Summary of findings 4. PET‐CT following chemoradiotherapy versus planned neck dissection either before or after chemoradiotherapy.
| PET‐CT following chemoradiotherapy versus planned neck dissection either before or after chemoradiotherapy | ||||||
|
Patient: adults with oral or oropharyngeal cancer Setting: inpatient Intervention: PET‐CT following chemoradiotherapy Comparison: planned neck dissection either before or after chemoradiotherapy | ||||||
| Outcomes | Illustrative comparative risks* (95% CI) | Relative effect (95% CI) | No of participants (studies) | Certainty of the evidence (GRADE) | Comments | |
| Assumed risk | Corresponding risk | |||||
| Planned neck dissection | PET‐CT | |||||
|
Total mortality (follow‐up: 2 years) |
500 per 1000 | 471 per 1000 (363 to 597) |
HR 0.92 (0.65 to 1.31) |
564 (1) | ⊕⊝⊝⊝ Very lowa,b | These data were from the HR for overall survival. 1 study, no evidence of a difference in mortality |
| Disease‐free survival | — | — | — | — | — | Outcome not reported in a usable way. |
| Locoregional recurrence | — | — | — | — | — | Outcome not reported in a usable way. |
| Recurrence | — | — | — | — | — | Outcome not reported in a usable way. |
| Adverse events | 22 surgical complications in PET‐CT group compared with 83 in planned surgery group. | |||||
| *The basis for the assumed risk (e.g. the median control group risk across studies) is provided in footnotes. The corresponding risk (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI). CI: confidence interval; HR: hazard ratio; PET‐CT: positron‐emission tomography–computed tomography. | ||||||
| GRADE Working Group grades of evidence High certainty: we are very confident that the true effect lies close to that of the estimate of the effect. Moderate certainty: we are moderately confident in the effect estimate; the true effect is likely to be close to the estimate of the effect, but there is a possibility that it is substantially different. Low certainty: our confidence in the effect estimate is limited; the true effect may be substantially different from the estimate of the effect. Very low certainty: we have very little confidence in the effect estimate; the true effect is likely to be substantially different from the estimate of effect. | ||||||
aDowngraded once as one study at unclear risk of bias.
bDowngraded twice for imprecision.