Influences of laparoscopic-assisted gastrectomy and open gastrectomy on serum interleukin-6 levels in patients with gastric cancer among Asian populations: a systematic review.

Li-Bo Sun,Hai-Ping Cao,Yong-Chao Li,Zhen-Bo Shu

doi:10.1186/s12876-015-0276-4

Li-Bo Sun, Hai-Ping Cao + Show 2 more

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https://doi.org/10.1186/s12876-015-0276-4

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Journal: BMC gastroenterology	Publication Date: Apr 28, 2015
Citations: 53	License type: CC BY 4.0

Affiliation: Union Hospital, Jilin University

Abstract

BackgroundTo compare the effects of laparoscopic-assisted gastrectomy (LAG) and open gastrectomy (OG) on serum interleukin-6 (IL-6) levels in gastric cancer (GC) patients from Asia.MethodsThe following scientific literature databases were searched for relevant clinical studies: PubMed, EBSCO, Ovid, Wiley, Web of Science, Cochrane library, EMBASE, WANFANG and VIP databases. The studies retrieved from database searches were screened based on stringent inclusion and exclusion criteria to select high quality cohort studies for the present meta-analysis. The data extracted from final selected studies were analyzed using STATA 12.0 software.ResultsA total of 54 studies were initially retrieved from database searches, and 11 clinical cohort studies were eventually enrolled in this meta-analysis. The 11 selected studies contained a combined total of 767 GC patients (427 patients in LAG group and 340 patients in OG group). Meta-analysis results demonstrated that postoperative serum IL-6 levels in GC patients in LAG group was significantly lower than the OG group (SMD = −2.16, 95% CI = −3.19 ~ −1.14, P < 0.001). The difference in serum IL-6 levels between the preoperative and postoperative GC patients was significantly lower in the LAG group compared to the difference found in the OG group (SMD = −3.44, 95% CI = −4.87 ~ −2.01, P < 0.001). Subgroup analysis based on country showed that, in both Chinese and Japanese GC patients, the postoperative increase in serum IL-6 levels in LAG group were significantly lower than the increase observed in the OG group (all P < 0.05). In Korean GC patients, the postoperative increase in serum IL-6 levels was not significantly different between the LAG group and OG group (all P > 0.05).ConclusionOur results provide strong evidence that LAG is associated with significantly lower serum IL-6 levels, compared to OG. Thus, LAG carries markedly lower risk of adverse inflammatory reactions in GC patients among Asian population.

Highlights

To compare the effects of laparoscopic-assisted gastrectomy (LAG) and open gastrectomy (OG) on serum interleukin-6 (IL-6) levels in gastric cancer (GC) patients from Asia
The 11 clinical cohort studies contained a combined total of 767 GC patients (427 patients in LAG group and 340 patients in OG group)
Subgroup analysis based on country showed that, in Chinese and Japanese GC patients, postoperative serum IL-6 levels in LAG group were significantly lower than OG group (Japanese: standardized mean difference (SMD) = −1.19, 95% CI = −1.81 ~ −0.57, P < 0.001; Chinese: SMD = −2.78, 95% CI = −4.21 −1.36, P < 0.001)

Summary

Introduction

To compare the effects of laparoscopic-assisted gastrectomy (LAG) and open gastrectomy (OG) on serum interleukin-6 (IL-6) levels in gastric cancer (GC) patients from Asia. Apart from Asia, GC has a higher incidence in South America [3].Surgical resection by gastrectomy is the only option for GC treatment that is sufficient to cure early-stage gastric cancer patients, and significantly enhance patient survival in more advanced GC, when combined with radiation therapy and chemotherapy. A recent study found that interleukin-6 (IL-6) is a major factor in peritoneal immune response after surgery in GC patients, and surgical options for GC will need to be re-evaluated in light of the potentially adverse influence of inflammatory responses on therapy safety and effectiveness [7]

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