Academic Journal
Five-year survival after minimally invasive versus open gastrectomy: A meta-analysis of randomized controlled trials with trial sequential analysis.
| Τίτλος: | Five-year survival after minimally invasive versus open gastrectomy: A meta-analysis of randomized controlled trials with trial sequential analysis. |
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| Συγγραφείς: | Nasri S; Department of Digestive Surgery B, Charles Nicolle University Hospital, Faculty of Medicine of Tunis, University of Tunis El Manar, Tunisia. Electronic address: salsabil_nasri@yahoo.fr., Laamiri G; Department of Digestive Surgery, Taher Maamouri University Hospital, Faculty of Medicine of Tunis, University of Tunis El Manar, Tunisia., Ben Safta A; Department of Digestive Surgery B, Charles Nicolle University Hospital, Faculty of Medicine of Tunis, University of Tunis El Manar, Tunisia., Trabelsi MM; Department of Digestive Surgery B, Charles Nicolle University Hospital, Faculty of Medicine of Tunis, University of Tunis El Manar, Tunisia., Kammoun N; Department of Digestive Surgery B, Charles Nicolle University Hospital, Faculty of Medicine of Tunis, University of Tunis El Manar, Tunisia., Samaali I; Department of Digestive Surgery B, Charles Nicolle University Hospital, Faculty of Medicine of Tunis, University of Tunis El Manar, Tunisia., Bouasker I; Department of Digestive Surgery B, Charles Nicolle University Hospital, Faculty of Medicine of Tunis, University of Tunis El Manar, Tunisia., Nouira R; Department of Digestive Surgery B, Charles Nicolle University Hospital, Faculty of Medicine of Tunis, University of Tunis El Manar, Tunisia., Dziri C; Fellow American College of Surgeons, Department of Digestive Surgery B, Charles Nicolle Hospital, Faculty of Medicine of Tunis, University of Tunis El Manar, Tunisia. |
| Πηγή: | Surgical oncology [Surg Oncol] 2026 Aug; Vol. 67, pp. 102488. Date of Electronic Publication: 2026 Jun 25. |
| Τύπος έκδοσης: | Journal Article; Meta-Analysis; Review |
| Γλώσσα: | English |
| Στοιχεία περιοδικού: | Publisher: Elsevier Science Country of Publication: Netherlands NLM ID: 9208188 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1879-3320 (Electronic) Linking ISSN: 09607404 NLM ISO Abbreviation: Surg Oncol Subsets: MEDLINE |
| Imprint Name(s): | Publication: Amsterdam : Elsevier Science Original Publication: Oxford ; Boston : Blackwell Scientific Publications, c1992- |
| Ιατρικοί όροι (MeSH): | Gastrectomy*/mortality , Gastrectomy*/methods , Stomach Neoplasms*/surgery , Stomach Neoplasms*/mortality , Stomach Neoplasms*/pathology , Minimally Invasive Surgical Procedures*/mortality , Randomized Controlled Trials as Topic*, Humans ; Survival Rate ; Prognosis |
| Περίληψη: | Background: Debates persist regarding long-term oncological safety of mini-invasive gastrectomy (MIG)compared to open gastrectomy (OG). KLASS-02 trial and CLASS-01 trial concluded to the absence of statistically significant difference in oncologic outcomes between the two approaches. This meta-analysis evaluates the 5-year survival outcomes of MIG versus OG with Trial Sequential Analysis (TSA). Methods: A systematic literature search was conducted in Medline, Embase and Scopus. The primary endpoint was 5-year overall survival (OS), and secondary endpoints included stage-specific OS and 5-year disease-free survival (DFS). Risk ratios (RR) with 95% confidence intervals (CI) were pooled using a random-effects model. TSA was performed to estimate the robustness of the meta-analysis. Results: Ten randomized trials were included. No significant difference in 5-year OS was observed between MIG and OG groups (RR = 1.009; 95% CI:0.994-1.025; p = 0.247; tau2 = 0). Subgroup analysis by TNM stage and meta-regression by percentage of total gastrectomies in the included trials confirmed long-term oncological safety of MIG irrespective of the TNM stage or the extent of the gastric resection. No significant statistical difference was observed for 5-year DFS (RR = 1.007; 95% CI:0.985-1.030; p = 0.514; tau2 = 0). TSA for 5-year OS demonstrated that the cumulative Z-curve crossed the futility boundaries and exceeded the required information size, confirming no statistical difference between the two approaches. Conclusion: MIG offers 5-year overall and disease-free survival outcomes comparable to those of OG. (Copyright © 2026 Elsevier Ltd. All rights reserved.) |
| Competing Interests: | Declaration of competing interest All authors have NO conflict of interest to disclose. |
| Contributed Indexing: | Keywords: Disease-free survival; Gastric cancer; Heterogeneity; Meta-analysis; Minimally invasive gastrectomy; Open gastrectomy; Overall survival; Prediction interval; Trial sequential analysis |
| Entry Date(s): | Date Created: 20260627 Date Completed: 20260717 Latest Revision: 20260814 |
| Update Code: | 20260815 |
| DOI: | 10.1016/j.suronc.2026.102488 |
| PMID: | 42364595 |
| Βάση Δεδομένων: | MEDLINE |
| ISSN: | 1879-3320 |
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| DOI: | 10.1016/j.suronc.2026.102488 |