Bursectomy Versus Nonbursectomy for Gastric Adenocarcinoma: A Single-Center, Propensity-Score Matched Cohort Study in China

Background: The therapeutic value of bursectomy remains controversial for patients with gastric cancer. Therefore, the purpose of our study was to explore the safety and survival benefits of bursectomy. Materials and Methods: A total of 943 patients with gastric adenocarcinoma were included in our study, and all patients were operated on by high-quality gastrointestinal surgeons. The factors associated with overall survival (OS) were determined using the Kaplan-Meier method. In addition, patients in the bursectomy group and nonbursectomy group were matched with 1:1 propensity score matching for sex, age, tumor location, type of operation, tumor size, degree of differentiation, and pathological stage to reduce the possibility of choice bias. Results: Among the 943 eligible patients, 188 (19.9%) underwent bursectomy and 755 (80.1%) did not. In all patients, the number of retrieved lymph nodes (P = .0596), blood loss volume (P = .0896), operation time (P = .0747), number of postoperative complications (P = .626), and OS in the bursectomy group were similar to those in the nonbursectomy group. After a stratified analysis of TNM grade and T stage, it was found that bursectomy could lead to survival benefits for patients with stage T4 disease (P = .0398). Conclusions: Bursectomy does not increase the amount of blood loss, operation time, or incidence of postoperative complications. This procedure is an extended and safe surgical method for gastric adenocarcinoma. Bursectomy does not improve the survival of all patients, but for patients with stage T4 disease, bursectomy can provide survival benefits.