Oncologic Effectiveness and Safety of Bursectomy in Patients with Advanced Gastric Cancer: A Systematic Review and Updated Meta-Analysis

Luigi Marano, Karol Polom, Alberto Bartoli, Alessandro Spaziani, Raffaele De Luca, Laura Lorenzon, Natale Di Martino, Daniele Marrelli, Franco Roviello, Giampaolo Castagnoli

Research output: Contribution to journalArticle

Abstract

Purpose/Aim: In the past few decades some researchers have questioned whether bursectomy for gastric cancer is essential from an oncological point of view and no consistent recommendations have been proposed. The aim of this systematic review with meta-analysis is to investigate the oncologic effectiveness and safety of bursectomy for the treatment of advanced gastric cancer patients. Materials and Methods: We planned and performed this systematic review and meta-analysis in accordance with Preferred Reporting Items for Systematic Review and Meta-analysis (PRISMA) statement and Cochrane Handbook for Systematic Reviews of Intervention. Results: Overall, four studies with a total of 1,340 patients met inclusion criteria. The pooled hazard ratio for overall survival between the bursectomy versus nonbursectomy groups was [HR = 0.85, 95% CI 0.66–1.11, p =.252]. Interestingly, the pooled HR between the two groups in serosa-positive cases subgroup, showed a significant improvement of overall survival rate in favor of bursectomy [HR = 0.72, 95% CI 0.73–0.99, p <.05]. Conclusions: Bursectomy represents a surgical procedure that might be able to improve overall survival in serosa positive gastric cancer patients. However, a definitive conclusion could not be made because of the studies’ methodological limitations. This meta-analysis points to the urgent need of high quality, large-scaled, clinical trials with short- as well as long-term evaluation comparing bursectomy with non bursectomy procedures, in a controlled randomized manner, helping future researches and establishing a modern and tailored approach to gastric cancer.

Original languageEnglish
Pages (from-to)529-538
Number of pages10
JournalJournal of Investigative Surgery
Volume31
Issue number6
DOIs
Publication statusPublished - Dec 2019

Keywords

  • bursectomy
  • D2 lymphadenectomy
  • gastrectomy
  • gastric cancer
  • meta-analysis
  • prognosis

ASJC Scopus subject areas

  • Surgery

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    Marano, L., Polom, K., Bartoli, A., Spaziani, A., De Luca, R., Lorenzon, L., Di Martino, N., Marrelli, D., Roviello, F., & Castagnoli, G. (2019). Oncologic Effectiveness and Safety of Bursectomy in Patients with Advanced Gastric Cancer: A Systematic Review and Updated Meta-Analysis. Journal of Investigative Surgery, 31(6), 529-538. https://doi.org/10.1080/08941939.2017.1355942