内镜黏膜下剥离术
癌症
内科学
随机对照试验
普通外科
胃
粘膜切除术
作者
Cheal Wung Huh,Dae Won Ma,Byung-Wook Kim,Joon Sung Kim,Seung-Jae Lee
出处
期刊:Clinical Endoscopy
[The Korean Society of Gastrointestinal Endoscopy]
日期:2021-02-17
卷期号:54 (2): 202-210
被引量:3
摘要
Background/Aims: The use of endoscopic submucosal dissection (ESD) for treating undifferentiated-type early gastric cancer is controversial. The objective of this study was to perform a meta-analysis to compare the long-term outcomes of ESD and surgery for undifferentiated-type early gastric cancer.
Methods: The PubMed, Cochrane Library, and EMBASE databases were used to search for relevant studies comparing ESD and surgery for undifferentiated-type early gastric cancer. The methodological quality of the included publications was evaluated using the Risk of Bias Assessment tool for Nonrandomized Studies. The rates of overall survival, recurrence, adverse event, and complete resection were determined. Odds ratios (ORs) and 95% confidence intervals (CIs) were also evaluated.
Results: This meta-analysis enrolled five studies with 429 and 1,236 participants undergoing ESD and surgery, respectively. No significant difference was found in the overall survival rate between the ESD and surgery groups (OR, 2.29; 95% CI, 0.98-5.36; p=0.06). However, ESD was associated with a higher recurrence rate and a lower complete resection rate. The adverse event rate was similar between the two groups.
Conclusions: ESD with meticulous surveillance esophagogastroduodenoscopy may be as effective and safe as surgery in patients with undifferentiated-type early gastric cancer. Further large-scale, randomized, controlled studies from additional regions are required to confirm these findings. Clin Endosc 2021;54:202-210
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