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Laparoscopic gastrectomy for advanced gastric cancer: Are the long‐term results comparable with conventional open gastrectomy? A systematic review and meta‐analysis
Author(s) -
Choi Yoon Young,
Bae Jung Min,
An Ji Yeong,
Hyung Woo Jin,
Noh Sung Hoon
Publication year - 2013
Publication title -
journal of surgical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.201
H-Index - 111
eISSN - 1096-9098
pISSN - 0022-4790
DOI - 10.1002/jso.23438
Subject(s) - medicine , gastrectomy , hazard ratio , meta analysis , cancer , confidence interval , randomized controlled trial , gastroenterology , laparoscopy , surgery
Background and Objective Laparoscopic gastrectomy (LG) for gastric cancer has been adopted to treat both early and locally advanced gastric cancer (AGC), but there are still concerns about its oncologic safety especially in AGC. The purpose of this meta‐analysis is to compare the long‐term outcomes of LG with those of open gastrectomy (OG) in patients with AGC. Methods The quantitative synthesis of outcomes of studies from three major databases, PubMed, Embase, and the Cochrane Central, was performed using common keywords related to gastric cancer and laparoscopy on July 31, 2012. Results Ten studies (one randomized controlled trial and nine retrospective cohort studies) with 1,819 participants (960 patients in OG, and 859 patients in LG) were included in the current meta‐analysis. Nine studies compared the overall survival rate between LG and OG for AGC, and five studies reported the disease‐free survival. There was no statistical difference in overall survival (hazard ratio [HR]: 0.90, 95% confidence interval [CI]: 0.76–1.06, P = 0.22) and disease‐free survival (HR: 1.03, 95% CI: 0.76–1.40, P = 0.86) between the two modalities. Conclusions The current clinical evidence revealed that there was no evidence that LG is inferior to OG even for AGC if the surgeons have sufficient experience. J. Surg. Oncol. 2013; 108:550–556 . © 2013 Wiley Periodicals, Inc.