Meta-analysis of D1 versus D2 gastrectomy for gastric adenocarcinoma
Paper
Paper/Presentation Title | Meta-analysis of D1 versus D2 gastrectomy for gastric adenocarcinoma |
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Presentation Type | Paper |
Authors | Subramanya, Manjunath S. (Author), Hossain, Md. Belal (Author), Khan, Shahjahan (Author), Memon, Breda (Author) and Memon, Muhammed A. (Author) |
Editors | Amin, Zeinab and Hadi, Ali S. |
Journal or Proceedings Title | Proceedings of the 10th Islamic Countries Conference on Statistical Sciences |
Journal Citation | 1, pp. 140-147 |
Number of Pages | 8 |
Year | 2010 |
Place of Publication | Lahore, Pakistan |
ISBN | 9789774163658 |
Web Address (URL) of Paper | https://old.isoss.net/downloads/ProcICCSX-1.pdf |
Web Address (URL) of Conference Proceedings | https://isoss.net/organization-2/ |
Conference/Event | 10th Islamic Countries Conference on Statistical Sciences |
Event Details | 10th Islamic Countries Conference on Statistical Sciences Parent Islamic Countries Conference on Statistical Sciences (ICCS) Delivery In person Event Date 20 to end of 23 Dec 2009 Event Location Cairo, Egypt |
Abstract | Objectives: To conduct a meta-analysis of randomized controlled trials evaluating the relative merits of limited (D1) versus extended lymphadenectomy (D2) for proven gastric adenocarcinoma. Data Sources and Review Methods: A search of Cochrane, Medline, PubMed, Embase, Science Citation Index and Current Contents electronic databases identified randomized Results: Six trials totalling 1876 patients (D1=946, D2=930) were analyzed. In five out of the six outcomes the summary point estimates favoured D1 over D2 group with a statistically significant reduction of (i) 7.12 days reduction in hospital stay (WMD -7.12, CI -12.90, -1.35, p=0.0001); (ii) 58% reduction in relative odds of developing postoperative complications (OR 0.42, CI 0.24, 0.71, p=0.0014); (iii) 59% reduction in anastomotic breakdown (OR 0.41, CI 0.26, 0.65, p=0.0002); 67% reduction in re-operation rate (OR 0.33, CI 0.15, 0.72, p=0.006) and 42% reduction in 30 day mortality rate (OR 0.58, CI 0.4, 0.85, p=0.0052). Lastly there was no significant difference in the 5 year survival (OR 0.97, CI 0.78, 1.20, p=0.76) between D1 and D2 gastrectomy patients. Conclusions: Based on this meta-analysis, D1 gastrectomy is associated with significant fewer anastomotic leaks, postoperative complication rate, reoperation rate, decreased length of hospital stay and 30 day mortality rate. Lastly the five year survival in D1 gastrectomy patients was similar to the D2 cohort. |
Keywords | D1 gastrectomy; D2 gastrectomy; gastric cancer; lymphadenectomy; metaanalysis; randomized controlled trials; patient's outcome; postoperative complications |
ANZSRC Field of Research 2020 | 320209. Gastroenterology and hepatology |
Byline Affiliations | Department of Health, Queensland |
Department of Mathematics and Computing | |
University of Queensland |
https://research.usq.edu.au/item/q036v/meta-analysis-of-d1-versus-d2-gastrectomy-for-gastric-adenocarcinoma
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Subramanya_Hossain_Khan_Memon_Memon_2_PV.pdf | ||
License: CC BY-NC 4.0 | ||
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