Evidence map›Paper›PMID 37261563›Full record

SynthesisAnnals of surgical oncology2023

Minimally Invasive and Open Gastrectomy for Gastric Cancer: A Systematic Review and Network Meta-Analysis of Randomized Clinical Trials.

Matthew G Davey, Hugo C Temperley, Niall J O'Sullivan, Vianka Marcelino, Odhrán K Ryan, Éanna J Ryan, Noel E Donlon, Sean M Johnston, William B Robb

Abstract readSystematic ReviewNetwork Meta-Analysis
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Annals of surgical oncology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers, 5 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
24citing papers in PubMed, 5 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

24 citing papers in PubMed, 5 syntheses or guidelines pooled it.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Matthew G DaveyDepartment of Surgery, Royal College of Surgeons in Ireland, Dublin 2, Republic of Ireland. matthewdavey21@rcsi.com.ORCID http://orcid.org/0000-0002-9892-9920
Hugo C TemperleyDepartment of Surgery, Trinity St. James's Cancer Institute, Trinity, St. James's Hospital, Trinity College Dublin, Dublin, Republic of Ireland.
Niall J O'SullivanDepartment of Surgery, Tallaght University Hospital, Dublin, Republic of Ireland.
Vianka MarcelinoDepartment of Surgery, St. Vincent's University Hospital, Dublin, Republic of Ireland.
Odhrán K RyanDepartment of Surgery, St. Vincent's University Hospital, Dublin, Republic of Ireland.
Éanna J RyanDepartment of Surgery, Royal College of Surgeons in Ireland, Dublin 2, Republic of Ireland.
Noel E DonlonDepartment of Surgery, Royal College of Surgeons in Ireland, Dublin 2, Republic of Ireland.
Sean M JohnstonDepartment of Surgery, Midlands University Hospital, Tullamore, Co. Offaly, Republic of Ireland.
William B RobbDepartment of Upper Gastrointestinal Surgery, Beaumont Hospital, Dublin 9, Co Dublin, Republic of Ireland.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

BACKGROUND AND

objectivesOptimal surgical management for gastric cancer remains controversial. We aimed to perform a network meta-analysis (NMA) of randomized clinical trials (RCTs) comparing outcomes after open gastrectomy (OG), laparoscopic-assisted gastrectomy (LAG), and robotic gastrectomy (RG) for gastric cancer.

methodsA systematic search of electronic databases was undertaken. An NMA was performed as per the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA)-NMA guidelines. Statistical analysis was performed using R and Shiny.

resultsTwenty-two RCTs including 6890 patients were included. Overall, 49.6% of patients underwent LAG (3420/6890), 46.6% underwent OG (3212/6890), and 3.7% underwent RG (258/6890). At NMA, there was a no significant difference in recurrence rates following LAG (odds ratio [OR] 1.09, 95% confidence interval [CI] 0.77-1.49) compared with OG. Similarly, overall survival (OS) outcomes were identical following OG and LAG (OS: OG, 87.0% [1652/1898] vs. LAG: OG, 87.0% [1650/1896]), with no differences in OS in meta-analysis (OR 1.02, 95% CI 0.77-1.52). Importantly, patients undergoing LAG experienced reduced intraoperative blood loss, surgical incisions, distance from proximal margins, postoperative hospital stays, and morbidity post-resection.

conclusionsLAG was associated with non-inferior oncological and surgical outcomes compared with OG. Surgical outcomes following LAG and RG superseded OG, with similar outcomes observed for both LAG and RG. Given these findings, minimally invasive approaches should be considered for the resection of local gastric cancer, once surgeon and institutional expertise allows.

Indexed as

LaparoscopyStomach NeoplasmsGastrectomyHumansPostoperative ComplicationsRandomized Controlled Trials as TopicTreatment OutcomeGastrectomyGastric cancerMinimally invasive surgeryOncological outcomesSurgical oncology

Identifiers

PMID37261563
PMCPMC10409677

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.