直肠癌侧方淋巴结清扫意义的meta分析

Lateral lymph node dissection for rectal cancer:a meta analysis

目的评价直肠癌侧方淋巴结清扫（lateral lymph node dissection,LLND）对患者术后5年生存率和局部复发率的影响,为直肠癌根治性手术中是否应常规进行侧方淋巴结清扫提供临床依据。方法利用meta分析的方法综合评价国内外公开发表的所有关于直肠癌侧方淋巴结清扫与局部复发率、5年生存率关系的文献。结果筛选出符合入选和排除标准的文献8篇,共4648例,其中LLND组2249例,LLND组5年生存率与非LLND组比较,合并值ORs为1.07（95%CI=0.80~1.42,P=0.67）,局部复发率合并值ORs为0.85（95%CI=0.51~1.39,P=0.51）。结论直肠癌侧方淋巴结清扫并不能提高患者的5年生存率,亦不能降低局部复发率。

Objective To evaluate the effect of lateral lymph node dissection for rectal carcinoma on local recurrence rate and 5-year overall survival rate. Methods The results from 8 literatures on lateral lymph node dissection and prognosis were analyzed synthetically by meta analysis. Results Eight literatures inclu- ding 4648 patients entered this study. Both the 5-year overall survival rate and local recurrence rate of patients undergone lateral lymph node dissection were similar to those not undergone,and odd ratios （ORs） were 1.07（95%CI=0.80-1.42, P =0.67）and 0. 85（95%CI=0.51-1.39, P =0.51）, respectively. Conclusion Lateral lymph node dissection for rectal cancer doesn＇t improve survival in patients with rectal cancer.