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.