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Lymph Node Dissection of Choice in Older Adult Patients with Gastric Cancer: A Systematic Review and Meta-Analysis

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dc.contributor.advisorIsaza Restrepo, Andrés
dc.contributor.advisorRamírez-Giraldo, Camilo
dc.creatorRamírez-Giraldo, Camilo
dc.creatorAvendaño-Morales, Violeta
dc.creatorVan-Londoño, Isabella
dc.creatorMelo-Leal, Daniela
dc.creatorCamargo-Areyanes, María Isabel
dc.creatorVenegas-Sanabria, Luis Carlos
dc.creatorVargas Vargas, Juan Pablo
dc.creatorAguirre-Salamanca, Edgar Javier
dc.creatorIsaza-Restrepo, Andrés
dc.creator.degreeEspecialista en Cirugía General
dc.creator.degreeLevelMaestría
dc.date.accessioned2025-08-06T21:04:01Z
dc.date.available2025-08-06T21:04:01Z
dc.date.created2024-10-28
dc.descriptionIntroducción: Si bien la literatura actual ha mostrado un creciente interés en el tratamiento quirúrgico del cáncer gástrico (CG) en adultos mayores en los últimos años, aún no existe consenso sobre el manejo adecuado en este subgrupo de pacientes. Este estudio se diseñó con el objetivo de evaluar la evidencia actual que compara la disección ganglionar limitada con la disección ganglionar extendida en pacientes adultos mayores (≥65 años) con CG resecable. Métodos: Se realizó una revisión sistemática en PubMed, la Biblioteca Cochrane y ScienceDirect, de acuerdo con las directrices PRISMA. Todos los estudios anteriores a 2018 se seleccionaron mediante una revisión sistemática de Mogal et al. Los estudios fueron elegibles para este metanálisis si eran ensayos controlados aleatorizados o estudios comparativos no aleatorizados que comparaban la disección ganglionar limitada con la disección ganglionar extendida en pacientes con CG resecable sometidos a gastrectomía. Resultados: Se incluyeron diecisiete estudios con un total de 5056 pacientes. No se observaron diferencias estadísticamente significativas en la sobrevida global (HR = 1,04, IC95% = 0,72-1,51), la sobrevida libre de enfermedad (HR = 0,92, IC95% = 0,62-1,38) ni la sobrevida específica por cáncer (HR = 1,24, IC95% = 0,74-2,10) entre los pacientes adultos mayores sometidos a linfadenectomía limitada y extendida, además de la gastrectomía como tratamiento quirúrgico actual para el CG. Si bien se observó una mayor tasa de complicaciones mayores en el grupo de linfadenectomía extendida, esta diferencia no fue estadísticamente significativa en la incidencia entre ambos grupos de pacientes (OR = 1,92, IC95% = 0,75-4,91). Conclusiones: La linfadenectomía limitada debe considerarse la mejor recomendación para el tratamiento quirúrgico del GC en pacientes adultos mayores, considerando los resultados oncológicos y las menores tasas de complicaciones en comparación con las disecciones ganglionares más radicales.
dc.description.abstractBackground: Although the current literature has shown an increasing interest in surgical treatment of gastric cancer (GC) in older adults in recent years, there is still no consensus on proper management in this subgroup of patients. This study was designed with the objective of evaluating the current evidence that compares limited lymph node dissection with extended lymph node dissection in older adult patients (≥65 years) coursing with resectable GC. Methods: A systematic review of PubMed, Cochrane library, and ScienceDirect was performed according to PRISMA guidelines. All studies before 2018 were selected using a systematic review by Mogal et al. Studies were eligible for this meta-analysis if they were randomized controlled trials or non-randomized comparative studies comparing limited lymph node dissection versus extended lymph node dissection in patients with resectable GC taken to gastrectomy. Results: Seventeen studies and a total of 5056 patients were included. There were not any statistically significant differences in OS (HR = 1.04, CI95% = 0.72–1.51), RFS (HR = 0.92, CI95% = 0.62–1.38), or CSS (HR = 1.24, CI95% = 0.74–2.10) between older adult patients taken to limited and extended lymphadenectomy in addition to gastrectomy as the current surgical treatment for GC. Although a higher rate of major complications was observed in the extended lymphadenectomy group, this difference was not statistically significant in incidence between both groups of patients (OR = 1.92, CI95% = 0.75–4.91). Conclusions: Limited lymphadenectomy must be considered as the better recommendation for surgical treatment for GC in older adult patients, considering the oncological outcomes and lower rates of complications compared with more radical lymph node dissections
dc.format.extent23 pp
dc.format.mimetypeapplication/pdf
dc.identifier.doihttps:// doi.org/10.3390/jcm13247678
dc.identifier.urihttps://repository.urosario.edu.co/handle/10336/46227
dc.language.isoeng
dc.publisherUniversidad del Rosario
dc.publisher.departmentEscuela de Medicina y Ciencias de la Salud
dc.publisher.programEspecialización en Cirugía General
dc.relation.urihttps://www.mdpi.com/2077-0383/13/24/7678
dc.rightsAttribution-NonCommercial-ShareAlike 4.0 International*
dc.rights.accesRightsinfo:eu-repo/semantics/openAccess
dc.rights.accesoAbierto (Texto Completo)
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dc.source.instnameinstname:Universidad del Rosario
dc.source.reponamereponame:Repositorio Institucional EdocUR
dc.subjectCáncer gástrico
dc.subjectLinfadenectomía
dc.subjectDisección ganglionar
dc.subjectAdultos mayores
dc.subjectPronóstico
dc.subject.keywordGastric cancer
dc.subject.keywordLymphadenectomy
dc.subject.keywordLymph node dissection
dc.subject.keywordOlder adults
dc.subject.keywordPrognosis
dc.titleLymph Node Dissection of Choice in Older Adult Patients with Gastric Cancer: A Systematic Review and Meta-Analysis
dc.title.TranslatedTitleDisección ganglionar de elección en adultos mayores con cáncer gástrico: Una revisión sistemática y meta-análisis
dc.typemasterThesis
dc.type.hasVersioninfo:eu-repo/semantics/acceptedVersion
dc.type.spaTrabajo de grado
local.department.reportEscuela de Medicina y Ciencias de la Salud
local.regionesBogotá
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