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Bursectomy for advanced gastric cancer: an update meta-analysis.


ABSTRACT:

Background

The present meta-analysis was to explore the surgical and oncological outcomes of bursectomy for advanced gastric cancer (AGC).

Methods

Relevant studies that evaluated the role of bursectomy for AGC were comprehensively examined to perform a meta-analysis. The primary outcomes were overall survival (OS) and disease-free survival (DFS). The secondary outcomes were the number of harvested lymph nodes (LNs), operation time, operative bleeding, hospital stay, postoperative complication and mortality.

Results

A total of seven studies comprising 2633 cases (1176 cases in the bursectomy group and 1457 cases in the non-bursectomy group) were finally included. There was no significant difference in OS (HR 0.95, P?=?0.647) and DFS (HR 0.99, P?=?0.936) between the two groups. Even for patients with serosa-penetrating tumours, OS was comparable between the two groups (HR 0.87, P?=?0.356). The operation time of the bursectomy group was longer (weighted mean difference, WMD 32.76 min, P?=?0.002). No significant difference was found between the two groups in terms of the number of dissected LNs (WMD 5.86, P?=?0.157), operative bleeding (WMD 66.99 ml, P?=?0.192) and hospital stay (WMD -?0.15 days, P?=?0.766). The overall postoperative complication (relative risk, RR 1.08, P?=?0.421) and mortality (RR 0.44, P?=?0.195) were similar between two groups.

Conclusions

This meta-analysis indicated that bursectomy is time-consuming without increasing the number of harvested LNs. Although bursectomy can be safely performed without increasing complications and mortality, it does not prolong the OS and DFS of AGC patients, including patients with serosa-penetrating tumours. Therefore, bursectomy should not be recommended as a standard procedure for AGC.

SUBMITTER: Nie RC 

PROVIDER: S-EPMC5872552 | biostudies-literature | 2018 Mar

REPOSITORIES: biostudies-literature

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Bursectomy for advanced gastric cancer: an update meta-analysis.

Nie Run-Cong RC   Yuan Shu-Qiang SQ   Chen Shi S   Yan Shu-Mei SM   Chen Yong-Ming YM   Chen Xiao-Jiang XJ   Chen Guo-Ming GM   Zhou Zhi-Wei ZW   Chen Ying-Bo YB   Li Yuan-Fang YF  

World journal of surgical oncology 20180327 1


<h4>Background</h4>The present meta-analysis was to explore the surgical and oncological outcomes of bursectomy for advanced gastric cancer (AGC).<h4>Methods</h4>Relevant studies that evaluated the role of bursectomy for AGC were comprehensively examined to perform a meta-analysis. The primary outcomes were overall survival (OS) and disease-free survival (DFS). The secondary outcomes were the number of harvested lymph nodes (LNs), operation time, operative bleeding, hospital stay, postoperative  ...[more]

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