Laparoscopic versus open D2 gastrectomy for advanced gastric cancer: A meta-analysis on long-term outcomes

Abstract

Objective To evaluate the long-term clinical between laparoscopic gastrectomy and open gastrectomy with D2 lymph dissection for advanced gastric cancer. Methods Clinical studies that compared clinical of laparoscopic gastrectomy and open gastrectomy for advanced gastric cancer were searched from PubMed, EMBASE, Medline, Cochrane Library, WanFang, CNKI, CMCC and VIP database with the Gastric neoplasms Laparoscopy Gastrectomy Long-term outcomes Meta-analysis between Jan. 2002 and Oct. 2016. Data of long-term survival and recurrence were analyzed by using of RevMan 5.2 software.Survival data were present by the odds ratio(OR) and 95%CI. The heterogeneity of the data was analyzed using the I2 test. Results Fifteen studies including 4, 053 cases were enrolled.There were 2, 091 patients in LG group and 1, 962 patients in the open gastrectomy group. There was no significant difference in the 3-year overall survival rate(OR=1.00, 95%CI: 0.83-1.20, P=0.98), 5-year overall survival rate(OR=1.14, 95%CI: 0.95-1.36, P=0.15), 5-year disease-free survival rate(OR=1.13, 95%CI: 0.93~1.39, P=0.22)and cancer recurrence rate(OR=0.96, 95%CI: 0.79~1.18, P=0.71) between the patients treated with laparoscopic gastrectomy, or open gastrectomy (P>0.05). Conclusion Laparoscopic gastrectomy with D2 lymph dissection for advanced gastric cancer has similar long-term as compared to open gastrectomy. Key words: Stomach neoplasms; Laparoscopes; Gastrectomy; Long-term outcomes; Meta-analysis