3.1. OS, DFS, and DSS
We found no significant differences in OS (HR = 1.1226; 95% CI 0.9263;
1.3604), DFS (HR = 1.0797; 95% CI 0.8765; 1.3300), or DSS (HR = 0.8652;
95% CI 0.6531; 1.1462) between SNB and END. Heterogeneity was not
detected in analyses of pooled OS, DFS, and DSS data
(I2 < 50) (Figure 2). Neither the Egger nor
Begg test revealed any publication bias in terms of OS (p = 0.8415) or
DSS (p = 0.7608) (Figure 3A, 3B). Although mild bias was apparently
present in the DFS for SNB (p = 0.004459; Figure 3C), the Duval and
Tweedie trim and fill method revealed no significant difference between
the observed and adjusted values (1.0797, p=0.4711 vs. 1.0390; p =
0.7086). Thus, we concluded that the DFS data were not biased. In the
sensitivity analyses, the OS, DFS, and DSS data did not change on
omission of any individual study (Figure 4).