Survival benefits of gastrectomy in patients with metastatic gastric cancer: A meta-analysis.

IF 2.1 4区医学 Q3 MEDICINE, RESEARCH & EXPERIMENTAL

Advances in Clinical and Experimental Medicine Pub Date : 2024-06-11 DOI:10.17219/acem/184268

Lifan Chen, Yu Chen

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引用次数: 0

Abstract

Background: Individuals with metastatic gastric cancer (MGC) are incurable and have a poor prognosis. To date, surgical resection with curative intent is the only treatment providing hope for a cure, but the role of surgical resection is still controversial.

Objectives: To assess the effects of gastrectomy compared to non-resection on MGC patient survival.

Material and methods: PubMed, Embase, Cochrane Library, and Web of Science databases were searched up to October 10, 2023. Primary outcomes were 1-, 2-, 3-, and 5-year overall survival (OS), OS, and OS time.

Results: Forty-six studies with 7,152 MGC patients were included. Compared to MGC patients receiving no resection, MGC patients with gastrectomy had significantly improved 1-year OS (pooled relative risk (RR):1.90, 95% confidence intervals (95% CIs): 1.50, 2.41), 2-year OS (pooled RR: 2.23, 95% CI: 1.40, 3.53), 3-year OS (pooled RR: 6.09, 95% CI: 3.12, 11.87), 5-year OS (pooled RR: 4.30, 95% CI: 1.35, 13.74), and reduced risk of death (pooled hazard ratio (HR): 0.49, 95% CI: 0.37, 0.65). Gastrectomy combined with metastasectomy or not also revealed similar results regarding OS and risk of death. Additionally, OS time was significantly longer in patients receiving gastrectomy than patients not receiving resection (pooled weighted mean difference (WMD): 6.06, 95% CI: 1.36, 10.760). No significant difference in postoperative morbidity was detected between the patients receiving gastrectomy and patients not receiving resection (pooled RR: 2.54, 95% CI: 0.13, 51.39).

Conclusion: Gastrectomy, with or metastasectomy, may provide MGC patients with survival benefits.

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胃切除术对转移性胃癌患者生存的益处：荟萃分析

背景转移性胃癌（MGC）患者无法治愈，预后较差。迄今为止，治愈性手术切除是唯一有希望治愈的治疗方法，但手术切除的作用仍存在争议：材料与方法：PubMed、Embase、Co.....：检索了截至 2023 年 10 月 10 日的 PubMed、Embase、Cochrane Library 和 Web of Science 数据库。主要结果为1年、2年、3年和5年总生存率（OS）、OS和OS时间：结果：共纳入46项研究，涉及7152名MGC患者。与未接受切除术的MGC患者相比，接受胃切除术的MGC患者的1年OS（汇总相对风险（RR）：1.90，95%置信区间（95% CI）：1.50，2.41）、2年OS（汇总RR：2.23，95% CI：1.40，3.53），3 年 OS（汇总 RR：6.09，95% CI：3.12，11.87），5 年 OS（汇总 RR：4.30，95% CI：1.35，13.74），死亡风险降低（汇总危险比（HR）：0.49，95% CI：0.37，0.65）。胃切除术是否合并转移灶切除术也显示了类似的OS和死亡风险结果。此外，接受胃切除术的患者的OS时间明显长于未接受切除术的患者（汇总加权平均差（WMD）：6.06，95% CI：1.36，10.760）。接受胃切除术的患者与未接受胃切除术的患者在术后发病率方面无明显差异（汇总RR：2.54，95% CI：0.13，51.39）：结论：胃切除术和转移灶切除术可为MGC患者带来生存益处。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Advances in Clinical and Experimental Medicine MEDICINE, RESEARCH & EXPERIMENTAL-

CiteScore

3.70

自引率

4.80%

发文量

153

审稿时长

6-12 weeks

期刊介绍： Advances in Clinical and Experimental Medicine has been published by the Wroclaw Medical University since 1992. Establishing the medical journal was the idea of Prof. Bogumił Halawa, Chair of the Department of Cardiology, and was fully supported by the Rector of Wroclaw Medical University, Prof. Zbigniew Knapik. Prof. Halawa was also the first editor-in-chief, between 1992-1997. The journal, then entitled "Postępy Medycyny Klinicznej i Doświadczalnej", appeared quarterly. Prof. Leszek Paradowski was editor-in-chief from 1997-1999. In 1998 he initiated alterations in the profile and cover design of the journal which were accepted by the Editorial Board. The title was changed to Advances in Clinical and Experimental Medicine. Articles in English were welcomed. A number of outstanding representatives of medical science from Poland and abroad were invited to participate in the newly established International Editorial Staff. Prof. Antonina Harłozińska-Szmyrka was editor-in-chief in years 2000-2005, in years 2006-2007 once again prof. Leszek Paradowski and prof. Maria Podolak-Dawidziak was editor-in-chief in years 2008-2016. Since 2017 the editor-in chief is prof. Maciej Bagłaj. Since July 2005, original papers have been published only in English. Case reports are no longer accepted. The manuscripts are reviewed by two independent reviewers and a statistical reviewer, and English texts are proofread by a native speaker. The journal has been indexed in several databases: Scopus, Ulrich’sTM International Periodicals Directory, Index Copernicus and since 2007 in Thomson Reuters databases: Science Citation Index Expanded i Journal Citation Reports/Science Edition. In 2010 the journal obtained Impact Factor which is now 1.179 pts. Articles published in the journal are worth 15 points among Polish journals according to the Polish Committee for Scientific Research and 169.43 points according to the Index Copernicus. Since November 7, 2012, Advances in Clinical and Experimental Medicine has been indexed and included in National Library of Medicine’s MEDLINE database. English abstracts printed in the journal are included and searchable using PubMed http://www.ncbi.nlm.nih.gov/pubmed.