Format

Send to

Choose Destination
Int J Clin Exp Med. 2015 Aug 15;8(8):13657-69. eCollection 2015.

Surgical interventions for gastric cancer: a review of systematic reviews.

Author information

1
Department of Gastrointestinal and Pancreatic Surgery, Centre of Gastric Cancer, The First Affiliated Hospital, Sun Yat-sen University Guangzhou 510080, Guangdong Province, P. R. China.
2
Musculoskeletal Center, Department of Orthopaedic Surgery, The First Affiliated Hospital, Sun Yat-sen University Guangzhou City 510080, Guangdong Province, China.
3
Department of Endocrinology, The First Affiliated Hospital of Sun Yat-sen University Guangzhou City 510080, Guangdong Province, China.
4
Department of Molecular & Medical Genetics, Oregon Health & Science University 3181 S.W. Sam Jackson Park Rd. Portland, Oregon 97239, USA.
5
The Sixth Affiliated Hospital of Sun Yat-sen University Guangzhou City 510080, Guangdong Province, China.
6
The First Affiliated Hospital, Guangzhou University of Chinese Medicine Guangzhou 510405, Guangdong Province, P. R. China.
7
Department of Pathology, The First Affiliated Hospital, Sun Yat-sen University Guangzhou 510080, Guangdong Province, China.
8
School of Basic Medical Sciences, Guangzhou University of Chinese Medicine, Guangzhou Higher Education Mega Center Guangzhou 510006, Guangdong Province, P. R. China.

Abstract

AIM:

To evaluate methodological quality and the extent of concordance among meta-analysis and/or systematic reviews on surgical interventions for gastric cancer (GC).

METHODS:

A comprehensive search of PubMed, Medline, EMBASE, the Cochrane library and the DARE database was conducted to identify the reviews comparing different surgical interventions for GC prior to April 2014. After applying included criteria, available data were summarized and appraised by the Oxman and Guyatt scale.

RESULTS:

Fifty six reviews were included. Forty five reviews (80.4%) were well conducted, with scores of adapted Oxman and Guyatt scale ≥ 14. The reviews differed in criteria for avoiding bias and assessing the validity of the primary studies. Many primary studies displayed major methodological flaws, such as randomization, allocation concealment, and dropouts and withdrawals. According to the concordance assessment, laparoscopy-assisted gastrectomy (LAG) was superior to open gastrectomy, and laparoscopy-assisted distal gastrectomy was superior to open distal gastrectomy in short-term outcomes. However, the concordance regarding other surgical interventions, such as D1 vs. D2 lymphadenectomy, and robotic gastrectomy vs. LAG were absent.

CONCLUSION:

Systematic reviews on surgical interventions for GC displayed relatively high methodological quality. The improvement of methodological quality and reporting was necessary for primary studies. The superiority of laparoscopic over open surgery was demonstrated. But concordance on other surgical interventions was rare, which needed more well-designed RCTs and systematic reviews.

KEYWORDS:

Gastric cancer; meta-analysis; methodological quality; surgical intervention; systematic review

PMID:
26550311
PMCID:
PMC4612996

Supplemental Content

Full text links

Icon for PubMed Central
Loading ...
Support Center