Results:
Of the 352 titles and abstracts included in the search, 52 were eligible
for final synthesis. The PRISMA flowchart (figure 1) details reasons for
exclusion at each level of the screening process.
In the included studies, it was found that there wasn’t a consistency in
survival rates, with some papers citing 1,2,3-year survival rates,
others showing 2,3 and 5-year survival rates, and others showing 2,5 and
10-year survival rates. Additionally, not all papers cited survival
rates with immunotherapy treatment versus non-immunotherapy treatment.
We sought to standardize survival rates at 2 years, 3 years, and 5
years. Additionally, we stratified survival rates based on treatment
with immunotherapy with or without other modalities and
non-immunotherapy based treatment, whatever the modality chosen.
The graph (figure 2) demonstrates survival rates with different
treatment modalities spread across 2 years, 3 years, and 5 years. The
numbers were obtained by gathering data of survival rates in percentages
from the different papers at the desired year interval, and calculating
the median.
At 2 years, it was found that the overall survival rate was 52.6%, with
treatments including immunotherapy showing a 58% survival rate and
treatment without immunotherapy showing 50% survival. Similarly, at 3
years, overall survival was 35%, with 70.1% survival rates in
immunotherapy treatment and 42.35% in non-immunotherapy treatment. At 5
years, overall survival was 35.7%, with 40.03% survival in
immunotherapy treatment and 31.7% in non-immunotherapy treatment.
The results of the literature reviewed clearly showed that in the
limited database, involvement of immunotherapy showed overall better
survival outcomes.
None of the papers reviewed however, commented on quality of life in
those who survived at every interval, treatment related complications,
involving significant disabilities, or death in more severe cases.