Transthoracic resection versus non-transthoracic resection for gastroesophageal junction cancer: a meta-analysis.
BACKGROUND: The aim of this meta-analysis is to evaluate the impact of transthoracic resection on long-term survival of patients with GEJ cancer and to compare the postoperative morbidity and mortality of patients undergoing transthoracic resection with those of patients who were not undergoing tran...
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| Format: | Article |
| Language: | English |
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Public Library of Science (PLoS)
2012-01-01
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| Series: | PLoS ONE |
| Online Access: | http://europepmc.org/articles/PMC3366974?pdf=render |
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| author | Kun Yang Hai-Ning Chen Xin-Zu Chen Qing-Chun Lu Lin Pan Jie Liu Bin Dai Bo Zhang Zhi-Xin Chen Jia-Ping Chen Jian-Kun Hu |
| author_facet | Kun Yang Hai-Ning Chen Xin-Zu Chen Qing-Chun Lu Lin Pan Jie Liu Bin Dai Bo Zhang Zhi-Xin Chen Jia-Ping Chen Jian-Kun Hu |
| author_sort | Kun Yang |
| collection | DOAJ |
| description | BACKGROUND: The aim of this meta-analysis is to evaluate the impact of transthoracic resection on long-term survival of patients with GEJ cancer and to compare the postoperative morbidity and mortality of patients undergoing transthoracic resection with those of patients who were not undergoing transthoracic resection. METHOD: Searches of electronic databases identifying studies from Medline, Cochrane Library trials register, and WHO Trial Registration etc were performed. Outcome measures were survival, postoperative morbidity and mortality, and operation related events. RESULTS: Twelve studies (including 5 RCTs and 7 non-RCTs) comprising 1105 patients were included in this meta-analysis, with 591 patients assigned treatment with transthoracic resection. Transthoracic resection did not increase the 5-y overall survival rate for RCTs and non-RCTs (HR = 1.01, 95% CI 0.80- 1.29 and HR = 0.89, 95% CI 0.70- 1.14, respectively). Stratified by the Siewert classification, our result showed no obvious differences were observed between the group with transthoracic resection and group without transthoracic resection (P>0.05). The postoperative morbidity (RR = 0.69, 95% CI 0.48- 1.00 and OR = 0.55, 95% CI 0.25- 1.22) and mortality (RD = -0.03, 95% CI -0.06- 0.00 and RD = 0.00, 95% CI -0.05- 0.05) of RCTs and non-RCTs did not suggest any significant differences between the two groups. Hospital stay was long with thransthoracic resection (WMD = -5.80, 95% CI -10.38- -1.23) but did not seem to differ in number of harvested lymph nodes, operation time, blood loss, numbers of patients needing transfusion, and reoperation rate. The results of sensitivity analyses were similar to the primary analyses. CONCLUSIONS: There were no significant differences of survival rate and postoperative morbidity and mortality between transthoracic resection group and non-transthoracic resection group. Both surgical approaches are acceptable, and that one offers no clear advantage over the other. However, the results should be interpreted cautiously since the qualities of included studies were suboptimal. |
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| institution | Directory Open Access Journal |
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| language | English |
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| spelling | doaj.art-b265c038b1de451697ac42028a257dc12022-12-21T21:04:40ZengPublic Library of Science (PLoS)PLoS ONE1932-62032012-01-0176e3769810.1371/journal.pone.0037698Transthoracic resection versus non-transthoracic resection for gastroesophageal junction cancer: a meta-analysis.Kun YangHai-Ning ChenXin-Zu ChenQing-Chun LuLin PanJie LiuBin DaiBo ZhangZhi-Xin ChenJia-Ping ChenJian-Kun HuBACKGROUND: The aim of this meta-analysis is to evaluate the impact of transthoracic resection on long-term survival of patients with GEJ cancer and to compare the postoperative morbidity and mortality of patients undergoing transthoracic resection with those of patients who were not undergoing transthoracic resection. METHOD: Searches of electronic databases identifying studies from Medline, Cochrane Library trials register, and WHO Trial Registration etc were performed. Outcome measures were survival, postoperative morbidity and mortality, and operation related events. RESULTS: Twelve studies (including 5 RCTs and 7 non-RCTs) comprising 1105 patients were included in this meta-analysis, with 591 patients assigned treatment with transthoracic resection. Transthoracic resection did not increase the 5-y overall survival rate for RCTs and non-RCTs (HR = 1.01, 95% CI 0.80- 1.29 and HR = 0.89, 95% CI 0.70- 1.14, respectively). Stratified by the Siewert classification, our result showed no obvious differences were observed between the group with transthoracic resection and group without transthoracic resection (P>0.05). The postoperative morbidity (RR = 0.69, 95% CI 0.48- 1.00 and OR = 0.55, 95% CI 0.25- 1.22) and mortality (RD = -0.03, 95% CI -0.06- 0.00 and RD = 0.00, 95% CI -0.05- 0.05) of RCTs and non-RCTs did not suggest any significant differences between the two groups. Hospital stay was long with thransthoracic resection (WMD = -5.80, 95% CI -10.38- -1.23) but did not seem to differ in number of harvested lymph nodes, operation time, blood loss, numbers of patients needing transfusion, and reoperation rate. The results of sensitivity analyses were similar to the primary analyses. CONCLUSIONS: There were no significant differences of survival rate and postoperative morbidity and mortality between transthoracic resection group and non-transthoracic resection group. Both surgical approaches are acceptable, and that one offers no clear advantage over the other. However, the results should be interpreted cautiously since the qualities of included studies were suboptimal.http://europepmc.org/articles/PMC3366974?pdf=render |
| spellingShingle | Kun Yang Hai-Ning Chen Xin-Zu Chen Qing-Chun Lu Lin Pan Jie Liu Bin Dai Bo Zhang Zhi-Xin Chen Jia-Ping Chen Jian-Kun Hu Transthoracic resection versus non-transthoracic resection for gastroesophageal junction cancer: a meta-analysis. PLoS ONE |
| title | Transthoracic resection versus non-transthoracic resection for gastroesophageal junction cancer: a meta-analysis. |
| title_full | Transthoracic resection versus non-transthoracic resection for gastroesophageal junction cancer: a meta-analysis. |
| title_fullStr | Transthoracic resection versus non-transthoracic resection for gastroesophageal junction cancer: a meta-analysis. |
| title_full_unstemmed | Transthoracic resection versus non-transthoracic resection for gastroesophageal junction cancer: a meta-analysis. |
| title_short | Transthoracic resection versus non-transthoracic resection for gastroesophageal junction cancer: a meta-analysis. |
| title_sort | transthoracic resection versus non transthoracic resection for gastroesophageal junction cancer a meta analysis |
| url | http://europepmc.org/articles/PMC3366974?pdf=render |
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