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- Title
Outcome of endoscopic submucosal dissection for early gastric cancer of conventional and expanded indications: Systematic review and meta-analysis.
- Authors
Peng, Li Jun; Tian, Shu Ni; Lu, Lin; Chen, Hao; Ouyang, Yang Yang; Wu, Yu Jing
- Abstract
OBJECTIVE: Current guidelines for treating early gastric cancer (EGC) with endoscopic submucosal dissection (ESD) are being developed with broader criteria. This systematic review and meta-analysis aimed to assess the application of expanded indications (EIN) by comparing outcomes between conventional indication (CIN) and EIN groups. METHODS: Literature databases were searched. Short-term outcomes, including endoscopic resection rates, complications and local recurrence, and longterm outcomes including gastric cancer-specific mortality and overall mortality were compared in the two groups. RESULTS: In all, 13 studies were identified and evaluated. The EIN group had lower rates of en bloc (93.6% vs 97.0%, P < 0.0001), complete (87.8% vs 95.8%, P < 0.00001) and curative resection (82.4% vs 94.0%, P < 0.00001) than the CIN group. The rates of delayed bleeding and perforation were both significantly higher in the EIN group (3.9% vs 2.8%, P = 0.04 and 3.9% vs 1.8%, P < 0.0001). Local recurrence rates were 0.6% in the CIN group and 1.5% in the EIN group (P = 0.03). There were no significant differences between the two groups in the gastric-cancer specific mortality (P = 0.22) and the overall mortality (P = 0.37). CONCLUSIONS: Long-term mortality in the EIN group did not significantly differ from those in the CIN group, although the EIN group was associated with more unfavorable short-term outcomes. Thus, ESD could be recommended as an effective therapy for EGC of EIN.
- Subjects
GASTRIC disease diagnosis; SURGICAL excision; DISSECTION; SUBMUCOUS plexus; META-analysis
- Publication
Journal of Digestive Diseases, 2015, Vol 16, Issue 2, p67
- ISSN
1751-2972
- Publication type
Article
- DOI
10.1111/1751-2980.12217