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Efficiency of complete omentectomy in patients with resectable gastric cancer: a meta‑analysis and systematic review

BACKGROUND: We performed a meta-analysis to investigate the efficacy of complete omentectomy (CO) in patients undergoing radical gastrectomy for gastric cancer. METHODS: We conducted a literature search in PubMed, Web of Science, and the Cochrane Library databases for clinical research that compared...

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Autores principales: Zhu, Akao, Yin, Guang, Liu, Xinchun, Kong, Wencheng, Zhang, Yu, Shan, Yuqiang, Ying, Rongchao, Zhang, Jian, Zhou, Chunhua
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8439052/
https://www.ncbi.nlm.nih.gov/pubmed/34521366
http://dx.doi.org/10.1186/s12876-021-01921-3
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author Zhu, Akao
Yin, Guang
Liu, Xinchun
Kong, Wencheng
Zhang, Yu
Shan, Yuqiang
Ying, Rongchao
Zhang, Jian
Zhou, Chunhua
author_facet Zhu, Akao
Yin, Guang
Liu, Xinchun
Kong, Wencheng
Zhang, Yu
Shan, Yuqiang
Ying, Rongchao
Zhang, Jian
Zhou, Chunhua
author_sort Zhu, Akao
collection PubMed
description BACKGROUND: We performed a meta-analysis to investigate the efficacy of complete omentectomy (CO) in patients undergoing radical gastrectomy for gastric cancer. METHODS: We conducted a literature search in PubMed, Web of Science, and the Cochrane Library databases for clinical research that compared CO with non-complete omentectomy (NCO). These articles were published prior to April 2021. Overall survival (OS) rates, relapse-free survival (RFS) rates, recurrence rates, operation times, estimates of blood loss, numbers of harvested lymph nodes, complications, and lengths of hospital stays were compared using relative risks (RRs) and weighted mean differences (WMDs). RevMan 5.3 software was used for statistical analysis. RESULTS: Nine studies that included 3329 patients (1960 in the CO group) and 1369 in the NCO group comprised the analysis. The meta-analysis showed that CO was associated with a decreased 3-year OS rate (RR = 0.94, 95% CI 0.90–0.98, P = 0.005) and 5-year OS rate (RR = 0.93, 95% CI 0.88–0.98, P = 0.007). However, it was not associated with the 3-year RFS rate (RR = 0.97, 95% CI 0.90–1.04, P = 0.44), 5-year RFS (RR = 0.98, 95% CI 0.90–1.06, P = 0.60), or recurrence rate (RR = 1.17, 95% CI 0.95–1.45, P = 0.15) compared to the NCO group. For surgical-related outcomes, significant heterogeneity existed between the studies. Compared to the NCO group, CO was found to be associated with significantly more estimated blood loss (WMD = 250.90, 95% CI 105.90–396.28, P = 0.0007) and less harvested lymph nodes (WMD = − 3.59, 95% CI − 6.88, − 0.29, P = 0.03). Although, there was no significant difference in the surgical time (WMD = 15.93, 95% CI − 0.21, 32.07, P = 0.05). No statistically significant differences were observed in the rates of overall (P = 0.79) and major complications (P = 0.90), or the lengths of hospital stays (P = 0.11) between the two groups. CONCLUSIONS: Based on the available evidence, CO is not superior to NCO in terms of survival. CO is not recommended as a routine surgery for gastric cancer. Future well-designed high-quality RCTs are warranted. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12876-021-01921-3.
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spelling pubmed-84390522021-09-14 Efficiency of complete omentectomy in patients with resectable gastric cancer: a meta‑analysis and systematic review Zhu, Akao Yin, Guang Liu, Xinchun Kong, Wencheng Zhang, Yu Shan, Yuqiang Ying, Rongchao Zhang, Jian Zhou, Chunhua BMC Gastroenterol Research BACKGROUND: We performed a meta-analysis to investigate the efficacy of complete omentectomy (CO) in patients undergoing radical gastrectomy for gastric cancer. METHODS: We conducted a literature search in PubMed, Web of Science, and the Cochrane Library databases for clinical research that compared CO with non-complete omentectomy (NCO). These articles were published prior to April 2021. Overall survival (OS) rates, relapse-free survival (RFS) rates, recurrence rates, operation times, estimates of blood loss, numbers of harvested lymph nodes, complications, and lengths of hospital stays were compared using relative risks (RRs) and weighted mean differences (WMDs). RevMan 5.3 software was used for statistical analysis. RESULTS: Nine studies that included 3329 patients (1960 in the CO group) and 1369 in the NCO group comprised the analysis. The meta-analysis showed that CO was associated with a decreased 3-year OS rate (RR = 0.94, 95% CI 0.90–0.98, P = 0.005) and 5-year OS rate (RR = 0.93, 95% CI 0.88–0.98, P = 0.007). However, it was not associated with the 3-year RFS rate (RR = 0.97, 95% CI 0.90–1.04, P = 0.44), 5-year RFS (RR = 0.98, 95% CI 0.90–1.06, P = 0.60), or recurrence rate (RR = 1.17, 95% CI 0.95–1.45, P = 0.15) compared to the NCO group. For surgical-related outcomes, significant heterogeneity existed between the studies. Compared to the NCO group, CO was found to be associated with significantly more estimated blood loss (WMD = 250.90, 95% CI 105.90–396.28, P = 0.0007) and less harvested lymph nodes (WMD = − 3.59, 95% CI − 6.88, − 0.29, P = 0.03). Although, there was no significant difference in the surgical time (WMD = 15.93, 95% CI − 0.21, 32.07, P = 0.05). No statistically significant differences were observed in the rates of overall (P = 0.79) and major complications (P = 0.90), or the lengths of hospital stays (P = 0.11) between the two groups. CONCLUSIONS: Based on the available evidence, CO is not superior to NCO in terms of survival. CO is not recommended as a routine surgery for gastric cancer. Future well-designed high-quality RCTs are warranted. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12876-021-01921-3. BioMed Central 2021-09-14 /pmc/articles/PMC8439052/ /pubmed/34521366 http://dx.doi.org/10.1186/s12876-021-01921-3 Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/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/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://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
Zhu, Akao
Yin, Guang
Liu, Xinchun
Kong, Wencheng
Zhang, Yu
Shan, Yuqiang
Ying, Rongchao
Zhang, Jian
Zhou, Chunhua
Efficiency of complete omentectomy in patients with resectable gastric cancer: a meta‑analysis and systematic review
title Efficiency of complete omentectomy in patients with resectable gastric cancer: a meta‑analysis and systematic review
title_full Efficiency of complete omentectomy in patients with resectable gastric cancer: a meta‑analysis and systematic review
title_fullStr Efficiency of complete omentectomy in patients with resectable gastric cancer: a meta‑analysis and systematic review
title_full_unstemmed Efficiency of complete omentectomy in patients with resectable gastric cancer: a meta‑analysis and systematic review
title_short Efficiency of complete omentectomy in patients with resectable gastric cancer: a meta‑analysis and systematic review
title_sort efficiency of complete omentectomy in patients with resectable gastric cancer: a meta‑analysis and systematic review
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8439052/
https://www.ncbi.nlm.nih.gov/pubmed/34521366
http://dx.doi.org/10.1186/s12876-021-01921-3
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