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D1-plus vs D2 nodal dissection in gastric cancer: a propensity score matched comparison and review of published literature
BACKGROUND: The results of D1-plus lymphadenectomy following gastric resection are seldom investigated. The aim of this study was to compare results of D1-plus vs D2 resections and to provide a literature review. METHODS: Patients who underwent upfront R0 gastrectomy for adenocarcinoma from 2000 to...
Autores principales: | , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7285465/ https://www.ncbi.nlm.nih.gov/pubmed/32522177 http://dx.doi.org/10.1186/s12893-020-00714-x |
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author | Lorenzon, Laura Giudicissi, Rosina Scatizzi, Marco Balducci, Genoveffa Cantafio, Stefano Biondi, Alberto Persiani, Roberto Mercantini, Paolo D’Ugo, Domenico |
author_facet | Lorenzon, Laura Giudicissi, Rosina Scatizzi, Marco Balducci, Genoveffa Cantafio, Stefano Biondi, Alberto Persiani, Roberto Mercantini, Paolo D’Ugo, Domenico |
author_sort | Lorenzon, Laura |
collection | PubMed |
description | BACKGROUND: The results of D1-plus lymphadenectomy following gastric resection are seldom investigated. The aim of this study was to compare results of D1-plus vs D2 resections and to provide a literature review. METHODS: Patients who underwent upfront R0 gastrectomy for adenocarcinoma from 2000 to 2016 in three Institutions were selected using propensity scores and categorized according to lymphadenectomy. Statistical analyses were performed for the nodal harvest (LNH) and survival. Published literature comparing D1-plus and D2 was reviewed and analyzed according to PICO and PRISMA guidelines. RESULTS: Two matched groups of 93 D1-plus and 93 D2 resections were selected. LNH was significantly greater in D2 vs D1-plus dissections (mean 31.2 vs 27.2, p 0.04), however LNH distribution was similar. The cumulative incidence curves for overall survival, disease free and disease specific events did not report significant differences, however Cox regression analysis disclosed that total gastrectomies (HR 1.8; 95% 1.0–2.9), advanced stages (HR 5.9; 95% 3.4–10.3) and D1-plus nodal dissection (HR 2.1; 95% 1.26–3.50) independently correlated with disease free survival. Literature review including 297 D1-plus and 556 D2 lymphadenectomies documented LNH in favor of D2 sub-group (SMD -0.772; 95%CI -1.222- -0.322). CONCLUSION: D2 provided greater LNH than D1-plus dissections; prospective studies should aim to investigate long-term survival of D1-plus lymphadenectomy. |
format | Online Article Text |
id | pubmed-7285465 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-72854652020-06-10 D1-plus vs D2 nodal dissection in gastric cancer: a propensity score matched comparison and review of published literature Lorenzon, Laura Giudicissi, Rosina Scatizzi, Marco Balducci, Genoveffa Cantafio, Stefano Biondi, Alberto Persiani, Roberto Mercantini, Paolo D’Ugo, Domenico BMC Surg Research Article BACKGROUND: The results of D1-plus lymphadenectomy following gastric resection are seldom investigated. The aim of this study was to compare results of D1-plus vs D2 resections and to provide a literature review. METHODS: Patients who underwent upfront R0 gastrectomy for adenocarcinoma from 2000 to 2016 in three Institutions were selected using propensity scores and categorized according to lymphadenectomy. Statistical analyses were performed for the nodal harvest (LNH) and survival. Published literature comparing D1-plus and D2 was reviewed and analyzed according to PICO and PRISMA guidelines. RESULTS: Two matched groups of 93 D1-plus and 93 D2 resections were selected. LNH was significantly greater in D2 vs D1-plus dissections (mean 31.2 vs 27.2, p 0.04), however LNH distribution was similar. The cumulative incidence curves for overall survival, disease free and disease specific events did not report significant differences, however Cox regression analysis disclosed that total gastrectomies (HR 1.8; 95% 1.0–2.9), advanced stages (HR 5.9; 95% 3.4–10.3) and D1-plus nodal dissection (HR 2.1; 95% 1.26–3.50) independently correlated with disease free survival. Literature review including 297 D1-plus and 556 D2 lymphadenectomies documented LNH in favor of D2 sub-group (SMD -0.772; 95%CI -1.222- -0.322). CONCLUSION: D2 provided greater LNH than D1-plus dissections; prospective studies should aim to investigate long-term survival of D1-plus lymphadenectomy. BioMed Central 2020-06-10 /pmc/articles/PMC7285465/ /pubmed/32522177 http://dx.doi.org/10.1186/s12893-020-00714-x Text en © The Author(s) 2020 Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
spellingShingle | Research Article Lorenzon, Laura Giudicissi, Rosina Scatizzi, Marco Balducci, Genoveffa Cantafio, Stefano Biondi, Alberto Persiani, Roberto Mercantini, Paolo D’Ugo, Domenico D1-plus vs D2 nodal dissection in gastric cancer: a propensity score matched comparison and review of published literature |
title | D1-plus vs D2 nodal dissection in gastric cancer: a propensity score matched comparison and review of published literature |
title_full | D1-plus vs D2 nodal dissection in gastric cancer: a propensity score matched comparison and review of published literature |
title_fullStr | D1-plus vs D2 nodal dissection in gastric cancer: a propensity score matched comparison and review of published literature |
title_full_unstemmed | D1-plus vs D2 nodal dissection in gastric cancer: a propensity score matched comparison and review of published literature |
title_short | D1-plus vs D2 nodal dissection in gastric cancer: a propensity score matched comparison and review of published literature |
title_sort | d1-plus vs d2 nodal dissection in gastric cancer: a propensity score matched comparison and review of published literature |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7285465/ https://www.ncbi.nlm.nih.gov/pubmed/32522177 http://dx.doi.org/10.1186/s12893-020-00714-x |
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