Personalized Surgery for Gastric Adenocarcinoma: A Meta-analysis of D1 versus D2 Lymphadenectomy View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2015-06

AUTHORS

Abraham El-Sedfy, Matthew Dixon, Rajini Seevaratnam, Alina Bocicariu, Roberta Cardoso, Alyson Mahar, Alex Kiss, Lucy Helyer, Calvin Law, Natalie G. Coburn

ABSTRACT

BACKGROUND: The recent publication of 5-year survival data for the Italian Gastric Cancer Study Group (IGCSG) D1 versus D2 lymphadenectomy for gastric cancer trial adds important data for analysis of whether a D2 lymphadenectomy improves survival. METHODS: Systematic searches were conducted using Medline, Embase, and the Cochrane Central Register of Controlled Trials from January 1, 1985 to February 1, 2014. Meta-analyses were performed using RevMan version 5 software. Long-term outcomes were analyzed. Subgroup analyses of T and N stage were performed. RESULTS: Outcomes of four randomized, controlled trials involving 1,599 patients (823 D1: 776 D2) enrolled from 1982 to 2005 were included for qualitative analysis and quantitative meta-analysis. Despite the addition of long-term survival data from the IGCSG, 5-year overall and nodal status survival was similar between D1 and D2 trials. However, subgroup analysis revealed a survival benefit for T3 patients (odds ratio 1.64, 95 % confidence interval 1.01-2.67) and a trend for survival benefit for advanced nodal stage (odds ratio 1.36, 95 % confidence interval 0.98-1.87) with D2 compared with D1 lymphadenectomy. CONCLUSIONS: As recent studies have demonstrated comparable short-term surgical outcomes for both D1 and D2 lymphadenectomies, consideration should be made for more extensive lymph node dissection among patients with advanced stage. More... »

PAGES

1820-1827

Identifiers

URI

http://scigraph.springernature.com/pub.10.1245/s10434-014-4168-6

DOI

http://dx.doi.org/10.1245/s10434-014-4168-6

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1051283559

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/25348779


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