Research Paper Volume 13, Issue 15 pp 19835—19866

Bisphosphonates and breast cancer survival: a meta-analysis and trial sequential analysis of 81508 participants from 23 prospective epidemiological studies

Summarized results for the longevity of the effect of bisphosphonates on breast cancer survival. (A) The natural history of breast cancer after diagnosis, presented as green arrow; (B) The procedure of RCT presented as blue arrow, and golden arrow represents the duration of adjuvant treatment with bisphosphonates; (C) The results from conventional subgroup analyses by follow-up duration; (D) The results from trial sequential analyses of each subgroup by follow-up duration. *Data regarding the relapse rate of breast cancer were obtained from the Surveillance, Epidemiology, and End Results (SEER) program of the National Cancer Institute (Cheng et al. 2012). Abbreviations: ACSS, the actually cumulative sample size; BCa, breast cancer; BPs, bisphosphonates; D2-RIS, the diversity adjusted required information size; RCT, randomized controlled trial; RR, hazard ratio; TSA, trial sequential analysis.

Figure 2. Summarized results for the longevity of the effect of bisphosphonates on breast cancer survival. (A) The natural history of breast cancer after diagnosis, presented as green arrow; (B) The procedure of RCT presented as blue arrow, and golden arrow represents the duration of adjuvant treatment with bisphosphonates; (C) The results from conventional subgroup analyses by follow-up duration; (D) The results from trial sequential analyses of each subgroup by follow-up duration. *Data regarding the relapse rate of breast cancer were obtained from the Surveillance, Epidemiology, and End Results (SEER) program of the National Cancer Institute (Cheng et al. 2012). Abbreviations: ACSS, the actually cumulative sample size; BCa, breast cancer; BPs, bisphosphonates; D2-RIS, the diversity adjusted required information size; RCT, randomized controlled trial; RR, hazard ratio; TSA, trial sequential analysis.