Evidence map›Paper›PMID 38564116›Full record

SynthesisJournal of gastrointestinal cancer2024

Laparoscopic Versus Open Gastrectomy for Advanced Gastric Cancer: A Meta-Analysis of Randomized Controlled Trials.

Vinicius Bittar, Mauricio Ferreira Boneli, Pedro C Abrahão Reis, Nicole Felix, Marcelo Antonio Pinheiro Braga, Kian M Rocha, Leonardo O Fogaroli, Gamaliel B Costa, Ana Carolina Comini, Gustavo Amaral and 2 more

Abstract readMeta-AnalysisComparative StudySystematic Review
PubMed Publisher
In one paragraph

Synthesis in Journal of gastrointestinal cancer, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
10citing papers in PubMed, 1 pooled it
4.2field-weighted citation impact, top 6% of its field
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

10 citing papers in PubMed, 1 synthesis or guideline pooled it, 10 citations in OpenAlex.

  1. Pooled it
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  7. Review
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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

12 authors at 5 institutions in 1 country.

Vinicius BittarCentro Universitário das Faculdades Associadas de Ensino, São João da Boa Vista, São Paulo, Brazil. vinibdepontes@gmail.com.
Mauricio Ferreira BoneliCentro Universitário das Faculdades Associadas de Ensino, São João da Boa Vista, São Paulo, Brazil.
Pedro C Abrahão ReisUniversidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil.
Nicole FelixUniversidade Federal de Campina Grande, Campina Grande, Brazil.
Marcelo Antonio Pinheiro BragaUniversidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil.
Kian M RochaUniversidade do Estado do Rio de Janeiro, Rio de Janeiro, Brazil.
Leonardo O FogaroliCentro Universitário das Faculdades Associadas de Ensino, São João da Boa Vista, São Paulo, Brazil.
Gamaliel B CostaCentro Universitário das Faculdades Associadas de Ensino, São João da Boa Vista, São Paulo, Brazil.
Ana Carolina CominiA. C. Camargo Cancer Center, São Paulo, Brazil.
Gustavo AmaralCentro Universitário das Faculdades Associadas de Ensino, São João da Boa Vista, São Paulo, Brazil.
Danyelle Cristine MariniCentro Universitário das Faculdades Associadas de Ensino, São João da Boa Vista, São Paulo, Brazil.
Marcos P G CamandarobaA. C. Camargo Cancer Center, São Paulo, Brazil.
AC Camargo Hospital · BRUniversidade Federal do Rio de Janeiro · BRCentro Universitário da Fundação de Ensino Octávio Bastos · BRUniversidade do Estado do Rio de Janeiro · BRUniversidade Federal de Campina Grande · BR

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundLaparoscopy-assisted gastrectomy (LAG) is a well-established surgical technique in treating patients with early gastric cancer. However, the efficacy and safety of LAG versus open gastrectomy (OG) in patients with advanced gastric cancer (AGC) remains unclear.

methodsWe systematically searched PubMed, Embase, and Cochrane Library in June 2023 for RCTs comparing LAG versus OG in patients with AGC. We pooled risk ratios (RR) and mean differences (MD) with 95% confidence intervals (CI) for binary and continuous endpoints, respectively. We performed all statistical analyses using R software version 4.3.1 and a random-effects model.

resultsNine RCTs comprising 3827 patients were included. There were no differences in terms of intraoperative complications (RR 1.14; 95% CI 0.72 to 1.82), number of retrieved lymph nodes (MD -0.54 lymph nodes; 95% CI -1.18 to 0.09), or mortality (RR 0.91; 95% CI 0.30 to 2.83). LAG was associated with a longer operative time (MD 49.28 minutes; 95% CI 30.88 to 67.69), lower intraoperative blood loss (MD -51.24 milliliters; 95% CI -81.41 to -21.06), shorter length of stay (MD -0.83 days; 95% CI -1.60 to -0.06), and higher incidence of pancreatic fistula (RR 2.44; 95% CI 1.08 to 5.50). Postoperatively, LAG was also superior to OG in reducing bleeding rates (RR 0.44; 95% CI 0.22 to 0.86) and time to first flatus (MD -0.27 days; 95% CI -0.47 to -0.07), with comparable results in anastomotic leakage, wound healing issues, major complications, time to ambulation, or time to first liquid intake. In the long-term analyses at 3 and 5 years, there were no significant differences between LAG and OG in terms of overall survival (RR 0.99; 95% CI 0.96 to 1.03) or relapse-free survival (RR 0.99; 95% CI 0.94 to 1.04).

conclusionThis meta-analysis of RCTs suggests that LAG may be an effective and safe alternative to OG for treating AGC; albeit, it may be associated with an increased risk for pancreatic fistula.

Indexed as

GastrectomyLaparoscopyRandomized Controlled Trials as TopicStomach NeoplasmsBlood Loss, SurgicalHumansLength of StayOperative TimePostoperative ComplicationsTreatment OutcomeAdvanced gastric cancerLaparoscopic-assisted gastrectomyOpen gastrectomy

Identifiers

PMID38564116
OpenAlexW4393497008

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

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.