PMID- 37499300
OWN - NLM
STAT- MEDLINE
DCOM- 20230918
LR  - 20230925
IS  - 1872-8421 (Electronic)
IS  - 0165-5728 (Linking)
VI  - 382
DP  - 2023 Sep 15
TI  - Effect and timing of operative treatment for teratoma associated 
      N-Methyl-d-Aspartate receptor-antibody encephalitis: A systematic review with 
      meta-analysis.
PG  - 578153
LID - S0165-5728(23)00139-X [pii]
LID - 10.1016/j.jneuroim.2023.578153 [doi]
AB  - Resection of an underlying ovarian teratoma in patients with N-Methyl-d-Aspartate 
      receptor (NMDAR)-antibody encephalitis is supported by pathophysiological studies 
      demonstrating the production of NMDAR antibodies within the teratoma. This 
      systematic review assesses the clinical effect of teratoma resection and compares 
      early versus late resection. Literature search was performed on the first of 
      October 2022 (MEDLINE, Embase, CENTRAL, Web of Science). Original studies 
      including more than three patients with NDMAR encephalitis and associated ovarian 
      teratoma were included and evaluated with the Study Quality Assessment Tool for 
      risk of bias. Fourteen studies referring to 1499 patients were included and 
      analyzed in four syntheses using the fixed Mantel-Haenszel method. The rate of 
      relapse in patients with ovarian teratoma resection was lower than in patients 
      without resection (risk ratio for relapse 0.30, 95% CI 0.17-0.51), however the 
      certainty level of evidence is very low. Despite some evidence pointing to a 
      beneficial effect of early teratoma resection in patients with NMDAR-antibody 
      encephalitis, systematically accessible data are insufficient to provide 
      recommendations for or against resection, as well as for timing of surgery. The 
      authors received no financial support for the research, authorship, or 
      publication of this article. For the systematic review no clinical-trial database 
      registration had been done.
CI  - Copyright (c) 2023 Elsevier B.V. All rights reserved.
FAU - Erlebach, Rolf
AU  - Erlebach R
AD  - Institute of Intensive Care Medicine, University Hospital Zurich, Zurich, 
      Switzerland.
FAU - Brandi, Giovanna
AU  - Brandi G
AD  - Institute of Intensive Care Medicine, University Hospital Zurich, Zurich, 
      Switzerland. Electronic address: giovanna.brandi@usz.ch.
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
PT  - Review
PT  - Systematic Review
DEP - 20230722
PL  - Netherlands
TA  - J Neuroimmunol
JT  - Journal of neuroimmunology
JID - 8109498
RN  - 0 (Receptors, N-Methyl-D-Aspartate)
RN  - 0 (Autoantibodies)
RN  - Teratoma, Ovarian
SB  - IM
MH  - Female
MH  - Humans
MH  - *Anti-N-Methyl-D-Aspartate Receptor Encephalitis/complications
MH  - Receptors, N-Methyl-D-Aspartate
MH  - Neoplasm Recurrence, Local/complications
MH  - *Ovarian Neoplasms/surgery
MH  - *Teratoma/surgery/complications
MH  - Autoantibodies
OTO - NOTNLM
OT  - Anti-N-Methyl-d-Aspartate Receptor Encephalitis
OT  - Meta-analysis
OT  - Modified Rankin scale
OT  - Operative
OT  - Ovarian teratoma
OT  - Relapse
OT  - Surgical procedures
OT  - Systematic review
COIS- Declaration of Competing Interest None.
EDAT- 2023/07/28 01:08
MHDA- 2023/09/18 12:42
CRDT- 2023/07/27 18:01
PHST- 2023/03/18 00:00 [received]
PHST- 2023/06/26 00:00 [revised]
PHST- 2023/07/18 00:00 [accepted]
PHST- 2023/09/18 12:42 [medline]
PHST- 2023/07/28 01:08 [pubmed]
PHST- 2023/07/27 18:01 [entrez]
AID - S0165-5728(23)00139-X [pii]
AID - 10.1016/j.jneuroim.2023.578153 [doi]
PST - ppublish
SO  - J Neuroimmunol. 2023 Sep 15;382:578153. doi: 10.1016/j.jneuroim.2023.578153. Epub 
      2023 Jul 22.