Impacts of omega-3 fatty acids intervention on immune functions and clinical outcomes in surgical gastric cancer patients: a systematic review and trial sequential meta-analysis
Abstract
BACKGROUND: Gastric cancer patients are vulnerable to postoperative complications. Omega-3 fatty acids may improve immune function and reduce postoperative complications. However, the impacts of omega-3 fatty acids intervention on immune function and clinical outcomes in gastric cancer patients are not clear. METHODS: Seven databases were retrieved: Cochrane Library, Embase, PubMed, Web of Science, China National Knowledge Infrastructure (CNKI), Wanfang, and Yiigle. Randomized controlled trials (RCTs) were included. The Revised Cochrane risk-of-bias tool (ROB 2) was used to assess the risk of bias of included RCTs. RevMan software was used for data synthesis. Subgroup analysis and sensitivity analysis were conducted to evaluate the stability of the results. Trial sequential analysis (TSA) was performed to explore the false-positive results and estimate the required information size (RIS). RESULTS: Thirty-two RCTs involving 2,404 gastric cancer patients were included. Compared with the control group, omega-3 fatty acids supplementation significantly decreased the incidence of infectious complication (RR = 0.42; 95% CI, [0.32, 0.54]; P<0.00001; I2 = 0%), shortened the length of hospital stay (MD=-1.27 days; 95% CI [-2.10, -0.45]; P = 0.002; I2 = 67%), and elevated the level of CD4+ T cell (MD = 4.96%; 95% CI, [3.49, 6.44]; P<0.00001; I2 = 84%). No significant difference was observed in in-hospital mortality between the two groups (RR = 0.54; 95% CI, [0.12, 2.42]; P = 0.42; I2…
How strong is the evidence?
Evidence Hub reads this as a meta-analysis, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 2,404 participants or records.
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