RESEARCH ARTICLE
Does Total Gastrectomy Provide Better Outcomes than Distal Subtotal Gastrectomy for Distal Gastric Cancer? A Systematic Review and Meta-Analysis Jin Qi1,2,3, Peng Zhang2, Yanan Wang4, Hao Chen1,2, Yumin Li1,2* 1 The Second Hospital of Lanzhou University, Lanzhou, Gansu, People’s Republic of China, 2 Key Laboratory of Digestive System Tumors of Gansu Province, Lanzhou, Gansu, People’s Republic of China, 3 Key Laboratory of Orthopedics of Gansu Province, Lanzhou, Gansu, People’s Republic of China, 4 The Evidence-Based Medicine Center of Lanzhou University, Lanzhou, Gansu, People’s Republic of China
a11111
* [email protected]
Abstract OPEN ACCESS Citation: Qi J, Zhang P, Wang Y, Chen H, Li Y (2016) Does Total Gastrectomy Provide Better Outcomes than Distal Subtotal Gastrectomy for Distal Gastric Cancer? A Systematic Review and Meta-Analysis. PLoS ONE 11(10): e0165179. doi:10.1371/journal.pone.0165179 Editor: Yanming Zhou, Xiamen University and Fujian Medical University Affiliated First Hospital, CHINA Received: July 21, 2016 Accepted: October 8, 2016 Published: October 26, 2016 Copyright: © 2016 Qi et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Data Availability Statement: All relevant data are within the paper and its Supporting Information files. Funding: The author(s) received no specific funding for this work. Competing Interests: The authors have declared that no competing interests exist.
Background/Aims Total gastrectomy (TG) has shown to be superior regarding low risk of recurrence and readmission to distal subtotal gastrectomy (DG) for treatment of distal stomach cancer, but the incidence of postoperative morbidity and mortality in TG cannot be ignored. Therefore, we performed a meta-analysis to compare the effectiveness between TG and DG for distal stomach cancer.
Methodology A search in PubMed, EMBASE, the Cochrane Library, Web of Science, Chinese Biomedical Database through January 2016 was performed. Eligible studies in comparing of TG and DG for distal gastric cancer were included in this meta-analysis. Review Manager 5.2 software from the Cochrane Collaboration was used for the performance of meta-analysis and STATA 12.0 software for meta-regression analysis.
Results Ten retrospective cohort studies and one randomized control trial involving 5447 patients were included. The meta-analysis showed no significant difference of postoperative mortality (RR = 1.48, 95%CI = 0. 90–2.44,p = 0.12), intraoperative blood loss (MD = 24.34, 95%CI = -3.31–51.99, p = 0.08) and length of hospital stay(MD = 0.76, 95%CI:-0.26–1.79, p = 0.15). TG procedure could retrieve more lymph nodes than DG(MD = 4.33, 95% CI = 2.34–6.31, p
Does Total Gastrectomy Provide Better Outcomes than Distal Subtotal Gastrectomy for Distal Gastric Cancer? A Systematic Review and Meta-Analysis Jin Qi1,2,3, Peng Zhang2, Yanan Wang4, Hao Chen1,2, Yumin Li1,2* 1 The Second Hospital of Lanzhou University, Lanzhou, Gansu, People’s Republic of China, 2 Key Laboratory of Digestive System Tumors of Gansu Province, Lanzhou, Gansu, People’s Republic of China, 3 Key Laboratory of Orthopedics of Gansu Province, Lanzhou, Gansu, People’s Republic of China, 4 The Evidence-Based Medicine Center of Lanzhou University, Lanzhou, Gansu, People’s Republic of China
a11111
* [email protected]
Abstract OPEN ACCESS Citation: Qi J, Zhang P, Wang Y, Chen H, Li Y (2016) Does Total Gastrectomy Provide Better Outcomes than Distal Subtotal Gastrectomy for Distal Gastric Cancer? A Systematic Review and Meta-Analysis. PLoS ONE 11(10): e0165179. doi:10.1371/journal.pone.0165179 Editor: Yanming Zhou, Xiamen University and Fujian Medical University Affiliated First Hospital, CHINA Received: July 21, 2016 Accepted: October 8, 2016 Published: October 26, 2016 Copyright: © 2016 Qi et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Data Availability Statement: All relevant data are within the paper and its Supporting Information files. Funding: The author(s) received no specific funding for this work. Competing Interests: The authors have declared that no competing interests exist.
Background/Aims Total gastrectomy (TG) has shown to be superior regarding low risk of recurrence and readmission to distal subtotal gastrectomy (DG) for treatment of distal stomach cancer, but the incidence of postoperative morbidity and mortality in TG cannot be ignored. Therefore, we performed a meta-analysis to compare the effectiveness between TG and DG for distal stomach cancer.
Methodology A search in PubMed, EMBASE, the Cochrane Library, Web of Science, Chinese Biomedical Database through January 2016 was performed. Eligible studies in comparing of TG and DG for distal gastric cancer were included in this meta-analysis. Review Manager 5.2 software from the Cochrane Collaboration was used for the performance of meta-analysis and STATA 12.0 software for meta-regression analysis.
Results Ten retrospective cohort studies and one randomized control trial involving 5447 patients were included. The meta-analysis showed no significant difference of postoperative mortality (RR = 1.48, 95%CI = 0. 90–2.44,p = 0.12), intraoperative blood loss (MD = 24.34, 95%CI = -3.31–51.99, p = 0.08) and length of hospital stay(MD = 0.76, 95%CI:-0.26–1.79, p = 0.15). TG procedure could retrieve more lymph nodes than DG(MD = 4.33, 95% CI = 2.34–6.31, p
