A significant difference between two randomized controlled trials to compare laparoscopic and open distal gastrectomy for early gastric cancer

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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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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First-Line Systemic Therapy for Advanced Gastric Cancer: A Systematic Review and Network Meta-Analysis of 118 Randomized Controlled Trials

SSRN Electronic Journal ◽

10.2139/ssrn.3210894 ◽

2018 ◽

Author(s):

Ji Cheng ◽

Ming Cai ◽

Xiaoming Shuai ◽

Jinbo Gao ◽

Guobin Wang ◽

...

Keyword(s):

Gastric Cancer ◽

Systematic Review ◽

Randomized Controlled Trials ◽

Advanced Gastric Cancer ◽

Systemic Therapy ◽

Meta Analysis ◽

Controlled Trials ◽

First Line ◽

Randomized Controlled

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Efficacy and Safety of Non-Steroidal Anti-Androgens in Patients with Metastatic Prostate Cancer: Meta-Analysis of Randomized Controlled Trials

Reviews on Recent Clinical Trials ◽

10.2174/1574887114666191105152404 ◽

2020 ◽

Vol 15 (1) ◽

pp. 34-47 ◽

Cited By ~ 1

Author(s):

Muhammed Rashid ◽

Madhan Ramesh ◽

K. Shamshavali ◽

Amit Dang ◽

Himanshu Patel ◽

...

Keyword(s):

Prostate Cancer ◽

Adverse Events ◽

Randomized Controlled Trials ◽

Quality Assessment ◽

Cochrane Library ◽

Control Group ◽

Controlled Trials ◽

Efficacy And Safety ◽

Randomized Controlled ◽

Significant Difference

Background: Prostate cancer (PCa) is the sixth primary cause of cancer death. However, conflicts are present about the efficacy and safety of Non-steroidal anti-androgens (NSAA) for its treatment. The aim of this study was to assess the efficacy and safety of NSAAs versus any comparator for the treatment of advanced or metastatic PCa (mPCa). Methodology: MEDLINE and the Cochrane Library were searched. References of included studies and clinicaltrials.gov were also searched for relevant studies. Only English language studies after 1990 were considered for review. Randomized controlled trials (RCTs) examining the efficacy and safety of NSAAs as compared with any other comparator including surgery or chemotherapy in mPCa patients were included. The outcomes include efficacy, safety and the tolerability of the treatment. The Cochrane Risk of Bias Assessment Tool was used for quality assessment. Two authors were independently involved in the selection, extraction and quality assessment of included studies and disagreements were resolved by discussion or by consulting a third reviewer. Results: Fifty-eight out of 1307 non-duplicate RCTs with 29154 patients were considered for the review. NSAA showed significantly better progression-free survival [PFS] (Hazard ratio [HR], 0.60; 95% confidence interval [CI], 0.46-0.78; P=0.0001), time to distant metastasis or death [TTD] (HR, 0.80; 95% CI 0.73-0.91; p<0.0001), objective response (Odds ratio [OR], 1.64; 95% CI 1.06-2.54; P=0.03) and clinical benefits (OR, 1.33; 95% CI 1.08-1.63; P=0.006) as compared to the control group. There was no significant difference observed between the groups in terms of overall survival (HR, 0.95; 95%CI, 0.87-1.03; P=0.18) and time to progression (HR, 0.93; 95% CI 0.77-1.11; P=0.43). Treatment-related adverse events were more with the NSAA group, but the discontinuation due to lack of efficacy reason was 43% significantly lesser than the control group in patients with mPCa. Rest of the outcomes were appeared to be non-significant. Conclusion: Treatment with NSAA was appeared to be better efficacious with respect to PFS, TTD, and response rate with considerable adverse events when compared to the control group in patients with metastatic PCa.

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