Lymph Node Dissection in Older Adults with Gastric Cancer
Author Information
Author(s): Ramírez-Giraldo Camilo, Avendaño-Morales Violeta, Van-Londoño Isabella, Melo-Leal Daniela, Camargo-Areyanes María Isabel, Venegas-Sanabria Luis Carlos, Vargas Juan Pablo Vargas, Aguirre-Salamanca Edgar Javier, Isaza-Restrepo Andrés
Primary Institution: Hospital Universitario Mayor-Méderi, Bogotá, Colombia; Universidad del Rosario, Bogotá, Colombia
Hypothesis
Is limited lymph node dissection more effective than extended lymph node dissection in older adult patients with resectable gastric cancer?
Conclusion
Limited lymphadenectomy is recommended for surgical treatment of gastric cancer in older adults due to similar oncological outcomes and lower complication rates compared to extended lymph node dissections.
Supporting Evidence
- There were no statistically significant differences in overall survival (OS), relapse-free survival (RFS), or cancer-specific survival (CSS) between limited and extended lymphadenectomy.
- A higher rate of major complications was observed in the extended lymphadenectomy group, but this was not statistically significant.
- Age was identified as an independent risk factor for lower OS in patients undergoing surgery for gastric cancer.
Takeaway
When older people have stomach cancer, it's better to do a smaller surgery to remove lymph nodes because it works just as well and has fewer problems.
Methodology
A systematic review and meta-analysis were conducted following PRISMA guidelines, including randomized controlled trials and non-randomized comparative studies.
Potential Biases
The overall quality of non-randomized studies was low due to selection bias and confounding factors.
Limitations
Results from different studies are difficult to compare due to varying definitions of 'older adult' and different scoring systems for comorbidities.
Participant Demographics
The studies included older adult patients (≥65 years) with resectable gastric cancer.
Statistical Information
P-Value
p<0.05
Confidence Interval
CI95% = 0.72–1.51 for OS, CI95% = 0.62–1.38 for RFS, CI95% = 0.74–2.10 for CSS
Digital Object Identifier (DOI)
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