Clinical values of extended lymph node dissection for gastric cancer:a meta-analysis for D1 versus D2 gastrectomy / 中华胃肠外科杂志
Chinese Journal of Gastrointestinal Surgery
;
(12): 425-430, 2007.
Artigo
em Chinês
| WPRIM
| ID: wpr-336435
ABSTRACT
<p><b>OBJECTIVE</b>To evaluate the survival, complication and postoperative mortality after D(1) or D(2) lymph node dissection for gastric cancer.</p><p><b>METHODS</b>All the randomized clinical trials about nodal dissection for gastric cancer published within the last 20 years were collected. Quality assessment was done on each trial and relevant data were extracted from qualified trials. Meta-analysis was performed with the use of RevMan 4.2 (Cochrane) for statistic analysis.</p><p><b>RESULTS</b>Three hundred and ninety-four trials were yielded at the initial search. Four trials, recruited 1316 cases of gastric cancer in total, were included after quality assessment. Results of Meta-analysis showed that standard D(2) dissection could effectively improve patients' long-term survival [RR 1.35, 95%CI(1.12-1.62), NNT=9] as compared with D(1) dissection. If splenectomy (or pancreatico-splenectomy) was involved, D(2) dissection only improved the clinical outcome of T(3)-staged cases [RR 1.80,95%CI(1.03-3.15), NNT=13]. D(2) dissection produced higher rates of postoperative complication [RR 1.72,95%CI(1.46-2.03), NNT=6] and mortality [RR 2.12,95%CI(1.39-3.25), NNT=21] than D(1) dissection.</p><p><b>CONCLUSIONS</b>Standard D(2) dissection can increase the overall survival rate when compared with D(1) dissection. If splenectomy (or pancreatico-splenectomy) cases are involved,D(2) dissection can only improve the survival rate of T(3)-staged patients. D(2) dissection yields higher postoperative morbidity and mortality than D(1) dissection.</p>
Texto completo:
DisponíveL
Índice:
WPRIM (Pacífico Ocidental)
Assunto principal:
Neoplasias Gástricas
/
Cirurgia Geral
/
Ensaios Clínicos Controlados Aleatórios como Assunto
/
Taxa de Sobrevida
/
Resultado do Tratamento
/
Gastrectomia
/
Excisão de Linfonodo
/
Métodos
Tipo de estudo:
Ensaio Clínico Controlado
/
Revisões Sistemáticas Avaliadas
Limite:
Humanos
Idioma:
Chinês
Revista:
Chinese Journal of Gastrointestinal Surgery
Ano de publicação:
2007
Tipo de documento:
Artigo
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