Three-field vs two-field lymph node dissection for XXXX : a meta-analysis.

@entity1 @entity129 @entity254 @entity260 @entity358 @entity418
AIM: To assess the effects of 3-field lymphadenectomy for @entity418 . METHODS: We conducted a computerized literature search of the PubMed, Cochrane Controlled Trials Register, and EMBASE databases from their inception to present. Randomized controlled trials (RCTs) or observational epidemiological studies (cohort studies) that compared the survival rates and/or @entity260 between 2-field lymphadenectomy (2FL) and 3-field lymphadenectomy (3FL) for @entity418 with R0 resection were included. Meta-analysis was conducted using published data on 3FL vs 2FL in @entity418 @entity1 . End points were 1-, 3-, and 5-year overall survival rates and @entity260 , including recurrent @entity129 , @entity254 leak, @entity358 , and chylothorax. Subgroup analysis was performed on the involvement of recurrent laryngeal lymph nodes. RESULTS: Two RCTs and 18 observational studies with over 7000 @entity1 were included. There was a clear benefit for 3FL in the 1- (RR = 1.16; 95%CI: 1.09-1.24; P < 0.01), 3- (RR = 1.44; 95%CI: 1.19-1.75; P < 0.01), and 5-year overall survival rates (RR = 1.37; 95%CI: 1.18-1.59; P < 0.01). For @entity260 , 3FL was associated with significantly more recurrent @entity129 (RR = 1.43; 95%CI: 1.28-1.60; P = 0.02) and @entity254 leak (RR = 1.26; 95%CI: 1.05-1.52; P = 0.09). In contrast, there was no significant difference for @entity358 (RR = 0.93; 95%CI: 0.75-1.16, random-effects model; P = 0.27) or chylothorax (RR = 0.77; 95%CI: 0.32-1.85; P = 0.69). CONCLUSION: This meta-analysis shows that 3FL improves overall survival rate but has more complications. Because of the high heterogeneity among outcomes, definite conclusions are difficult to draw.
