Long-term survival following laparoscopic and open colectomy for colon cancer: a meta-analysis of randomized controlled trials

Abstract Background There is a controversy for the therapeutic effect of laparoscopy-assisted gastrectomy (LADG) and open gastrectomy for a long time. The meta-analysis in this article evaluates and compares the effectiveness of these two treatments to patients' long-term survival. Method We searched MEDLINE (PubMed), EMBASE (Ovid) and the Cochrane Library and identified all qualified researches from January 2002 to January 2020. The statistic analysis is performed by Revman 5.3 and Version 3 Comprehensive Meta-analysis. Through the results, we compared the advantages and long-term survival of LADG and ODG. Result According to the result of 8 randomized controlled trials which involves 2650 patients with early gastric cancer, compared with ODG, LAGD has longer surgery time (MD=78.11,95%CI=59.14-97.07,P<0.00001), less blood loss (MD=-100.59,95%CI=-127.71--73.46,P<0.00001), a shorter incision (MD=-12.25,95%CI=-13.18--11.31,P<0.00001), shorter time to start the first time of flatus (MD=-0.66,95%CI=-1.01--0.32,P=0.0001), shorter hospital stay (MD=-0.94,95%CI=-1.66--0.22,P=0.01), and lower frequency of analgesic utilization (MD=-1.69,95%CI=-2.18--1.21,P<0.00001). However, there is no statistical difference between ODG and LAGD on the number of harvested lymph nodes, time of the first meal, short-term surgical complications, cancer recurrence rate, and long-term survival rate. Conclusion According to the result of meta-analysis, compared with ODG, LADG has a significant advantage in blood loss in surgery, early rehabilitation, scar development, management of postoperative pain, etc. Meanwhile, LADG and ODG have the same performance on long-term survival. Therefore, we believe LADG is a safe and effective replacement of ODG for early gastric cancer.

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A Meta-Analysis of the Short- And Long-Term Results of Randomized Controlled Trials That Compared Laparoscopy-Assisted and Open Colectomy for Colon Cancer

Journal of Cancer ◽

10.7150/jca.3621 ◽

2012 ◽

Vol 3 ◽

pp. 49-57 ◽

Cited By ~ 80

Author(s):

Hiroshi Ohtani ◽

Yutaka Tamamori ◽

Yuichi Arimoto ◽

Yukio Nishiguchi ◽

Kiyoshi Maeda ◽

...

Keyword(s):

Colon Cancer ◽

Randomized Controlled Trials ◽

Meta Analysis ◽

Open Colectomy ◽

Long Term Results ◽

Controlled Trials ◽

Randomized Controlled ◽

Short And Long Term

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The influence of laparoscopy-assisted gastrectomy versus open gastrectomy to long-term survival for early gastric cancer: an updated meta-analysis based on randomized controlled trials

10.21203/rs.3.rs-30582/v1 ◽

2020 ◽

Author(s):

Zhao Zhai ◽

Shenghan Lou ◽

Ziyu Zhu ◽

Xiliang Cong ◽

Jialiang Gao ◽

...

Keyword(s):

Gastric Cancer ◽

Early Gastric Cancer ◽

Blood Loss ◽

Randomized Controlled Trials ◽

Meta Analysis ◽

Controlled Trials ◽

Term Survival ◽

Long Term Survival ◽

Randomized Controlled

Abstract BackgroundThere is a controversy for the therapeutic effect of laparoscopy-assisted gastrectomy (LADG) and open gastrectomy for a long time. The meta-analysis in this article evaluates and compares the effectiveness of these two treatments to patients' long-term survival.MethodWe searched MEDLINE (PubMed), EMBASE (Ovid) and the Cochrane Library and identified all qualified researches from January 2002 to January 2020. The statistic analysis is performed by Revman 5.3 and Version 3 Comprehensive Meta-analysis. Through the results, we compared the advantages and long-term survival of LADG and ODG.ResultAccording to the result of 8 randomized controlled trials which involves 2650 patients with early gastric cancer, compared with ODG, LAGD has longer surgery time (MD=78.11，95%CI=59.14-97.07，P＜0.00001), less blood loss (MD=-100.59，95%CI=-127.71--73.46，P＜0.00001), a shorter incision (MD=-12.25，95%CI=-13.18--11.31，P＜0.00001), shorter time to start the first time of flatus (MD=-0.66，95%CI=-1.01--0.32，P=0.0001), shorter hospital stay (MD=-0.94，95%CI=-1.66--0.22，P=0.01), and lower frequency of analgesic utilization (MD=-1.69，95%CI=-2.18--1.21，P＜0.00001). However, there is no statistical difference between ODG and LAGD on the number of harvested lymph nodes, time of the first meal, short-term surgical complications, cancer recurrence rate, and long-term survival rate.ConclusionAccording to the result of meta-analysis, compared with ODG, LADG has a significant advantage in blood loss in surgery, early rehabilitation, scar development, management of postoperative pain, etc. Meanwhile, LADG and ODG have the same performance on long-term survival. Therefore, we believe LADG is a safe and effective replacement of ODG for early gastric cancer.

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Impact of Intermittent Pringle Maneuver on Long-Term Survival After Hepatectomy for Hepatocellular Carcinoma: Result from Two Combined Randomized Controlled Trials

World Journal of Surgery ◽

10.1007/s00268-019-05130-8 ◽

2019 ◽

Vol 43 (12) ◽

pp. 3101-3109 ◽

Cited By ~ 5

Author(s):

Kit Fai Lee ◽

Charing C. N. Chong ◽

Sunny Y. S. Cheung ◽

John Wong ◽

Andrew K. Y. Fung ◽

...

Keyword(s):

Hepatocellular Carcinoma ◽

Randomized Controlled Trials ◽

Pringle Maneuver ◽

Controlled Trials ◽

Term Survival ◽

Long Term Survival ◽

Randomized Controlled

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The use of high venous ligation as an adjunct to endovenous therapy in the management of great saphenous vein incompetence: A systematic review and meta-analysis of randomized controlled trials

Phlebology The Journal of Venous Disease ◽

10.1177/0268355518821805 ◽

2019 ◽

Vol 34 (7) ◽

pp. 433-444

Author(s):

Thomas M Aherne ◽

Mekki Medani ◽

Shaheel Sahebally ◽

Elrasheid Kheirelseid ◽

Edward Mulkern ◽

...

Keyword(s):

Randomized Controlled Trials ◽

Meta Analysis ◽

Hybrid Approach ◽

Outcome Data ◽

Operative Intervention ◽

Controlled Trials ◽

Recurrence Rates ◽

Randomized Controlled ◽

Venous Surgery

Background In recent years, endovenous intervention has emerged as a minimally invasive alternative to open venous surgery. However, endovenous intervention does not formally disconnect the deep and superficial venous systems and it is hypothesized that recurrence may be greater in the absence of high venous ligation. This study aims to compare the efficacy of a hybrid endovenous approach with adjuvant high venous ligation and standard operative intervention in the management of great saphenous incompetence. Methods In March 2018, Medline and Embase were systematically searched for relevant randomized controlled trials. All randomized controlled trials comparing a hybrid approach with standard operative intervention were included. Studies were required to include at least one pre-defined outcome. Data were extracted and assessed by two independent reviewers. Pooled risk ratios were calculated using a random effects model. Additional subgroup analyses were performed. Results Eight randomized controlled trials including 1244 patients were analysed. Pooled standardized data revealed no difference in overall recurrence (pooled RR = 1.00 [95% CI = 0.57, 1.77]), major operative morbidity (RR = 0.43 [95% CI = 0.06, 2.89]), or re-interventions (RR = 0.94 [95% CI = 0.12, 7.24]) for the hybrid group compared with standard operative intervention alone. Subgroup analysis revealed comparable short-, medium- and long-term recurrence rates between both cohorts. Furthermore, no difference in recurrence was identified when the hybrid approach was compared to open surgery alone (RR = 1.01 [95% CI = 0.63, 1.61]) or endovenous monotherapy (RR = 0.67 [95% CI = 0.04, 12.24]). Conclusion The use of a hybrid approach in the management of great saphenous incompetence appears to offer no recurrence, re-intervention or morbidity benefit when compared to standard operative intervention.

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Long-term efficacy and safety of proprotein convertase subtilisin/kexin 9 monoclonal antibodies: A meta-analysis of 11 randomized controlled trials

Journal of Clinical Lipidology ◽

10.1016/j.jacl.2018.01.004 ◽

2018 ◽

Vol 12 (2) ◽

pp. 277-291.e3 ◽

Cited By ~ 7

Author(s):

Jie Bai ◽

Li-lin Gong ◽

Qi-fu Li ◽

Zhi-hong Wang

Keyword(s):

Monoclonal Antibodies ◽

Randomized Controlled Trials ◽

Meta Analysis ◽

Controlled Trials ◽

Efficacy And Safety ◽

Proprotein Convertase ◽

Randomized Controlled ◽

Term Efficacy

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Overall survival after perioperative chemotherapy in the management of pulmonary metastasis in osteosarcoma.

Journal of Clinical Oncology ◽

10.1200/jco.2021.39.15_suppl.e23508 ◽

2021 ◽

Vol 39 (15_suppl) ◽

pp. e23508-e23508

Author(s):

Zeba Siddiqui ◽

Megan E Delisle ◽

Amirrtha Srikanthan ◽

Ying Wang

Keyword(s):

Overall Survival ◽

Randomized Controlled Trials ◽

Meta Analysis ◽

Pulmonary Metastasectomy ◽

Cochrane Library ◽

Controlled Trials ◽

Perioperative Chemotherapy ◽

Extrinsic Factors ◽

Term Survival ◽

Randomized Controlled

e23508 Background: Pulmonary metastasectomy is performed on a select cohort of patients with advanced osteosarcoma with the potential for long term survival. However, evidence on peri-operative chemotherapy at time of metastasectomy is not completely understood and difficult to summarize without a systematic examination of existing literature. The purpose of this project is to perform a meta-analysis of existing studies to determine overall survival (OS) and prognostic factors in adults and children with advanced and recurrent osteosarcoma receiving chemotherapy around time of metastasectomy. Methods: We reviewed survival studies conducted in children and adults with advanced and recurrent osteosarcoma who undergo pulmonary metastasectomy published in English with more than 5 patients. The primary outcome was overall survival. Literature searches were performed in multiple electronic databases including Ovid MEDLINE (1946 to present), Ovid EMBASE (1974 to present), Web of Science, and Cochrane Library. Two investigators independently screened all citations, abstracts, and full-text articles. Results: 24 out of 80 observational studies between 1977 to 2018 were included. 2146 patients were studied of which 987 underwent pulmonary metastasectomy for osteosarcoma. 822 patients received perioperative chemotherapy in this setting. No randomized controlled trials were identified. Studies included patients from Asia, Africa, Europe, and North America. The median OS ranged between 20 to 90 months. 5-year OS ranged between 15 to 63%. Factors associated with survival included: age, number of lesions, disease free interval, time of development of metastases, number of lesions and laterality of pulmonary disease. Conclusions: Overall survival in study has a significant range. Factors influencing survival included intrinsic factors such as patient age and disease characteristics, as well as extrinsic factors such as evolution of chemotherapy regimen over the past four decades. The main limitations are related to the inherently low-quality evidence as a result of lack of randomized controlled trials. More comprehensive data is needed to guide shared decision making in this area.

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