TY - JOUR
T1 - Personalized Surgery for Gastric Adenocarcinoma
T2 - A Meta-analysis of D1 versus D2 Lymphadenectomy
AU - El-Sedfy, Abraham
AU - Dixon, Matthew
AU - Seevaratnam, Rajini
AU - Bocicariu, Alina
AU - Cardoso, Roberta
AU - Mahar, Alyson
AU - Kiss, Alex
AU - Helyer, Lucy
AU - Law, Calvin
AU - Coburn, Natalie G.
N1 - Publisher Copyright:
© 2014, Society of Surgical Oncology.
PY - 2015/6/1
Y1 - 2015/6/1
N2 - 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.
AB - 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.
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U2 - 10.1245/s10434-014-4168-6
DO - 10.1245/s10434-014-4168-6
M3 - Article
C2 - 25348779
AN - SCOPUS:84940002039
SN - 1068-9265
VL - 22
SP - 1820
EP - 1827
JO - Annals of Surgical Oncology
JF - Annals of Surgical Oncology
IS - 6
ER -