Su Ping-Jui, Huang Yen-Ta, Liao Ting-Kai, Lu Wei-Hsun, Wang Chih-Jung, Chao Ying-Jui, Shan Yan-Shen
Division of General Surgery, Department of Surgery, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 704, Taiwan, R.O.C.
Department of Surgery, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 704, Taiwan, R.O.C.
Oncol Lett. 2024 Jul 5;28(3):427. doi: 10.3892/ol.2024.14560. eCollection 2024 Sep.
The present systematic review and meta-analysis aimed to compare long-term survival after proximal gastrectomy (PG) and total gastrectomy (TG) for locally advanced proximal gastric cancer (GC). The PubMed, EMBASE and Cochrane CENTRAL databases were searched from their inception to May 2023. Only published two-arm prospective or retrospective studies were included. The selected studies included patients with locally advanced GC who underwent PG or TG and reported quantitative survival outcomes. The primary outcome was overall survival (OS) after gastrectomy. Three studies involving a total of 4,815 patients met the inclusion criteria. The age of the patients ranged from 57.03-64.46 years and 78.80% were male. The estimated 5-year OS probability after TG varied from 30.14 to 72.0%, and from 42.06 to 74.9% after PG. Results of the meta-analyses revealed a significant association between PG and improved OS compared with that of TG, with a pooled hazard ratio of 1.15 (95% CI, 1.05-1.25). No heterogeneity was observed in the included studies (I=0%). Overall, in managing locally advanced GC, PG demonstrated comparable or marginally improved OS compared with TG during postoperative follow-up; however, further meta-analyses are required to provide stronger evidence.
本系统评价和荟萃分析旨在比较局部进展期近端胃癌（GC）行近端胃切除术（PG）和全胃切除术（TG）后的长期生存率。检索了PubMed、EMBASE和Cochrane CENTRAL数据库，检索时间从各数据库创建至2023年5月。仅纳入已发表的双臂前瞻性或回顾性研究。所选研究纳入了接受PG或TG治疗且报告了定量生存结果的局部进展期GC患者。主要结局是胃切除术后的总生存期（OS）。三项共纳入4815例患者的研究符合纳入标准。患者年龄在57.03 - 64.46岁之间，78.80%为男性。TG术后估计的5年OS概率在30.14%至72.0%之间，PG术后为42.06%至74.9%。荟萃分析结果显示，与TG相比，PG与改善的OS显著相关，合并风险比为1.15（95%CI，1.05 - 1.25）。纳入的研究中未观察到异质性（I² = 0%）。总体而言，在治疗局部进展期GC时，PG在术后随访期间与TG相比，OS相当或略有改善；然而，需要进一步的荟萃分析以提供更有力的证据。
