Gastrectomy and risk of pancreatic cancer: systematic review and meta-analysis of observational studies
A partir d'une revue systématique de la littérature (11 études cas-témoins et 4 études de cohorte), cette méta-analyse évalue l'association entre une gastrectomie et le risque de cancer du pancréas
Purpose To investigate the association between gastrectomy and risk of pancreatic cancer (PaC). Methods We identified eligible studies in Medline and EMBASE up to 11 February 2012 and the reference lists of original studies and review articles on this topic. Summary relative risks with their 95 % confidence intervals were calculated with a random-effects model. Between-study heterogeneity was assessed using Cochran Q and I 2 statistics. Results Fifteen studies (11 case–control studies and 4 cohort studies) met eligibility criteria. The current data suggest that gastrectomy is associated with a 54 % excess risk of PaC (SRRs = 1.54; 95 % CI, 1.25–1.90; test for heterogeneity Q = 17.94, p < 0.001, I 2 = 22 %). There was no publication bias in the present meta-analysis. Conclusion A significant increased risk of PaC exists in patients who have undergone gastrectomy, particularly those receiving Billroth II resection with a long postoperative interval.