Total vs. proximal gastrectomy for proximal gastric cancer: a systematic review and meta-analysis

Hepato-gastroenterology
Lei WenJian-Kun Hu

Abstract

To compare effectiveness between total gastrectomy (TG) and proximal gastrectomy (PG) for proximal gastric cancer. PubMed, Embase, Cochrane library and Chinese CNKI databases were searched to select eligible studies comparing TG to PG for proximal gastric cancer. Outcome measures included overall survival, recurrence, mortality and morbidity rates, as well as nutritional states. Meta-analyses were performed by RevMan 5.0. One randomized controlled trial and 7 retrospective studies involving 1077 patients were included. Meta-analysis showed no significant difference of 5-year overall survival rate (OR=0.89, p=0.53). However, TG achieved a lower recurrence rate (Peto OR=0.53, p=0.004). PG experienced higher morbidity risk (OR=0.11, p<0.00001), concerning higher risks of reflux esophagitis (OR=0.04, p<0.00001) and anastomotic stenosis (OR=0.14, p<0.00001) in a short period. TG performed longer operation time (p=0.002) and more blood loss (p<0.00001). Operative mortality and nutritional states were comparable without significant differences. Based on current retrospective evidences, TG and PG had similar overall survival outcome for proximal gastric cancer, but TG showed lower recurrence rate. PG with gastroesophagostomy had higher...Continue Reading

Citations

Mar 14, 2013·Gastric Cancer : Official Journal of the International Gastric Cancer Association and the Japanese Gastric Cancer Association·Sang-Hoon AhnHyung-Ho Kim
Jan 15, 2014·World Journal of Gastroenterology : WJG·Xin-Zu ChenJian-Kun Hu
Sep 21, 2013·Gastric Cancer : Official Journal of the International Gastric Cancer Association and the Japanese Gastric Cancer Association·Sang-Hoon AhnHyung-Ho Kim
Dec 30, 2014·Indian Journal of Medical and Paediatric Oncology : Official Journal of Indian Society of Medical & Paediatric Oncology·Shailesh V ShrikhandeGoura Shankar Rath
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May 10, 2016·Journal of the American College of Surgeons·Shinji KurodaToshiyoshi Fujiwara
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May 23, 2020·Journal of Gastrointestinal Cancer·Lam Viet TrungNguyen Lam Vuong
Apr 24, 2019·World Journal of Gastroenterology : WJG·Shinichi KinamiTakeo Kosaka
Feb 20, 2019·Gastric Cancer : Official Journal of the International Gastric Cancer Association and the Japanese Gastric Cancer Association·Masahiro YuraTakaki Yoshiaki
May 12, 2017·Langenbeck's Archives of Surgery·Kimitaka TanakaSatoshi Hirano
Oct 12, 2017·Gastroenterology Research and Practice·Yeon-Ju Huh, Joo-Ho Lee

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