Multivisceral Resection for Locally Advanced Gastric Cancer: A Systematic Review and Evidence Quality Assessment
Patients with locally advanced gastric cancer (LAGC) often require multivisceral resection (MVR) of the involved organs to achieve R0 resection and local disease control. The aim of the present study was to systematically review all available literature on the postoperative and long-term outcomes of...
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| Format: | Article |
| Language: | English |
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MDPI AG
2023-11-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/12/23/7360 |
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| author | Dimitrios Schizas Ilias Giannakodimos Konstantinos S. Mylonas Emmanouil I. Kapetanakis Alexandra Papavgeri Georgios D. Lianos Dionysios Dellaportas Aikaterini Mastoraki Andreas Alexandrou |
| author_facet | Dimitrios Schizas Ilias Giannakodimos Konstantinos S. Mylonas Emmanouil I. Kapetanakis Alexandra Papavgeri Georgios D. Lianos Dionysios Dellaportas Aikaterini Mastoraki Andreas Alexandrou |
| author_sort | Dimitrios Schizas |
| collection | DOAJ |
| description | Patients with locally advanced gastric cancer (LAGC) often require multivisceral resection (MVR) of the involved organs to achieve R0 resection and local disease control. The aim of the present study was to systematically review all available literature on the postoperative and long-term outcomes of MVR for gastric cancer. The PubMed database was systematically searched by two independent investigators for studies concerning MVR for LAGC. In total, 30 original studies with 3362 patients met our inclusion criteria. R0 resection was achieved in 67.77% (95% CI, 65.75–69.73%) of patients. The spleen, colon and pancreas comprised the most frequently resected organs in the context of MVR. Pancreatic fistulae (10.08%, 95% CI, 7.99–12.63%), intraabdominal abscesses (9.92%, 95% CI, 7.85–12.46%) and anastomotic leaks (8.09%, 95% CI, 6.23–10.45%) constituted the most common postoperative complications. Using the available data, we estimated the mean 1-year survival at 62.2%, 3-year survival at 33.05%, and 5-year survival at 30.21% for the entire cohort. The survival rates were mainly correlated with lymphatic invasion, tumor size and patient age. Therefore, gastrectomy, together with MVR, is feasible and may offer a survival advantage compared to gastrectomy alone or no other surgical treatment in a selected group of patients. Consequently, both patient and tumor characteristics should be carefully assessed to optimize candidate selection. |
| first_indexed | 2024-03-09T01:48:12Z |
| format | Article |
| id | doaj.art-b56f9f9859af4b788944fba2600f79a3 |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-09T01:48:12Z |
| publishDate | 2023-11-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-b56f9f9859af4b788944fba2600f79a32023-12-08T15:19:37ZengMDPI AGJournal of Clinical Medicine2077-03832023-11-011223736010.3390/jcm12237360Multivisceral Resection for Locally Advanced Gastric Cancer: A Systematic Review and Evidence Quality AssessmentDimitrios Schizas0Ilias Giannakodimos1Konstantinos S. Mylonas2Emmanouil I. Kapetanakis3Alexandra Papavgeri4Georgios D. Lianos5Dionysios Dellaportas6Aikaterini Mastoraki7Andreas Alexandrou8First Department of Surgery, “Laikon” General Hospital, National and Kapodistrian University of Athens, 115 27 Athens, GreeceFirst Department of Surgery, “Laikon” General Hospital, National and Kapodistrian University of Athens, 115 27 Athens, GreeceFirst Department of Surgery, “Laikon” General Hospital, National and Kapodistrian University of Athens, 115 27 Athens, GreeceDepartment of Thoracic Surgery, “Attikon” University Hospital, National and Kapodistrian University of Athens, 124 62 Athens, GreeceFirst Department of Surgery, “Laikon” General Hospital, National and Kapodistrian University of Athens, 115 27 Athens, GreeceDepartment of Surgery, University Hospital of Ioannina, 451 10 Ioannina, GreeceThird Department of Surgery, “Attikon” University Hospital, National and Kapodistrian University of Athens, 124 62 Athens, GreeceFirst Department of Surgery, “Laikon” General Hospital, National and Kapodistrian University of Athens, 115 27 Athens, GreeceFirst Department of Surgery, “Laikon” General Hospital, National and Kapodistrian University of Athens, 115 27 Athens, GreecePatients with locally advanced gastric cancer (LAGC) often require multivisceral resection (MVR) of the involved organs to achieve R0 resection and local disease control. The aim of the present study was to systematically review all available literature on the postoperative and long-term outcomes of MVR for gastric cancer. The PubMed database was systematically searched by two independent investigators for studies concerning MVR for LAGC. In total, 30 original studies with 3362 patients met our inclusion criteria. R0 resection was achieved in 67.77% (95% CI, 65.75–69.73%) of patients. The spleen, colon and pancreas comprised the most frequently resected organs in the context of MVR. Pancreatic fistulae (10.08%, 95% CI, 7.99–12.63%), intraabdominal abscesses (9.92%, 95% CI, 7.85–12.46%) and anastomotic leaks (8.09%, 95% CI, 6.23–10.45%) constituted the most common postoperative complications. Using the available data, we estimated the mean 1-year survival at 62.2%, 3-year survival at 33.05%, and 5-year survival at 30.21% for the entire cohort. The survival rates were mainly correlated with lymphatic invasion, tumor size and patient age. Therefore, gastrectomy, together with MVR, is feasible and may offer a survival advantage compared to gastrectomy alone or no other surgical treatment in a selected group of patients. Consequently, both patient and tumor characteristics should be carefully assessed to optimize candidate selection.https://www.mdpi.com/2077-0383/12/23/7360gastric cancergastrectomylocally advancedmultivisceral resectionsystematic review |
| spellingShingle | Dimitrios Schizas Ilias Giannakodimos Konstantinos S. Mylonas Emmanouil I. Kapetanakis Alexandra Papavgeri Georgios D. Lianos Dionysios Dellaportas Aikaterini Mastoraki Andreas Alexandrou Multivisceral Resection for Locally Advanced Gastric Cancer: A Systematic Review and Evidence Quality Assessment Journal of Clinical Medicine gastric cancer gastrectomy locally advanced multivisceral resection systematic review |
| title | Multivisceral Resection for Locally Advanced Gastric Cancer: A Systematic Review and Evidence Quality Assessment |
| title_full | Multivisceral Resection for Locally Advanced Gastric Cancer: A Systematic Review and Evidence Quality Assessment |
| title_fullStr | Multivisceral Resection for Locally Advanced Gastric Cancer: A Systematic Review and Evidence Quality Assessment |
| title_full_unstemmed | Multivisceral Resection for Locally Advanced Gastric Cancer: A Systematic Review and Evidence Quality Assessment |
| title_short | Multivisceral Resection for Locally Advanced Gastric Cancer: A Systematic Review and Evidence Quality Assessment |
| title_sort | multivisceral resection for locally advanced gastric cancer a systematic review and evidence quality assessment |
| topic | gastric cancer gastrectomy locally advanced multivisceral resection systematic review |
| url | https://www.mdpi.com/2077-0383/12/23/7360 |
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