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The Survival Benefit and Safety of Splenectomy for Gastric Cancer With Total Gastrectomy: Updated Results(†)
BACKGROUND: Splenectomy was traditionally performed to dissect the splenic hilar lymph nodes. Considering the important functions of spleen, whether splenectomy would bring beneficial to gastric cancer patients is debatable. This meta-analysis aimed to make an updated evaluation on the effectiveness...
Autores principales: | , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Frontiers Media S.A.
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7873941/ https://www.ncbi.nlm.nih.gov/pubmed/33585191 http://dx.doi.org/10.3389/fonc.2020.568872 |
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author | Yang, Kun Zang, Zhi-Yun Niu, Kai-Fan Sun, Li-Fei Zhang, Wei-Han Zhang, Yue-Xin Chen, Xiao-Long Zhou, Zong-Guang Hu, Jian-Kun |
author_facet | Yang, Kun Zang, Zhi-Yun Niu, Kai-Fan Sun, Li-Fei Zhang, Wei-Han Zhang, Yue-Xin Chen, Xiao-Long Zhou, Zong-Guang Hu, Jian-Kun |
author_sort | Yang, Kun |
collection | PubMed |
description | BACKGROUND: Splenectomy was traditionally performed to dissect the splenic hilar lymph nodes. Considering the important functions of spleen, whether splenectomy would bring beneficial to gastric cancer patients is debatable. This meta-analysis aimed to make an updated evaluation on the effectiveness and safety of splenectomy. METHODS: Literature searches were performed to identify eligible RCTs concerning effectiveness or safety of splenectomy with gastrectomy from PubMed, MEDLINE, CBMdisc, EMBASE, and Cochrane Central Register of Controlled Trials. Two reviewers completed the study selection, data extraction, and quality assessment independently. The meta-analyses were performed by RevMan 5.3. RESULTS: A total of 971 patients from four studies were included (485 in splenectomy group and 486 in spleen preservation group). Splenectomy did not increase 5-year overall survival rate (RR=1.05, 95% CI: 0.96, 1.16) or increase postoperative mortality (RR=1.21, 95% CI: 0.41, 3.54). However, the analysis demonstrated that gastrectomy with splenectomy had significantly higher incidence of postoperative complications (RR=1.80, 95% CI: 1.33, 2.45). No significant differences were found in terms of the number of resected lymph nodes and reoperation rate; however, splenectomy had a tendency to prolong the duration of surgery and hospital stays. Subgroup analyses indicated that splenectomy could not increase overall survival rate for either whole or proximal gastric cancer. Sensitivity analyses also found similar results compared to the primary analyses. CONCLUSIONS: Splenectomy cannot benefit the survival of patients with tumor located at lesser curvature, and it could instead increase postoperative morbidity. |
format | Online Article Text |
id | pubmed-7873941 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Frontiers Media S.A. |
record_format | MEDLINE/PubMed |
spelling | pubmed-78739412021-02-11 The Survival Benefit and Safety of Splenectomy for Gastric Cancer With Total Gastrectomy: Updated Results(†) Yang, Kun Zang, Zhi-Yun Niu, Kai-Fan Sun, Li-Fei Zhang, Wei-Han Zhang, Yue-Xin Chen, Xiao-Long Zhou, Zong-Guang Hu, Jian-Kun Front Oncol Oncology BACKGROUND: Splenectomy was traditionally performed to dissect the splenic hilar lymph nodes. Considering the important functions of spleen, whether splenectomy would bring beneficial to gastric cancer patients is debatable. This meta-analysis aimed to make an updated evaluation on the effectiveness and safety of splenectomy. METHODS: Literature searches were performed to identify eligible RCTs concerning effectiveness or safety of splenectomy with gastrectomy from PubMed, MEDLINE, CBMdisc, EMBASE, and Cochrane Central Register of Controlled Trials. Two reviewers completed the study selection, data extraction, and quality assessment independently. The meta-analyses were performed by RevMan 5.3. RESULTS: A total of 971 patients from four studies were included (485 in splenectomy group and 486 in spleen preservation group). Splenectomy did not increase 5-year overall survival rate (RR=1.05, 95% CI: 0.96, 1.16) or increase postoperative mortality (RR=1.21, 95% CI: 0.41, 3.54). However, the analysis demonstrated that gastrectomy with splenectomy had significantly higher incidence of postoperative complications (RR=1.80, 95% CI: 1.33, 2.45). No significant differences were found in terms of the number of resected lymph nodes and reoperation rate; however, splenectomy had a tendency to prolong the duration of surgery and hospital stays. Subgroup analyses indicated that splenectomy could not increase overall survival rate for either whole or proximal gastric cancer. Sensitivity analyses also found similar results compared to the primary analyses. CONCLUSIONS: Splenectomy cannot benefit the survival of patients with tumor located at lesser curvature, and it could instead increase postoperative morbidity. Frontiers Media S.A. 2021-01-07 /pmc/articles/PMC7873941/ /pubmed/33585191 http://dx.doi.org/10.3389/fonc.2020.568872 Text en Copyright © 2021 Yang, Zang, Niu, Sun, Zhang, Zhang, Chen, Zhou and Hu http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. |
spellingShingle | Oncology Yang, Kun Zang, Zhi-Yun Niu, Kai-Fan Sun, Li-Fei Zhang, Wei-Han Zhang, Yue-Xin Chen, Xiao-Long Zhou, Zong-Guang Hu, Jian-Kun The Survival Benefit and Safety of Splenectomy for Gastric Cancer With Total Gastrectomy: Updated Results(†) |
title | The Survival Benefit and Safety of Splenectomy for Gastric Cancer With Total Gastrectomy: Updated Results(†) |
title_full | The Survival Benefit and Safety of Splenectomy for Gastric Cancer With Total Gastrectomy: Updated Results(†) |
title_fullStr | The Survival Benefit and Safety of Splenectomy for Gastric Cancer With Total Gastrectomy: Updated Results(†) |
title_full_unstemmed | The Survival Benefit and Safety of Splenectomy for Gastric Cancer With Total Gastrectomy: Updated Results(†) |
title_short | The Survival Benefit and Safety of Splenectomy for Gastric Cancer With Total Gastrectomy: Updated Results(†) |
title_sort | survival benefit and safety of splenectomy for gastric cancer with total gastrectomy: updated results(†) |
topic | Oncology |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7873941/ https://www.ncbi.nlm.nih.gov/pubmed/33585191 http://dx.doi.org/10.3389/fonc.2020.568872 |
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