Efficacy and safety of herbal medicine treatment on postsurgical recovery in gastric cancer patients: A systematic review and meta-analysis

Background: Gastric cancer (GC) is the second most prevalent cancer in Korea, and is associated with significant morbidity and mortality. Although advancements in early detection and treatment have improved survival rates, management of postsurgical recovery remains vital. Herbal medicine (HM) has emerged as a potential adjunct therapy for enhancing the recovery and quality of life (QoL) of patients post-GC surgery. Methods: This systematic review and meta-analysis evaluated the efficacy and safety of HM in the postsurgical recovery of patients with GC. We searched both Korean and international databases and identified 16 randomized controlled trials that met our inclusion criteria. We assessed the study quality using the Cochrane Risk of Bias tool and analyzed the data using the Review Manager Software (RevMan). Results: Our analysis included 1546 patients from selected studies, demonstrating that HM significantly improved gastrointestinal recovery times, including the time to first flatus, bowel movement, and return of bowel sounds. Significant improvements were also observed in nutritional markers, such as albumin and prealbumin, along with beneficial effects on immune markers, such as CD3 + and CD4 + levels. QoL assessments using the WHOQOL-BREF and QLQ-C30 indicated substantial improvements. HM had a favorable safety profile, showing a reduced incidence of adverse effects compared to the controls. Conclusion: The findings suggest that HM can significantly enhance recovery and improve quality of life following GC surgery, with a favorable safety profile. However, due to the considerable heterogeneity in study results, extended clinical trials and rigorous follow-ups are recommended to comprehensively assess long-term effects and side effects.