岭南现代临床外科2026，Vol.26Issue(4)：230-238,9.DOI:10.3969/j.issn.1009-976X.2026.04.004
近端胃癌新辅助治疗后行近端胃切除与全胃切除疗效比较的系统综述与Meta分析
Proximal versus total gastrectomy for proximal gastric cancer after neoadjuvant therapy:a sys-tematic review and meta-analysis
摘要
Abstract
Objective To compare the safety and efficacy of radical proximal gastrectomy(PG)versus total gastrectomy(TG)in patients with proximal gastric cancer after neoadjuvant therapy.Methods A systematic search was conducted in PubMed,Ovid,Web of Science,the Cochrane Library,CNKI,and Wanfang Data.Quantitative pooling was restricted to observational cohorts from which data could be extracted after propensity score matching(PSM).Conference abstracts of randomized trials,database studies,preprints,and studies with potential cohort overlap were descriptively synthesized.Meta-analysis was performed using R software and the metafor package for overall survival,R0 resection rate,anasto-motic leakage rate,and perioperative outcomes.The number of studies eligible for pooling did not exceed three.Results from the common-effect model were primarily reported,with the random-effects model and the modified Hartung-Knapp method used as sensitivity analyses.Results Seven reports were included,of which three PSM cohorts were included in the quantitative pooling(a maximum of 514 patients,241 in the PG group and 273 in the TG group).The remaining four reports were descriptively synthesized only;their reported sample sizes contained potential overlaps and were not summed to derive a total number of cases.The common-effect model showed no statistically significant differences between PG and TG in overall survival(HR=0.91,95%CI:0.70～1.17),R0 resection rate(RR=1.00,95%CI:0.97～1.02),anastomotic leakage(RR=1.46,95%CI:0.54～3.97),or overall complications(RR=0.97,95%CI:0.50～1.90).Operative time was shorter in the PG group under the common-effect model(MD=-13.79 min,95%CI:-28.1 to 0.70),but with high inter-study heterogeneity.Conclusion Current evidence is insufficient to determine whether there are differences in survival,R0 resection rates,and perioperative safety between PG and TG after neoadjuvant therapy.These findings still require validation by prospec-tive randomized trials.关键词
新辅助治疗/近端胃癌/近端胃切除术/全胃切除术/系统综述/Meta分析Key words
neoadjuvant therapy/proximal gastric cancer/proximal gastrectomy/total gastrectomy/systematic review/meta-analysis分类
医药卫生引用本文复制引用
何俊飞,开乌塞·吐尔洪江,蔡秀琴,戴伟钢,赵日升..近端胃癌新辅助治疗后行近端胃切除与全胃切除疗效比较的系统综述与Meta分析[J].岭南现代临床外科,2026,26(4):230-238,9.基金项目
国家自然科学基金青年科学基金项目(82100626) （82100626）
