Endoscopic Submucosal Dissection versus Surgery for Undifferentiated-Type Early Gastric Cancer: A Systematic Review and Meta-Analysis
1
조회
0
다운로드
5
인용
0
참고문헌
키워드
초록
Background/Aims: The use of endoscopic submucosal dissection (ESD) for treating undifferentiated-type early gastric cancer iscontroversial. The objective of this study was to perform a meta-analysis to compare the long-term outcomes of ESD and surgery forundifferentiated-type early gastric cancer. Methods: The PubMed, Cochrane Library, and EMBASE databases were used to search for relevant studies comparing ESD andsurgery for undifferentiated-type early gastric cancer. The methodological quality of the included publications was evaluated usingthe Risk of Bias Assessment tool for Nonrandomized Studies. The rates of overall survival, recurrence, adverse event, and completeresection 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. Nosignificant 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 wassimilar between the two groups. Conclusions: ESD with meticulous surveillance esophagogastroduodenoscopy may be as effective and safe as surgery in patientswith undifferentiated-type early gastric cancer. Further large-scale, randomized, controlled studies from additional regions arerequired to confirm these findings.
Abstract
Background/Aims: The use of endoscopic submucosal dissection (ESD) for treating undifferentiated-type early gastric cancer iscontroversial. The objective of this study was to perform a meta-analysis to compare the long-term outcomes of ESD and surgery forundifferentiated-type early gastric cancer. Methods: The PubMed, Cochrane Library, and EMBASE databases were used to search for relevant studies comparing ESD andsurgery for undifferentiated-type early gastric cancer. The methodological quality of the included publications was evaluated usingthe Risk of Bias Assessment tool for Nonrandomized Studies. The rates of overall survival, recurrence, adverse event, and completeresection 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. Nosignificant 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 wassimilar between the two groups. Conclusions: ESD with meticulous surveillance esophagogastroduodenoscopy may be as effective and safe as surgery in patientswith undifferentiated-type early gastric cancer. Further large-scale, randomized, controlled studies from additional regions arerequired to confirm these findings.
참고문헌 (40)
- Tsujitani S, "Less invasive surgery for early gastric cancer based on the low probability of lymph node metastasis", Surgery, 125, pp.148~154 (1999)
- Gotoda T, "Incidence of lymph node metastasis from early gastric cancer : estimation with a large number of cases at two large centers", Gastric Cancer, 3, pp.219~225 (2000)
- Japanese Gastric Cancer Association, "Japanese gastric cancer treatment guidelines 2010(ver. 3)", Gastric Cancer, 14, pp.113~123 (2011)
- 박찬혁, "Clinical Practice Guideline for Endoscopic Resection of Early Gastrointestinal Cancer", Clinical Endoscopy, 53(2), pp.142~166 (2020), 대한소화기내시경학회[DOI]
- Lee H, "A feasibility study on the expanded indication for endoscopic submucosal dissection of early gastric cancer", Surg Endosc, 25, pp.1985~1993 (2011)
- Ahn JY, "Endoscopic and oncologic outcomes after endoscopic resection for early gastric cancer : 1370 cases of absolute and extended indications", Gastrointest Endosc, 74, pp.485~493 (2011)
- Hirasawa T, "Incidence of lymph node metastasis and the feasibility of endoscopic resection for undifferentiated-type early gastric cancer", Gastric Cancer, 12, pp.148~152 (2009)
- Aihara R, "Mucin phenotypic expression in early signet ring cell carcinoma of the stomach : its relationship with the clinicopathologic factors", Dig Dis Sci, 49, pp.417~424 (2004)
- Sun K, "Endoscopic resection versus surgery for early gastric cancer : a systematic review and meta-analysis", Dig Endosc, 28, pp.513~525 (2016)
- Meng FS, "Comparison of endoscopic resection and gastrectomy for the treatment of early gastric cancer : a meta-analysis", Surg Endosc, 30, pp.3673~3683 (2016)
- Kondo A, "Endoscopy vs surgery in the treatment of early gastric cancer : systematic review", World J Gastroenterol, 21, pp.13177~13187 (2015)
- Bang CS, "Endoscopic submucosal dissection for early gastric cancer with undifferentiated-type histology : a meta-analysis", World J Gastroenterol, 21, pp.6032~6043 (2015)
- Kim JH, "Follow-up outcomes of endoscopic resection for early gastric cancer with undifferentiated histology", Surg Endosc, 28, pp.2627~2633 (2014)
- Okada K, "Long-term outcomes of endoscopic submucosal dissection for undifferentiated-type early gastric cancer", Endoscopy, 44, pp.122~127 (2012)
- Kamada K, "Endoscopic submucosal dissection for undifferentiated early gastric cancer as the expanded indication lesion", Digestion, 85, pp.111~115 (2012)
- Liberati A, "The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions : explanation and elaboration", J Clin Epidemiol, 62, pp.e1~e34 (2009)
- Kim SY, "Testing a tool for assessing the risk of bias for nonrandomized studies showed moderate reliability and promising validity", J Clin Epidemiol, 66, pp.408~414 (2013)
- Higgins JP, "Measuring inconsistency in meta-analyses", BMJ, 327, pp.557~560 (2003)
- Sterne JA, "Funnel plots for detecting bias in meta-analysis : guidelines on choice of axis", J Clin Epidemiol, 54, pp.1046~1055 (2001)
- Begg CB, "Operating characteristics of a rank correlation test for publication bias", Biometrics, 50, pp.1088~1101 (1994)
- Lim JH, "Long-term clinical outcomes of endoscopic vs. surgical resection for early gastric cancer with undifferentiated histology", Surg Endosc, 33, pp.3589~3599 (2019)
- Park JC, "Long-term outcomes of endoscopic submucosal dissection in comparison to surgery in undifferentiated-type intramucosal gastric cancer using propensity score analysis", Surg Endosc, 32, pp.2046~2057 (2018)
- Lee S, "Long-term outcomes of endoscopic submucosal dissection versus surgery in early gastric cancer meeting expanded indication including undifferentiated-type tumors : a criteria-based analysis", Gastric Cancer, 21, pp.490~499 (2018)
- Hahn KY, "Comparative study between endoscopic submucosal dissection and surgery in patients with early gastric cancer", Surg Endosc, 32, pp.73~86 (2018)
- 정민우, "미분화 조기위암에서 내시경 점막하박리술과 위절제수술의 장기 치료 성적 비교", 대한소화기학회지, 63(2), pp.90~98 (2014), 대한소화기학회
- Park CH, "Long-term outcome of early gastric cancer after endoscopic submucosal dissection : expanded indication is comparable to absolute indication", Dig Liver Dis, 45, pp.651~656 (2013)
- Lee IS, "Suitability of endoscopic submucosal dissection for treatment of submucosal gastric cancers", Br J Surg, 100, pp.668~673 (2013)
- 민양원, "Endoscopic Resection for Early Gastric Cancer beyond Absolute Indication with Emphasis on Controversial Issues", Journal of Gastric Cancer, 14(1), pp.7~14 (2014), 대한위암학회[DOI]
- Lee TH, "Appropriate indications for endoscopic submucosal dissection of early gastric cancer according to tumor size and histologic type", Gastrointest Endosc, 71, pp.920~926 (2010)
- Kang HY, "Clinical outcomes of endoscopic submucosal dissection for undifferentiated early gastric cancer", Surg Endosc, 24, pp.509~516 (2010)
- Choi J, "Comparison of endoscopic ultrasonography and conventional endoscopy for prediction of depth of tumor invasion in early gastric cancer", Endoscopy, 42, pp.705~713 (2010)
- Inokuchi Y, "Outcomes and precautions of endoscopic submucosal dissection for undifferentiated-type early gastric cancer", Therap Adv Gastroenterol, 8, pp.255~262 (2015)
- Kim YY, "Endoscopic submucosal dissection for early gastric cancer with undifferentiated histology : could we extend the criteria beyond?", Surg Endosc, 27, pp.4656~4662 (2013)
- Abe S, "Short-and long-term outcomes of endoscopic submucosal dissection for undifferentiated early gastric cancer", Endoscopy, 45, pp.703~707 (2013)
- Kato M, "Scheduled endoscopic surveillance controls secondary cancer after curative endoscopic resection for early gastric cancer : a multicentre retrospective cohort study by Osaka University ESD study group", Gut, 62, pp.1425~1432 (2013)
- Hahn KY, "Incidence and impact of scheduled endoscopic surveillance on recurrence after curative endoscopic resection for early gastric cancer", Gastrointest Endosc, 84, pp.628~638 (2016)
- "The general rules for the gastric cancer study in surgery and pathology. Part II. Histological classification of gastric cancer", Jpn J Surg, 11, pp.140~145 (1981)
- Kim DY, "Clinicopathological characteristics of signet ring cell carcinoma of the stomach", ANZ J Surg, 74, pp.1060~1064 (2004)
- Hyung WJ, "Early gastric carcinoma with signet ring cell histology", Cancer, 94, pp.78~83 (2002)
- Adachi Y, "Pathology and prognosis of gastric carcinoma : well versus poorly differentiated type", Cancer, 89, pp.1418~1424 (2000)