Copyright
©The Author(s) 2017.
World J Gastrointest Oncol. Dec 15, 2017; 9(12): 475-491
Published online Dec 15, 2017. doi: 10.4251/wjgo.v9.i12.475
Published online Dec 15, 2017. doi: 10.4251/wjgo.v9.i12.475
Ref. | Country of origin | Study type | Study period | Female(number, L/O) | Mean age (yr, L/O) | Intervention (L-CME) right/transverse/left location of the tumor | Control (O-CME) right/transverse/left location of the tumor | Adjuvant chemotherapy |
Kim et al[23], 2016 | South Korea | Case control, unicentre, prospective database | 2008-2013 | 62/44 | 69/67 | 116/0/0 | 99/0/0 | L-CME = 68 pts (58.62%), O-CME = 78 pts (78.78%), recommended to all stage II and III |
Storli et al[22], 2016 | Norway | Prospective non RT, unicentre | 2007-2014 | 22/13 | 73/23 | 0/33/0 | 0/23/0 | L-CME = 8 (61.5%), O-CME = 5 (62.5%), all stage III below 75 yr |
Huang et al[24], 2015 | China | Case control, unicentre | 2012-2013 | 20/21 | 56/55 | 53/0/0 | 49/0/0 | NR |
Yamamoto et al[20], 2014 | Japan | RCT, multicentre | 2004-2009 | 248/215 | 64/64 | 144/0/389 | 156/0/368 | NR, recommended for all stage III |
Munkedal et al[25], 2014 | Denmark | Prospective nonRT, unicentre | 2008-2011 | 30/38 | 69.1/72.9 | 30/0/53 | 41/0/38 | NR |
Bae et al[27], 2014 | South Korea | Case control, unicentre | 2006-2008 | 40/38 | 64/65 | 73/12/0 | 76/9/0 | All stage III and II with poor prognosis |
Han et al[26], 2014 | China | Case control, unicentre | 2003-2010 | 94/67 | 67/65 | 177/0/0 | 147/0/0 | NR, recommended for high risk stage II and stage III |
Zhao et al[28], 2014 | China | Case control, multicentre | 2000-2009 | 53/44 | 61.3/64.5 | 89/30/0 | 65/36/0 | NR, recommended for high risk stage II and stage III |
Cong et al[29], 2014 | China | Case control, unicentre | 2008-2011 | 53/45 | 61.5/62.3 | 96/0/0 | 82/0/0 | NR |
Storli et al[30], 2013 | Norway | Prospective nonRT, unicentre | 2007-2010 | 49/60 | 71.9/73.1 | 50/18/60 2 pts - multiple | 35/44/42 | All stage III below 75 yr |
Gouvas et al[31], 2012 | Greece | Prospective nonRT, multicentric | 2006-2010 | 19/17 | 62.1/66.3 | 7/9/33 | 9/9/23 | NR |
Sun et al[32], 2012 | China | Case control, unicentre | 2000-2008 | 58/45 | 60.1/61.9 | 49/7/91 | 43/9/74 | NR, according to stage |
Quality evaluation criteria | Kim et al[23], 2016 | Storli et al[22], 2016 | Storli et al[30], 2016 | Huang et al[24], 2015 | Munkedal et al[25], 2014 | Bae et al[27], 2014 | Han et al[26], 2014 | Zhao et al[28], 2014 | Cong et al[29], 2014 | Gouvas et al[31], 2012 | Sun et al[32], 2012 |
Clear stated aim | 2 | 2 | 2 | 2 | 2 | 2 | 2 | 2 | 2 | 2 | 2 |
Inclusion of consecutive patients | 2 | 2 | 2 | 2 | 2 | 2 | 2 | 2 | 1 | 2 | 2 |
Prospective data collection | 2 | 2 | 2 | 0 | 2 | 0 | 0 | 0 | 0 | 2 | 0 |
Endpoints appropriate to the study aim | 2 | 2 | 2 | 2 | 2 | 2 | 2 | 2 | 2 | 2 | 2 |
Unbiased assessment of study end-point | 2 | 2 | 2 | 2 | 2 | 2 | 2 | 1 | 1 | 2 | 1 |
Appropriate follow-up period | 2 | 2 | 2 | 1 | 2 | 2 | 2 | 2 | 2 | 2 | 2 |
Loss to follow-up less than 5% | 1 | 2 | 2 | 1 | 2 | 2 | 2 | 1 | 1 | 2 | 1 |
Prospective calculation of the study size | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
Adequate group control | 2 | 2 | 2 | 2 | 2 | 2 | 2 | 2 | 0 | 2 | 2 |
Contemporary groups | 2 | 2 | 2 | 2 | 2 | 2 | 2 | 2 | 2 | 2 | 2 |
Baseline equivalence | 2 | 2 | 2 | 2 | 2 | 2 | 2 | 2 | 2 | 2 | 2 |
Adequate statistical analysis | 2 | 2 | 2 | 2 | 2 | 2 | 2 | 2 | 2 | 2 | 1 |
Total | 21 | 22 | 22 | 18 | 22 | 20 | 20 | 18 | 15 | 22 | 17 |
Outcome or subgroups | No. of Studies | Participants | Statistical method (95%CI) | Effect estimate (95%CI) | P value | Heterogeneity P, I2 (%) |
Survival and recurrences | ||||||
Overall survival | 6 | 1777 | OR (M-H, random) | 1.32 (0.83, 2.10) | 0.24 | 0.002, 70 |
Three-year | 4 | 1010 | OR (M-H, random) | 2.02 (1.31, 3.12) | 0.001 | 0.24, 28 |
Five-year | 3 | 767 | OR (M-H, random) | 0.77 (0.44, 1.37) | 0.38 | 0.07, 63 |
Disease free survival | 4 | 856 | OR (M-H, random) | 1.15 (0.70, 1.87) | 0.58 | 0.09, 54 |
Three-year | 3 | 686 | OR (M-H, random) | 1.45 (1.00, 2.10) | 0.05 | 0.89, 0 |
Five-year | 1 | 170 | OR (M-H, random) | 0.50 (0.24, 1.05) | 0.07 | NA |
Local recurrences | 5 | 1233 | OR (M-H, fixed) | 0.67 (0.38, 1.17) | 0.16 | 0.60, 0 |
One-year | 2 | 466 | OR (M-H, fixed) | 0.52 (0.20, 1.35) | 0.18 | 0.30, 7 |
Five-year | 3 | 767 | OR (M-H, fixed) | 0.77 (0.38, 1.54) | 0.46 | 0.52, 0 |
Distant recurrences | 4 | 1018 | OR (M-H, random) | 0.98 (0.61, 1.58) | 0.94 | 0.17, 40 |
Three-year | 1 | 251 | OR (M-H, random) | 1.28 (0.54, 3.03) | 0.58 | NA |
Five-year | 3 | 767 | OR (M-H, random) | 0.90 (0.48, 1.69) | 0.75 | 0.10, 57 |
Port site metastasis | 2 | 494 | OR (M-H, fixed) | 1.52 (0.20, 11.42) | 0.69 | 0.55, 0 |
Quality of the resected specimen | ||||||
Lymphnodes retrieved | 10 | 2647 | MD (IV, random) | -1.06 (-3.65, 1.53) | 0.42 | < 0.001, 92 |
RCTs | 1 | 1057 | MD (IV, random) | 1.00 (-0.34, 2.34) | 0.14 | NA |
NRCTs | 9 | 1590 | MD (IV, random) | -1.32 (-4.42, 1.78) | 0.40 | < 0.001, 92 |
Lymphnodes retrieved | 10 | 2647 | MD (IV, random) | -1.06 (-3.65, 1.53) | 0.42 | < 0.001, 92 |
< 100 patients | 4 | 478 | MD (IV, random) | -3.18 (-8.69, 2.33) | 0.26 | < 0.001, 85 |
> 100 patients | 6 | 2169 | MD (IV, random) | 0.29 (-1.64, 2.21) | 0.77 | < 0.001, 83 |
Lymphnodes retrieved | 10 | 2647 | MD (IV, random) | -1.06 (-3.65, 1.53) | 0.42 | < 0.001, 92 |
Europe | 4 | 559 | MD (IV, random) | -3.33 (-8.31, 1.64) | 0.19 | < 0.001, 90 |
Asia | 6 | 2088 | MD (IV, random) | 0.56 (-1.33, 2.46) | 0.56 | < 0.001, 77 |
Tumor to arterial high tie (mm) | 2 | 252 | MD (IV, random) | 14.26 (-4.30, 32.82) | 0.13 | < 0.001, 92 |
Resected mesocolon surface (cm2) | 2 | 252 | MD (IV, fixed) | 11.75 (9.50, 13.99) | < 0.001 | 0.55, 0 |
Complete mesocolic plane excision | 1 | 90 | OR (M-H, fixed) | 0.77 (0.20, 2.96) | 0.71 | NA |
Operative data | ||||||
Duration of surgery | 7 | 2266 | MD (IV, random) | 26.26 (5.06, 47.46) | 0.02 | < 0.001, 94 |
Incision length (cm) | 2 | 1159 | MD (IV, random) | -14.01 (-14.35, -13.66) | < 0.001 | 0.89, 0 |
Blood loss (mL) | 5 | 1868 | MD (IV, random) | -52.11 (-78.57, -25.65) | < 0.001 | < 0.001, 89 |
Transfusion requirement | 2 | 1272 | OR (M-H, random) | 0.45 (0.27, 0.75) | 0.002 | 0.54, 0 |
Intraoperative morbidity | 1 | 1057 | OR (M-H, fixed) | 2.12 (0.95, 4.72) | 0.07 | NA |
Postoperative course | ||||||
Time to first flatus (d) | 4 | 1771 | MD (IV, random) | -0.90 (-1.46, -0.34) | 0.002 | < 0.001, 97 |
Time to liquid diet (d) | 5 | 1031 | MD (IV, random) | -1.84 (-2.93, -0.74) | 0.001 | < 0.001, 98 |
Short-term morbidity and mortality | ||||||
Thirty-day overall morbidity | 7 | 2144 | OR (M-H, fixed) | 0.57 (0.46, 0.71) | < 0.001 | 0.76, 0 |
RCTs | 1 | 1057 | OR (M-H, fixed) | 0.66 (0.49, 0.89) | 0.006 | NA |
NRCTs | 6 | 1087 | OR (M-H, fixed) | 0.49 (0.36, 0.68) | < 0.001 | 0.89, 0 |
Wound complications | 8 | 2322 | OR (M-H, fixed) | 0.43 (0.30, 0.61) | < 0.001 | 0.80, 0 |
Postoperative bleeding | 4 | 1662 | OR (M-H, fixed) | 1.20 (0.46, 3.12) | 0.71 | 0.75, 0 |
Pneumonia | 5 | 867 | OR (M-H, random) | 0.61 (0.20, 1.84) | 0.38 | 0.21, 32 |
Anastomotic leakage | 8 | 2471 | OR (M-H, fixed) | 0.82 (0.54, 1.25) | 0.36 | 0.77, 0 |
Need for reoperation | 2 | 1113 | OR (M-H, fixed) | 0.59 (0.28, 1.23) | 0.16 | 0.79, 0 |
Thirty-day mortality | 6 | 2237 | OR (M-H, fixed) | 0.42 (0.16, 1.12) | 0.07 | 0.98, 0 |
Hospital stay (d) | 9 | 2573 | MD (IV, random) | -4.07 (-5.87, -2.28) | < 0.001 | < 0.001, 91 |
- Citation: Negoi I, Hostiuc S, Negoi RI, Beuran M. Laparoscopic vs open complete mesocolic excision with central vascular ligation for colon cancer: A systematic review and meta-analysis. World J Gastrointest Oncol 2017; 9(12): 475-491
- URL: https://www.wjgnet.com/1948-5204/full/v9/i12/475.htm
- DOI: https://dx.doi.org/10.4251/wjgo.v9.i12.475