scholarly journals Efficacy of Omentum-Preserving Gastrectomy for Patients With Gastric Cancer: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 11 ◽  
Author(s):  
Zonglin Li ◽  
Min Song ◽  
Yejiang Zhou ◽  
Huaiwu Jiang ◽  
Linxia Xu ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Recurrence Rate ◽  
Operative Time ◽  
Meta Analysis ◽  
Pooled Analysis ◽  
Cochrane Library ◽  
Safe Procedure ◽  
Free Survival ◽  
Oncological Outcomes ◽  
Analysis Quality

BackgroundComplete omentectomy is considered to be essential in the radical gastrectomy for gastric cancer (GC), but its clinical benefit remains unclear. This study aims to evaluate the efficacy of omentum-preserving gastrectomy (OPG) for patients with GC.MethodsStudies comparing the surgical and oncological outcomes of OPG and gastrectomy with complete omentectomy (GCO) for GC up to March 2021 were systematically searched from PubMed, Web of Science, Embase, and Cochrane Library. A pooled analysis was performed for the available data regarding the baseline features, surgical and oncological outcomes. The RevMan 5.3 software was used to perform the statistical analysis. Quality evaluation and publication bias were also conducted.ResultsNine studies with a total of 3335 patients (1372 in the OPG group and 1963 in the GCO group) undergoing gastrectomy were included. In the pooled analysis, the baseline data in two groups were all comparable (p > 0.05). However, the OPG group was associated with shorter operative time (MD = −18.67, 95% CI = −31.42 to −5.91, P = 0.004) and less intraoperative blood loss (MD = −38.09, 95% CI = −53.78 to −22.41, P < 0.00001) than the GCO group. However, the number of dissected lymph nodes (MD = 2.16, 95% CI = −0.61 to 4.93, P = 0.13), postoperative complications (OR = 0.92, 95% CI = 0.74 to 1.15, p = 0.47), overall recurrence rate (OR = 0.83, 95% CI = 0.66 to 1.06, p = 0.14), peritoneal recurrence rate (OR = 0.91, 95% CI = 0.65 to 1.29, p = 0.60), 3-year relapse-free survival (RFS) rate (OR = 1.40, 95% CI = 0.86 to 2.27, p = 0.18), and 5-year RFS rate (OR = 1.21, 95% CI = 0.95 to 1.55, p = 0.12) of the two groups were comparable.ConclusionsOPG might be an oncologically safe procedure with better surgical outcomes for patients with GC than GCO. However, high-quality randomized controlled trials are needed to confirm this benefit.

scholarly journals Partial Versus Total Omentectomy in Patients with Gastric Cancer: A Systemic Review and Meta-Analysis

Cancers ◽  
2021 ◽  
Vol 13 (19) ◽  
pp. 4971
Author(s):  
Shion Wei Chai ◽  
Suo-Hsien Wang ◽  
Chih-Yuan Wang ◽  
Yi-Chan Chen ◽  
Ruey-Shyang Soong ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Overall Survival ◽  
Meta Analysis ◽  
Disease Free Survival ◽  
Systemic Review ◽  
Cochrane Library ◽  
Free Survival ◽  
Significant Difference ◽  
Hospital Stays ◽  
Disease Free

Background: Surgical treatment is the key to cure localized gastric cancer. There is no strong evidence that supports the value of omentectomy. Thus, a meta-analysis was conducted to compare the safety and efficiency of partial and total omentectomy in patients with gastric cancer. Methods: PubMed, Embase, and Cochrane Library databases were searched. All studies that compared total and partial omentectomy as treatments for gastric cancer were included. The primary outcomes were patients’ overall survival and disease-free survival, while the secondary outcomes were perioperative outcome and postoperative complications. Results: A total of nine studies were examined, wherein 1043 patients were included in the partial omentectomy group, and 1995 in the total omentectomy group. The partial omentectomy group was associated with better overall survival (hazard ratio: 0.80, 95% CI: 0.66 to 0.98, p = 0.04, I2 = 0%), shorter operative time, and lesser blood loss than the total omentectomy group. In addition, no statistically significant difference was observed in the number of dissected lymph nodes, length of hospital stays, complication rate, and disease-free survival. Conclusions: Our results show that, compared with total omentectomy in gastric cancer surgery, partial omentectomy had non-inferior oncological outcomes and comparable safety outcomes.

Proximal gastrectomy versus total gastrectomy for adenocarcinoma of the esophagogastric junction: a meta-analysis

2019 ◽  
Vol 8 (10) ◽  
pp. 753-766 ◽  
Author(s):  
Yi-chuan Chen ◽  
Li Lu ◽  
Kai-hu Fan ◽  
Dao-han Wang ◽  
Wei-hua Fu
Keyword(s):  
Gastric Cancer ◽  
Overall Survival ◽  
Survival Rate ◽  
Total Gastrectomy ◽  
Recurrence Rate ◽  
Meta Analysis ◽  
Proximal Gastrectomy ◽  
Cochrane Library ◽  
Overall Survival Rate ◽  
Upper Third

Aim: To compare efficacy between total gastrectomy (TG) and proximal gastrectomy (PG) for upper-third gastric cancer. Materials & methods: PubMed, Embase and Cochrane library were searched to select suitable researches. Stata was used for meta-analysis including 5-year overall survival rate, recurrence rate, complication morbidities and serum nutritional levels. Results: Ten retrospective English researches were contained. Our study showed no significant difference of 5-year overall survival rate, recurrence rate, reflux symptoms and anastomotic leakage. TG experienced longer operation time, more lymph nodes-retrieved number, more estimated blood loss and higher ileus, but less anastomotic stricture. PG showed advantages over TG in terms of serum nutritional levels. Conclusion: PG is more preferable to TG for treatment of upper-third gastric cancer.

Clinicopathological and Prognostic Value of S100A4 Expression in Gastric Cancer: A Meta-Analysis

2014 ◽  
Vol 29 (2) ◽  
pp. 99-111 ◽  
Author(s):  
Zhian Ling ◽  
Ruolin Li
Keyword(s):  
Gastric Cancer ◽  
Cancer Patients ◽  
Prognostic Value ◽  
Meta Analysis ◽  
Tumor Grade ◽  
Pooled Analysis ◽  
Cochrane Library ◽  
Clinicopathological Parameters ◽  
S100a4 Expression ◽  
Gastric Cancer Patients

Purposes For several years S100A4 has been implicated in tumor progression and prognosis. However, the prognostic value of S100A4 overexpression in patients with gastric cancer remains unknown. Therefore, we performed a meta-analysis to assess the relationship between S100A4 overexpression and clinical outcome of gastric cancer. Methods and Results Candidate studies were searched from PubMed, Embase, Cochrane Library, and ISI Web of Science. We included studies that evaluated the prognostic value of S100A4 expression in gastric cancer patients with regard to survival and a series of clinicopathological parameters. The pooled hazard ratios (HR) and odds ratios (OR) with 95% confidence intervals (CI) were used to estimate the effects. Ten studies, all from Asia, were included in the meta-analysis. The pooled analysis showed that S100A4 overexpression was significantly associated with worse overall survival (OS) (HR=1.86, 95% CI: 1.45-2.38, p<0.00001) without heterogeneity in the data (I2=43.6%, p=0.131). Furthermore, our results showed that S100A4 overexpression was significantly correlated with some clinicopathological parameters such as tumor grade, stage, metastasis, invasion, and relapse. Conclusions The results of our meta-analysis indicate that S100A4 overexpression correlates with more adverse clinical features and a poor prognosis of gastric cancer patients in Asia, thus suggesting that S100A4 could be a useful marker to evaluate progression and prognosis of Asian gastric cancer patients. More studies from Western countries with a larger number of tumors and standardized methods are required before significant conclusions can be drawn.

scholarly journals Comparison of Survival and Safety Between Total Omentectomy and Partial Omentectomy for Gastric Cancer: A Meta-Analysis

2021 ◽  
Vol 8 ◽  
Author(s):  
Yue-Xin Zhang ◽  
Han-Dong Liu ◽  
Ze-Hua Chen ◽  
Tao Jin ◽  
Jian-Kun Hu ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Blood Loss ◽  
Weighted Mean Difference ◽  
Meta Analysis ◽  
Disease Free Survival ◽  
Operation Time ◽  
Greater Omentum ◽  
Cochrane Library ◽  
Intraoperative Blood Loss ◽  
Free Survival

Background: The greater omentum can limit abdominal inflammation and act as a protective cushion, but it is always involved in dissemination of gastric cancer. The purpose of this meta-analysis was to compare the survival and safety between total omentectomy and partial omentectomy for gastric cancer.Methods: Two investigators independently conducted a systematic search of PubMed, Embase, CNKI, and Cochrane Library ranging from January 2000 to November 2020. The pooled odds ratio (ORs) and weighted mean difference (WMD) with the 95% confidence interval (95% CI) were used to assess perioperative and survival parameters.Results: A total of 2,031 patients in 11 studies (574 patients in the partial omentectomy group and 1,457 patients in the total omentectomy group) were included. The results found shorter operation time (WMD = −25.584; P = 0.000) and less intraoperative blood loss (WMD = −47.301; P = 0.050) in the partial omentectomy group, compared to total omentectomy. There were no significant differences in terms of incidence of complications (OR = 0.770; P = 0.164), blood transfusions rates (OR = 0.269; P = 0.161), time to first flatus (WMD = 0.160; P = 0.345), hospital stay (WMD = −1.258; P = 0.087), and number of harvested lymph nodes (WMD = 1.265; P = 0.662). For the disease-free survival (OR = 0.80; P = 0.381) and overall survival, there were no statistical differences between the two procedures.Conclusions: The partial omentectomy could reduce operation time and trended to decrease intraoperative blood loss. And the survival in patients with partial omentectomy seemed to be comparable to that of patients with total omentectomy.

scholarly journals The prognosis benefits of adjuvant versus salvage radiotherapy for patients after radical prostatectomy with adverse pathological features: a systematic review and meta-analysis

2019 ◽  
Vol 14 (1) ◽  
Author(s):  
Ronggui Tao ◽  
Jindong Dai ◽  
Yunjin Bai ◽  
Jiyu Yang ◽  
Guangxi Sun ◽  
...  
Keyword(s):  
Systematic Review ◽  
Radical Prostatectomy ◽  
Subgroup Analysis ◽  
Meta Analysis ◽  
Final Analysis ◽  
Pooled Analysis ◽  
Salvage Radiotherapy ◽  
Cochrane Library ◽  
Pathological Features ◽  
Free Survival

Abstract Background The appropriate timing of radiotherapy (RT) for patients after radical prostatectomy (RP) with adverse pathological features (APFs) remains controversial. This systematic review was conducted to compare the efficacy of adjuvant radiotherapy (ART) and salvage radiotherapy (SRT). Methods PubMed, EMBASE, Web of Science and the Cochrane Library electronic databases were searched to retrieve the required. The hazard ratio (HR) and corresponding 95% confidence interval (CI) of overall survival (OS), biochemical recurrence-free survival (BRFS) and distant metastases-free survival (DMFS) were extracted. The survival benefits of ART with SRT (including early salvage radiotherapy (ESRT)) were analyzed. The process of the meta-analysis was performed with RevMan version 5.3. Results A total of fifteen retrospective studies were finally included in the final analysis including 5586 patients. The pooled analysis indicated that ART could achieve better control of prostate cancer and improve OS (p = 0.0006), BRFS (p < 0.0001) and DMFS (p < 0.0001), when compared to SRT. The subgroup analysis of the 5-year OS rate demonstrated that the ART group still had survival advantages compared to the SRT group (p = 0.0006). However, ART and SRT were comparable in 10-year OS rate (p = 0.07). ART had advantages over SRT in both 5-year (p = 0.0003) and 10-year BRFS (p = 0.0003). The subgroup analysis with different follow-up starting points from RP or RT was essentially consistent with the above results. The pooled analysis also showed that ART was superior to ESRT on OS (p = 0.008) and DMFS (p = 0.03), and comparable to ESRT on BRFS (p = 0.1). Conclusions According to this meta-analysis, ART could be served as a preferential treatment for patients with APFs after RP to improve prognosis. Certainly, high-quality, multicenter randomized controlled trials (RCTs) are expecting to confirm the outcomes of our meta-analysis in the future.

scholarly journals The Impact of Diagnostic Ureteroscopy Prior to Radical Nephroureterectomy on Oncological Outcomes in Patients with Upper Tract Urothelial Carcinoma: A Comprehensive Systematic Review and Meta-analysis

2021 ◽  
Author(s):  
Łukasz Nowak ◽  
Wojciech Krajewski ◽  
Joanna Chorbińska ◽  
Paweł Kiełb ◽  
Michał Sut ◽  
...  
Keyword(s):  
Systematic Review ◽  
Urothelial Carcinoma ◽  
Meta Analysis ◽  
Upper Tract Urothelial Carcinoma ◽  
Cochrane Library ◽  
Radical Nephroureterectomy ◽  
Free Survival ◽  
Upper Tract ◽  
Oncological Outcomes ◽  
The Impact

Background: The incidence of intravesical recurrence (IVR) following radical nephroureterectomy (RNU) is reported in up to 50% of patients with upper tract urothelial carcinoma (UTUC). It was suggested that preoperative diagnostic ureteroscopy (URS) could increase the IVR rate after RNU, however, the available data are often conflicting. Thus, in this systematic review and meta-analysis we sought to synthesize that available data for the impact of pre-RNU URS for UTUC on IVR and other oncological outcomes; Materials and methods: A systematic literature search of the PubMed, Embase and Cochrane Library databases was performed in June 2020. Cumulative analyses of hazard ratios (HRs) and their corresponding 95% confidence intervals (CI) were conducted. The primary endpoint was intravesical recurrence-free survival (IVRFS), with the secondary endpoints being cancer-specific survival (CSS), overall survival (OS), and metastasis-free survival (MFS); Results: Among a total of 5489 patients included in the sixteen selected papers, 2387 (43.4%) underwent diagnostic URS before RNU and 3102 (56.6%) did not. Pre-RNU diagnostic URS was significantly associated with worse IVRFS after RNU (HR=1.44, 95% CI: 1.29-1.61, p&amp;lt;0.001) than RNU alone. However, subgroup analysis including patients without biopsy during URS revealed no significant impact of diagnostic URS on IVRFS (HR=1.28, 95% CI: 0.90-1.80, p=0.16). The results of other analyses showed no significant differences in CSS (HR=0.94, p=0.63), OS (HR: 0.94, p=0.56), and MFS (HR: 0.91, p=0.37) between patients who underwent URS before RNU and those who did not. Conclusions: The results of this meta-analysis confirm that diagnostic URS prior to RNU is significantly associated with worse IVRFS, albeit with no concurrent impact on the other long-term survival outcomes. Our results indicate that URS has a negative impact on IVRFS only when combined with endoscopic biopsy. Future studies are warranted to assess the role of immediate postoperative intravesical chemotherapy in patients undergoing biopsy during URS for suspected UTUC.

scholarly journals Circulating Tumour Cells (CTCs) as Potential Biomarkers of Clinicopathological and Prognostic Significance in Gastric Cancer Patients: A Systematic Review and Meta-Analysis

2020 ◽  
Author(s):  
Yiding Li ◽  
Guiling Wu ◽  
Wanli Yang ◽  
Xiaoqian Wang ◽  
Lili Duan ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Meta Analysis ◽  
Prognostic Significance ◽  
Disease Free Survival ◽  
Progression Free Survival ◽  
Cancer Staging ◽  
Diagnostic Value ◽  
Pooled Analysis ◽  
Clinicopathological Parameters ◽  
Free Survival

Abstract Background: Gastric cancer (GC) is a common highly recurrent malignant tumor that is associated with poor prognosis. Circulating tumor cells (CTCs) have drawn much attention because of their diagnostic value in diverse cancers, including GC. This study aimed to assess the relevance of CTCs in predicting the clinicopathological parameters and prognostic significance of GC. Methods: We systematically searched PubMed, Medline and Web of Science for relevant studies. Each database was searched from its date of inception through January 22, 2020. The odds ratios (ORs), hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated as effect values using the random-effects model. Results: In total, 52 articles that reported 68 studies comprising 4158 GC patients were included. The pooled results on TNM stage indicated that the III/IV group had a notably higher CTCs positivity rate than the I/II group (OR=2.73, 95% CI (1.95,3.82), I2=65%). The poorly differentiated group had a significantly higher CTCs positivity rate than the well/moderately differentiated group (overall: OR=1.91, 95% CI (0.77,4.71)), as well as the Lauren classification diffuse/hybrid type group and the intestinal group (overall: OR=1.77, 95% CI (0.70,4.44)). The bulk of analysis revealed that CTC positivity detected in GC patients was correlated with worse overall survival (OS) (HR =1.94, 95% CI (1.64,2.30), P≤0.001), progression-free survival (PFS) (HR =2.45, 95% CI (1.65,3.64), P≤0.001), and disease-free survival (DFS) (HR =2.78, 95% CI (1.89,4.10), P≤0.001). Then, we extracted data and analyzed the DCR of chemotherapy in patients with GC, and the pooled analysis demonstrated that the DCR of the CTC positivity was lower than that of the CTC negativity (RR =0.63, 95% CI (0.44,0.91))Conclusions: In conclusion, our study demonstrated that the CTCs positivity was correlated with the poor OS, PFS and DFS in GC patients and provided a scientific foundation for gastric cancer staging.

scholarly journals Does Extended Intraoperative Peritoneal Lavage Really Bring Benefit on Patients With Gastric Cancer? A Meta-Analysis of Published Clinical Trials

2021 ◽  
Vol 11 ◽  
Author(s):  
Wei Tao ◽  
Xiao-Yu Liu ◽  
Yu-Xi Cheng ◽  
Bing Kang ◽  
Hua Zhang ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Postoperative Complications ◽  
Peritoneal Lavage ◽  
Meta Analysis ◽  
Disease Free Survival ◽  
Cochrane Library ◽  
Short Term ◽  
Curative Gastrectomy ◽  
Free Survival ◽  
Significant Difference

PurposeThe purpose of the current meta-analysis is to analyze whether extended intraoperative peritoneal lavage (EIPL) can bring benefit on short-term outcomes or survival for patients undergoing curative gastrectomy for gastric cancer.MethodsThe PubMed, Embase, and Cochrane Library databases were searched from inception to May 3, 2021, to find eligible studies. Postoperative complications, overall survival (OS), disease-free survival (DFS), and peritoneal recurrence–free survival (PRFS) were compared between EIPL group and No EIPL group.ResultsA total of five randomized controlled trials with 1,790 patients were included in the current meta-analysis. No difference was found in baseline information (p &gt; 0.05). After pooling up the data of overall postoperative complications, no significant difference was found between EIPL group and No EIPL group (OR = 0.88, 95% CI = 0.51 to 1.53, P = 0.65). Furthermore, there was no significant difference between EIPL group and No EIPL group in terms of OS (HR = 0.77, 95% CI = 0.36 to 1.64, P = 0.49), DFS (HR = 0.97, 95% CI = 0.71 to 1.33, P = 0.87), and PRFS (HR = 1.03, 95% CI = 0.74 to 1.43, P = 0.86). In terms of subgroup analysis of OS, no significant difference was found as well (HR = 1.05, 95% CI = 0.82 to 1.34, P = 0.69).ConclusionsEIPL did not bring benefit in terms of short-term outcomes or survival. Therefore, EIPL is not recommended for patients undergoing curative gastrectomy for gastric cancer.

scholarly journals LigaSure small jaw versus conventional neck dissection: a systematic review and meta-analysis

2021 ◽  
Vol 50 (1) ◽  
Author(s):  
Tai-Yu Chen ◽  
Li-Jen Hsin ◽  
Wan-Ni Lin ◽  
Ming-Shao Tsai ◽  
Yao-Te Tsai ◽  
...  
Keyword(s):  
Systematic Review ◽  
Neck Dissection ◽  
Operative Time ◽  
Meta Analysis ◽  
Length Of Hospital Stay ◽  
Pooled Analysis ◽  
Cochrane Library ◽  
Postoperative Hematoma ◽  
Personal Experiences ◽  
The Cochrane Library

Abstract Background Neck dissection has a central role in the management of head and neck cancers. This systematic review aimed to compare the intraoperative and postoperative parameters between conventional and LigaSure Small Jaw (LSJ)-assisted neck dissection. Methods PubMed (MEDLINE), Embase, and the Cochrane Library were searched. independently by two authors for relevant articles comparing the outcomes of conventional and LSJ-assisted neck dissection. Data from each study were extracted, and a random-effects model was used in the pooled analysis. Results Compared with conventional techniques, LSJ-assisted neck dissection was associated with a significantly reduced operative time. The rates of postoperative hematoma, infection, amount of intraoperative blood loss, the length of hospital stay and the drainage amount showed no significant intergroup differences. Conclusions The meta-analysis provides evidence that properly using LSJ may reduce the operative time compared with that of conventional techniques. Surgeons may consider using LSJ in neck dissection according to personal experiences. Graphical abstract

scholarly journals Low Pretreatment Albumin-to-Globulin Ratio Predicts Poor Prognosis in Gastric Cancer: Insight From a Meta-Analysis

2021 ◽  
Vol 10 ◽  
Author(s):  
Chengzhi Wei ◽  
Zhu Yu ◽  
Gonghe Wang ◽  
Yiming Zhou ◽  
Lei Tian
Keyword(s):  
Gastric Cancer ◽  
Poor Prognosis ◽  
Meta Analysis ◽  
Prognostic Significance ◽  
Disease Free Survival ◽  
Progression Free Survival ◽  
Cochrane Library ◽  
China National Knowledge Infrastructure ◽  
Free Survival ◽  
Albumin To Globulin Ratio

BackgroundIn recent five years, reports regarding albumin-to-globulin ratio (AGR) and the survival of gastric cancer (GC) have emerged rapidly, yet their association remains controversial. This meta-analysis was aimed to provide an insight into the prognostic significance of pretreatment AGR in GC.MethodsPubMed, Embase, Cochrane library, Web of Science, WanFang, China National Knowledge Infrastructure (CNKI) and VIP databases were searched for relevant studies, from inception to September 30, 2020. Individual hazard ratios (HRs) with their 95% confidence intervals (CIs) were combined by Stata 12.0 software to evaluate the association between pretreatment AGR and overall survival (OS) and disease-free survival/progression-free survival (DFS/PFS).ResultsA total of 8,305 patients with GC from 12 studies were included for further analysis. Pooled analyses indicated that low AGR was closely associated with worse OS (HR = 1.531, 95% CI: 1.300–1.803, P &lt; 0.001) and worse DFS/PFS (HR = 2.008, 95% CI: 1.162–3.470, P = 0.012) in GC patients. Moreover, subgroup analyses demonstrated that the association between low AGR and worse OS remained constant despite variations in country, tumor stage, cut-off value, cut-off selection and treatment method.ConclusionAGR could act as an efficient prognostic indicator for GC, and that low pretreatment AGR predicts poor prognosis in GC.

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