Background: Indocyanine green-guided (ICG-guided) lymphadenectomy during gastrectomy for cancer has been proposed to enhance the accuracy of lymphadenectomy. The impact of ICG-guided lymphadenectomy on patient survival remains debated. Methods: The findings of the systematic review were reconstructed into an individual patient data (IDP) meta-analysis with restricted mean survival time difference (RMSTD). Overall survival (OS) and disease-free (DFS) survival were primary outcomes. RMSTD, standardized mead difference (SMD), and 95% confidence intervals (CI) were used as pooled effect size measures. Results: Three studies (6325 patients) were included; 42% of patients underwent ICG-guided lymphadenectomy. The patients’ age ranged from 47 to 72 years and 58% were males. Proximal, distal, and total gastrectomy were completed in 6.8%, 80.4%, and 12.8% of patients, respectively. The surgical approach was laparoscopic (62.3%) and robotic (37.7%). ICG-guided lymphadenectomy was associated with a higher number of harvested lymph nodes compared to non-ICG-guided lymphadenectomy (SMD 0.50; 95% CI 0.45–0.55). At the 42-month follow-up, OS and DFS estimates for ICG-guided vs. non-ICG-guided lymphadenectomy were 0.5 months (95% CI −0.01, 1.1) and 1.3 months (95% CI 0.39, 2.15), respectively. Conclusions: Our analysis suggests that ICG-guided lymphadenectomy offers equivalent long-term OS and DFS compared to non-ICG-guided lymphadenectomy.
背景：在胃癌切除术中应用吲哚菁绿引导（ICG引导）淋巴结清扫术被认为可提高淋巴结清扫的精确性，但其对患者生存率的影响仍存争议。方法：本研究将系统评价结果重构为基于个体患者数据（IPD）的荟萃分析，采用限制平均生存时间差（RMSTD）作为评估指标。主要结局指标为总生存期（OS）和无病生存期（DFS）。通过RMSTD、标准化均值差（SMD）及95%置信区间（CI）进行效应量合并分析。结果：共纳入3项研究（6325例患者），其中42%患者接受ICG引导淋巴结清扫术。患者年龄范围为47-72岁，男性占58%。近端胃切除术、远端胃切除术及全胃切除术分别占6.8%、80.4%和12.8%。手术方式包括腹腔镜手术（62.3%）和机器人手术（37.7%）。与非ICG引导组相比，ICG引导组获取淋巴结数量显著增加（SMD 0.50；95% CI 0.45-0.55）。在42个月随访期内，ICG引导组与非ICG引导组的OS和DFS差异分别为0.5个月（95% CI -0.01, 1.1）和1.3个月（95% CI 0.39, 2.15）。结论：本分析表明，ICG引导淋巴结清扫术与非ICG引导术式相比，在长期总生存期和无病生存期方面具有等效性。
肿瘤(癌症)患者之家