Meta-Analysis
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World J Gastroenterol. Oct 28, 2014; 20(40): 14986-14991
Published online Oct 28, 2014. doi: 10.3748/wjg.v20.i40.14986
Effect of gastrectomy with bursectomy on prognosis of gastric cancer: A meta-analysis
Wei-Song Shen, Hong-Qing Xi, Bo Wei, Lin Chen
Wei-Song Shen, Hong-Qing Xi, Bo Wei, Lin Chen, Department of General Surgery, Chinese People’s Liberation Army General Hospital, Beijing 100853, China
Author contributions: Shen WS and Xi HQ contributed equally to this work; Shen WS, Xi HQ, Wei B and Chen L designed the research; Shen WS and Chen L performed the research; Wei B and Chen L contributed analytical tools; Shen WS, Xi HQ and Wei B analyzed the data; Shen WS and Xi HQ wrote the paper.
Supported by Special Scientific Research Program of the National Health and Family Planning Commission of China, No. 20130206
Correspondence to: Lin Chen, MD, Professor, Department of General Surgery, Chinese People’s Liberation Army General Hospital, 28 Fuxing Road, Haidian District, Beijing 100853, China. chenlinbj@163.com
Telephone: +86-10-66938128 Fax: +86-10-68181689.
Received: February 26, 2014
Revised: April 27, 2014
Accepted: June 12, 2014
Published online: October 28, 2014
Processing time: 245 Days and 18.7 Hours
Abstract

AIM: To evaluate the effect of bursectomy on overall survival, recurrence-free survival and safety of patients with gastric cancer by performing a meta-analysis.

METHODS: A literature search was performed in PubMed, EMBASE, and the Cochrane Library databases for clinical research that compared bursectomy with non-bursectomy published before October 2013. Inclusion and exclusion criteria were established and applied. Overall survival, recurrence-free survival, complications, hospital stay, operative time and blood loss were compared using hazard ratios (HRs), relative risks and weighted mean differences. Stata 12.0 software was used for statistical analysis.

RESULTS: Four studies including 1130 patients were available for the analysis (430 in the bursectomy group, 700 in the non-bursectomy group). No statistically significant difference was observed in the rate of complications between the bursectomy group and the non-bursectomy group. Bursectomy did not have a significant effect (combined HR = 1.14, 95%CI: 0.88-1.47) on overall survival, and it was not a significant factor for recurrence-free survival (combined HR = 1.06, 95%CI: 0.82-1.37).

CONCLUSION: Gastrectomy with bursectomy is not superior to non-bursectomy in terms of survival. Bursectomy is not recommended as a routine procedure for the surgical treatment of gastric cancer.

Keywords: Gastric cancer; Bursectomy; Prognosis; Gastrectomy; Meta-analysis

Core tip: To our knowledge, no large-scale studies have investigated the survival benefit of bursectomy. Several studies have described the relationship between bursectomy and prognosis in gastric cancer. However, the results were inconsistent. The purpose of this study was to determine the survival benefit of bursectomy by meta-analysis comparing the prognosis in patients undergoing gastrectomy with bursectomy for gastric cancer with that in patients undergoing gastrectomy alone.