cancers. There was evidence of a beneficial effect on preventing infections, with 70% of RCTs' (21/30) direction of effect favoring probiotics. However, five RCTs (17%) favored controls for infections, including one trial with RR 1.57 (95% CI: 0.79, 3.12). One RCT that changed (balanced) its antibiotics protocol after enrolling some participants had mortality risk RR 3.55 (95% CI: 0.77, 16.47; 7/64 vs. 2/65 deaths). The RCT identified with the most promising results overall administered an oral formulation of Lactobacillus acidophilus LA-5 + Lactobacillus plantarum + Bifidobacterium lactis BB-12 + Saccharomyces boulardii. Methodological quality appraisals revealed an overall substantial risk-of-bias, with only five RCTs judged as low risk-of-bias. CONCLUSIONS: This large evidence synthesis found encouraging results from most formulations, though this was contrasted by potential harms from a few others, thus validating the literature that "probiotics" are not homogeneous microorganisms. Given microbiome developments and infections morbidity, further high-quality research is warranted using those promising probiotics identified herein.

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http://hdl.handle.net/10453/152733