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meta-analysis gastrectomy D2

Luigi Marano, Fabio Rondelli, Alberto Bartoli, Mario Testini, Giampaolo Castagnoli, Graziano Ceccarelli
BACKGROUND/AIM: The role of splenectomy as an essential component of radical surgery for proximal gastric cancer, from an oncological point of view, is still debated, and no consistent recommendations have been proposed. The aim of this systematic review with meta-analysis was to provide a more robust answer regarding the oncological effectiveness and safety of splenectomy in total gastrectomy for proximal gastric carcinoma. MATERIALS AND METHODS: A systematic review and meta-analysis of randomized controlled trials was planned and performed in accordance with Preferred Reporting Items for Systematic Review and Meta-analysis (PRISMA) statement and Cochrane Handbook for Systematic Reviews of Intervention...
June 2018: Anticancer Research
Stefano Caruso, Alberto Patriti, Franco Roviello, Lorenzo De Franco, Franco Franceschini, Andrea Coratti, Graziano Ceccarelli
Radical gastrectomy with an adequate lymphadenectomy is the main procedure which makes it possible to cure patients with resectable gastric cancer (GC). A number of randomized controlled trials and meta-analysis provide phase III evidence that laparoscopic gastrectomy is technically safe and that it yields better short-term outcomes than conventional open gastrectomy for early-stage GC. While laparoscopic gastrectomy has become standard therapy for early-stage GC, especially in Asian countries such as Japan and South Korea, the use of minimally invasive techniques is still controversial for the treatment of more advanced tumours, principally due to existing concerns about its oncological adequacy and capacity to carry out an adequately extended lymphadenectomy...
July 7, 2016: World Journal of Gastroenterology: WJG
Weiling He, Jian Tu, Zijun Huo, Yuhuang Li, Jintao Peng, Zhenwen Qiu, Dandong Luo, Zunfu Ke, Xinlin Chen
AIM: To evaluate methodological quality and the extent of concordance among meta-analysis and/or systematic reviews on surgical interventions for gastric cancer (GC). METHODS: A comprehensive search of PubMed, Medline, EMBASE, the Cochrane library and the DARE database was conducted to identify the reviews comparing different surgical interventions for GC prior to April 2014. After applying included criteria, available data were summarized and appraised by the Oxman and Guyatt scale...
2015: International Journal of Clinical and Experimental Medicine
Yanming Zhou, Feng Yu, Lupeng Wu, Feng Ye, Leilei Zhang, Yumin Li
BACKGROUND: Lymph node metastasis is one of the most important prognostic factors for survival of patients with gastric cancer (GC) after surgical resection. Nevertheless, a considerable number of patients have node-negative disease. We performed the present systematic review to evaluate survival and identify prognostic factors in node-negative GC patients undergoing curative intent resection. MATERIAL AND METHODS: Relevant studies published between January 2000 and January 2015 were identified by searching the PubMed database and reviewed systematically...
2015: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
Hang Cheng, Chia-Wen Hsiao, Jeffrey W Clymer, Michael L Schwiers, Bryanna N Tibensky, Leena Patel, Nicole C Ferko, Edward Chekan
The ultrasonic Harmonic scalpel has demonstrated clinical and surgical benefits in dissection and coagulation. To evaluate its use in gastrectomy, we conducted a systematic review and meta-analysis of randomized controlled trials comparing the Harmonic scalpel to conventional techniques in gastrectomy for patients with gastric cancer. International databases were searched without language restrictions for comparisons in open or laparoscopic gastrectomy and lymphadenectomy. The meta-analysis used a random-effects model for all outcomes; continuous variables were analyzed for mean differences and dichotomous variables were analyzed for risk ratios...
2015: International Journal of Surgical Oncology
Zhen-Hong Zou, Li-Ying Zhao, Ting-Yu Mou, Yan-Feng Hu, Jiang Yu, Hao Liu, Hao Chen, Jia-Ming Wu, Sheng-Li An, Guo-Xin Li
AIM: To conduct a meta-analysis comparing laparoscopic (LGD2) and open D2 gastrectomies (OGD2) for the treatment of advanced gastric cancer (AGC). METHODS: Randomized controlled trials (RCTs) and non-RCTs comparing LGD2 with OGD2 for AGC treatment, published between 1 January 2000 and 12 January 2013, were identified in the PubMed, Embase, and Cochrane Library databases. Primary endpoints included operative outcomes (operative time, intraoperative blood loss, and conversion rate), postoperative outcomes (postoperative analgesic consumption, time to first ambulation, time to first flatus, time to first oral intake, postoperative hospital stay length, postoperative morbidity, incidence of reoperation, and postoperative mortality), and oncologic outcomes (the number of lymph nodes harvested, tumor recurrence and metastasis, disease-free rates, and overall survival rates)...
November 28, 2014: World Journal of Gastroenterology: WJG
Canrong Lu, Sixin Zhou, Zheng Peng, Lin Chen
OBJECTIVE: To determine by meta-analysis, whether D2 lymphadenectomy at laparoscopic-assisted distal gastrectomy (LADG) is as effective as that during open distal gastrectomy (ODG) for patients with advanced gastric cancer (AGC). DATA SOURCES AND REVIEW METHODS: All clinical trials that compared laparoscopic with open D2 lymphadenectomy for AGC published in English from January 1995 to June 2013 were identified in PubMed, Embase, Web of Science, and Cochrane library searches...
June 2015: Surgical Endoscopy
Yu-Ling Huang, Hai-Guan Lin, Jian-Wu Yang, Fu-Quan Jiang, Tao Zhang, He-Ming Yang, Cheng-Lin Li, Yan Cui
A raising number of surgeons have chosen laparoscopy-assisted gastrectomy (LAG) as an alternative to open gastrectomy (OG) with D2 lymph node dissection for treatment of advanced gastric cancer (ADG). But no meta-analysis has been performed to evaluate the value of LAG versus OG with regard to safety and efficacy for treatment of ADG. A comprehensive literature research was performed in PubMed, Web of Science and Embase to identify studies that compared LAG and OG with D2 lymph node dissection for treatment of ADG...
2014: International Journal of Clinical and Experimental Medicine
Olivier Glehen, Guillaume Passot, Laurent Villeneuve, Delphine Vaudoyer, Sylvie Bin-Dorel, Gilles Boschetti, Eric Piaton, Alfredo Garofalo
BACKGROUND: In Europe, gastric cancer remains diagnosed at advanced stage (serosal and/or lymph node involvement). Despite curative management combining perioperative systemic chemotherapy and gastrectomy with D1-D2 lymph node dissection, 5-year survival rates of T3 and/or N + patients remain under 30%. More than 50% of recurrences are peritoneal and/or locoregional. The use of adjuvant hyperthermic intraperitoneal chemotherapy that eliminates free cancer cells that can be released into peritoneal cavity during the gastrectomy and prevents peritoneal carcinomatosis recurrences, was extensively evaluated by several randomized trials conducted in Asia...
March 14, 2014: BMC Cancer
Di Zhou, Zhiwei Quan, Jiandong Wang, Mingning Zhao, Yong Yang
Laparoscopic-assisted distal gastrectomy (LADG) with D2 resection is gradually being performed for treating advanced gastric cancer. This meta-analysis aims to compare the clinical outcomes between LADG and open distal gastrectomy (ODG) when considering the impact of the learning curve. The PubMed, Embase, and ISI databases and the Cochrane Library were electronically searched. Randomized controlled trails and retrospective comparative studies published between 1994 and 2013 were collected. We divided the included studies into two subgroups according to whether the authors had experience of at least or fewer than 40 cases of LADG with D2 resection and then compared the operative time, intraoperative bleeding, the amount of resected lymph nodes, short-term recovery parameters, and complications between LADG and ODG groups...
March 2014: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
Weizhi Wang, Zheng Li, Jie Tang, Meilin Wang, Baolin Wang, Zekuan Xu
OBJECTIVE: To elucidate the feasibility and safety of laparoscopic total gastrectomy with D2 dissection (LTGD2) for gastric cancer in comparison with open total gastrectomy with D2 dissection (OTGD2). BACKGROUND: More surgeons have chosen laparoscopic total gastrectomy as an alternative to open total gastrectomy. But no meta-analysis has been performed to evaluate the value of LTGD2. METHODS: Original articles compared LTGD2 and OTGD2 for gastric cancer, which published in English from January 1990 to March 2013 were searched in PubMed, Embase, and Web of Knowledge by two reviewers independently...
October 2013: Journal of Cancer Research and Clinical Oncology
Guang-gai Xia, Chang-hua Zhang, Zhe-wei Wei, Ying Wu, Yu-long He
OBJECTIVE: To evaluate efficacy of adjuvant chemotherapy after D2 dissection on survival for patients with gastric cancer. METHODS: Randomized clinical trials (RCT) that compared adjuvant chemotherapy after D2 dissection with D2 dissection alone for gastric cancer were searched with Pubmed, Cochrane, Embase and CBM databases. Eligible trials published between 1990 and 2012 were included in the study. The quality of RCTs was assessed by the Jadad scale. Data synthesis and statistical analysis were performed by RevMan 5...
May 1, 2013: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
Yuan-Yuan Huang, Qiong Yang, Si-Wei Zhou, Ying Wei, Yan-Xian Chen, De-Rong Xie, Bei Zhang
BACKGROUND: Both chemoradiotherapy and chemotherapy are used in postoperative adjuvant therapy for resected gastric cancer. However, it is controversial whether chemoradiotherapy or chemotherapy is the optimal strategy for patients with gastric cancer after D2 lymphadenectomy. The present meta-analysis aims to provide more evidence on the relative benefits of adjuvant therapies in this setting. METHODS: We conducted a systematic review of randomized controlled trials, extracted time-to-event data using Tierney methods (when not reported), and performed meta-analysis to obtain the relative hazards of adjuvant chemoradiotherapy to chemotherapy on efficacy and toxicities...
2013: PloS One
Lei Jiang, Ke-Hu Yang, Quan-Lin Guan, Peng Zhao, Yan Chen, Jin-Hui Tian
BACKGROUND: The objective of the present meta-analysis was to estimate the magnitude of survival and recurrence free benefits from different lymphadenectomy in patients with resectable gastric cancer. METHODS: A comprehensive search was performed for original studies published from their inception to 2012. Two reviewers independently assessed search results, methodological quality, and data extraction of included studies. Results regarding the overall survival (OS) and recurrence free survival (RFS) in the meta-analysis were expressed as hazard ratios (HR) with 95% confidence intervals (CI)...
June 2013: Journal of Surgical Oncology
Yi-Ke Zeng, Zu-Li Yang, Jun-Sheng Peng, Han-Sheng Lin, Ling Cai
OBJECTIVE: To evaluate the safety and efficacy of laparoscopy-assisted distal gastrectomy (LADG) in patients with early gastric cancer (EGC) to determine whether LADG is an acceptable alternative to open distal gastrectomy (ODG). BACKGROUND: LADG combined with less than D2 or D2 lymphadenectomy for EGC is still a controversial surgical intervention for its uncertain oncological safety and economic benefit. We conducted this systematic review and meta-analysis that included randomized control trials (RCTs) and non-RCTs of LADG versus ODG to evaluate whether the safety and efficacy of LADG in patients with EGC are equivalent to those of ODG...
July 2012: Annals of Surgery
Peter McCulloch, Marcelo Eidi Nita, Hussain Kazi, Joaquin J Gama-Rodrigues
BACKGROUND: Surgeons disagree about the merits and risks of radical lymph node clearance during gastrectomy for cancer. OBJECTIVES: To evaluate survival and peri-operative mortality after limited or extended lymph node removal during gastrectomy for cancer. SEARCH METHODS: We searched MEDLINE, EMBASE, CancerLit, LILACS, Central Medical Journal Japanese Database and the Cochrane register, references from relevant articles and conference proceedings...
2012: Cochrane Database of Systematic Reviews
Hong-Bo Wei, Bo Wei, Cui-Ling Qi, Tu-Feng Chen, Yong Huang, Zong-Heng Zheng, Jiang-Long Huang, Jia-Feng Fang
BACKGROUND: Nowadays laparoscopic gastrectomy with D2 lymph node dissection (LGD2) is used for gastric cancer, which provides an alternative to open radical gastrectomy (OGD2). But it has not gained wide acceptance, and its oncological safety remains controversial. The aim of this study is to evaluate the efficiency and safety of LGD2 through a meta-analysis. MATERIALS AND METHODS: Original articles of clinical trials comparing LGD2 and OGD2 for gastric cancer, published in English language from January 2001 to April 2010 were searched in the MEDLINE, Current Contents, and Pubmed...
December 2011: Surgical Laparoscopy, Endoscopy & Percutaneous Techniques
Jie Ding, Guo-Qing Liao, He-Li Liu, Sheng Liu, Jing Tang
BACKGROUND: To assess the value of laparoscopy-assisted distal gastrectomy with D2 dissection for treatment of gastric cancer. METHODS: We collected studies that have compared laparoscopy-assisted distal gastrectomy (LADG) and open distal gastrectomy (ODG) with D2 dissection for treatment of gastric cancer in the past 15 years. Data of interest for LADG and ODG were subjected to meta-analysis using a fixed-effect and random-effect model. RESULTS: We analyzed 8 studies that included 1,065 patients...
March 2012: Journal of Surgical Oncology
Muhammed Ashraf Memon, Manjunath S Subramanya, Shahjahan Khan, Md Belal Hossain, Emma Osland, Breda Memon
OBJECTIVES: To conduct a meta-analysis of randomized controlled trials evaluating the efficacy and drawbacks of limited (D1) versus extended lymphadenectomy (D2) for proven gastric adenocarcinoma. METHODS: A search of Cochrane, Medline, PubMed, Embase, Science Citation Index and Current Contents electronic databases identified randomized controlled trials published in the English language between 1980 and 2008 comparing the outcomes of D1 versus D2 gastrectomy for gastric adenocarcinoma...
May 2011: Annals of Surgery
Yi Liao, Zu-li Yang, Jun Xiang, Xiao-bin Wu, Hua-she Wang, Jun-sheng Peng
OBJECTIVE: To evaluate the safety and efficacy of laparoscopy- assisted distal gastrectomy (LADG) with D2 lymph node dissection for gastric cancer. METHODS: Literature search was performed in Pubmed, Medline, EMBASE, the Chinese Biomedical Database (CBM) to identify controlled trials comparing LADG and open distal gastrectomy (ODG) for gastric cancer published between January 2005 and February 2010. A meta-analysis was performed using RevMan 5.0 software. RESULTS: Seven controlled trials were included...
November 2010: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
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