Expert opinion on laparoscopic surgery for colorectal cancer parallels evidence from a cumulative meta-analysis of randomized controlled trials.
Expert opinion on laparoscopic surgery for colorectal cancer parallels evidence from a cumulative meta-analysis of randomized controlled trials.
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DOI：
10.1371/journal.pone.0035292
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发表时间：
2012
期刊：
影响因子：
3.7
通讯作者：
Fergusson DA
中科院分区：
文献类型：
--
作者：
Martel G;Crawford A;Barkun JS;Boushey RP;Ramsay CR;Fergusson DA
本研究试图综合腹腔镜和开腹结直肠癌手术试验的生存结果，并确定文献中专家对这项技术的接受是否具有平行的累积生存证据。对随机试验进行了系统评价。主要结局是生存，并对事件发生时间数据进行荟萃分析。文献（已发表的评论、指南和教科书章节）中关于腹腔镜结直肠癌可接受性的专家意见采用 7 分制进行分级。汇总的生存数据及时与累积的专家意见评分相关联。共筛选了 5,800 条引用。其中，与 23 项单独试验相关的 39 篇出版物被保留。此外，还包括 414 条评论（28 条指南、30 条教科书章节、20 条系统评论、336 条叙述性评论）。总共 5,782 名患者被随机分配接受腹腔镜 (n = 3,031) 和开腹 (n = 2,751) 结直肠手术。生存数据发表在 16 种出版物中。就总生存率而言，腹腔镜手术并不逊于开腹手术（HR = 0.94，95% CI 0.80，1.09）。文献中有关结肠癌腹腔镜手术的肿瘤学可接受性的专家意见与 2002-2004 年大型随机对照试验的发表密切相关。尽管自 2006 年以来越来越多的人接受腹腔镜直肠癌手术，但仍然存在争议。就总生存率而言，腹腔镜结肠癌手术并不逊色于开腹手术，自 2004 年以来一直如此。自 2002 年至 2004 年以来，文献中的大多数专家意见都认为这两种技术是等效的。自2006年以来，腹腔镜直肠癌手术越来越被接受，但仍存在争议。该领域的知识转化工作似乎与临床试验证据的积累并行。
This study sought to synthesize survival outcomes from trials of laparoscopic and open colorectal cancer surgery, and to determine whether expert acceptance of this technology in the literature has parallel cumulative survival evidence. A systematic review of randomized trials was conducted. The primary outcome was survival, and meta-analysis of time-to-event data was conducted. Expert opinion in the literature (published reviews, guidelines, and textbook chapters) on the acceptability of laparoscopic colorectal cancer was graded using a 7-point scale. Pooled survival data were correlated in time with accumulating expert opinion scores. A total of 5,800 citations were screened. Of these, 39 publications pertaining to 23 individual trials were retained. As well, 414 reviews were included (28 guidelines, 30 textbook chapters, 20 systematic reviews, 336 narrative reviews). In total, 5,782 patients were randomized to laparoscopic (n = 3,031) and open (n = 2,751) colorectal surgery. Survival data were presented in 16 publications. Laparoscopic surgery was not inferior to open surgery in terms of overall survival (HR = 0.94, 95% CI 0.80, 1.09). Expert opinion in the literature pertaining to the oncologic acceptability of laparoscopic surgery for colon cancer correlated most closely with the publication of large RCTs in 2002–2004. Although increasingly accepted since 2006, laparoscopic surgery for rectal cancer remained controversial. Laparoscopic surgery for colon cancer is non-inferior to open surgery in terms of overall survival, and has been so since 2004. The majority expert opinion in the literature has considered these two techniques to be equivalent since 2002–2004. Laparoscopic surgery for rectal cancer has been increasingly accepted since 2006, but remains controversial. Knowledge translation efforts in this field appear to have paralleled the accumulation of clinical trial evidence.
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DOI：
10.1590/s0041-87812003000300002
发表时间：
2003-01-01
期刊：
Revista do Hospital das Clínicas
影响因子：
--
作者：
Araujo, Sergio Eduardo Alonso;Sousa Jr, Afonso Henrique da Silva e;Gama-Rodrigues, Joaquim José
通讯作者：
Gama-Rodrigues, Joaquim José
影响因子：
168.9
作者：
Barkun, Jeffrey S.;Aronson, Jeffrey K.;Strasberg, Steven M.
通讯作者：
Strasberg, Steven M.
影响因子：
45.3
作者：
Jayne, David G.;Guillou, Pierre J.;Brown, Julia M.
通讯作者：
Brown, Julia M.
影响因子：
168.9
作者：
Lacy, AM;García-Valdecasas, JC;Visa, J
通讯作者：
Visa, J
影响因子：
2.8
作者：
King, P. M.;Blazeby, J. M.;Kennedy, R. H.
通讯作者：
Kennedy, R. H.