A meta-analysis of the impact on gastrectomy versus endoscopic submucosal dissection for early stomach cancer-Reference-Cited by-同舟云学术

A meta-analysis of the impact on gastrectomy versus endoscopic submucosal dissection for early stomach cancer

Published:2023-11-03 Issue:3 Volume:1 Page:
ISSN:3005-480X
Container-title:International Journal of Clinical Medical Research
language:en
Short-container-title:IJCMR

Author:

Singh Rajesh K.

Abstract

Background: We conducted a meta-analysis to assess the impact of gastrectomy versus endoscopic submucosal dissection for early stomach cancer. There are-now-a-variety-of-viewpoints-on-gastrectomy-versus-endoscopic-submucosal-dissection-for-early-stomach-cancer,-and-there-are-not-many-thorough-assessments-that-are-pertinent. Methods: A-systematic-literature-search-up-to-July-2022-was-performed-and-2456-related-studies-were-evaluated.-The-chosen-studies-comprised-15461-early-stomach-cancer-subjects-who-participated-in-the-selected-studies'-baseline-trials;-6503-of-them-used-the-endoscopic-submucosal-dissection, while 8958 used gastrectomy. Odds ratio (OR), and mean difference (MD) with 95% confidence intervals (CIs) were calculated <span style="font-size: 10.0pt; font-family: 'Arial',sans-serif; mso-ascii-theme-font: minor-bidi; mso-fareast-font-family: Calibri; mso-fareast-theme-font: minor-latin; mso-hansi-theme-font: minor-bidi; mso-bidi-theme-font: minor-bidi;">to assess the effect of the gastrectomy versus endoscopic submucosal dissection for early stomach cancer by the dichotomous, and contentious methods with a random or fixed effect model. Results: The use of endoscopic submucosal dissection resulted in significantly lower 5-year overall survivals (OR, 0.59; 95% CI, 0.45-0.77, p<0.001), lower the 5-year overall survival in propensity score-matched patients (OR, 0.49; 95% CI, 0.41-0.59, p<0.001), higher recurrences (OR, 6.99; 95% CI, 5,03-9.70, p<0.001), and higher synchronous lesion (OR, 7.24; 95% CI, 2.78-18.83, p<0.001), and higher metachronous lesion (OR,10.05; 95% CI, 6.44-15.67, p<0.001) compared to the gastrectomy for early stomach cancer. However, no significant difference was found between submucosal dissection and gastrectomy for early stomach cancer <span style="font-size: 10.0pt; font-family: 'Arial',sans-serif; mso-ascii-theme-font: minor-bidi; mso-fareast-font-family: Calibri; mso-fareast-theme-font: minor-latin; mso-hansi-theme-font: minor-bidi; mso-bidi-theme-font: minor-bidi;">in recurrence-free survival (OR, 0.74; 95% CI, 0.54-1.00, p=0.05), disease-free survival (OR, 0.43; 95% CI, 0.16-1.16, p=0.10),<span style="font-size: 10.0pt; font-family: 'Arial',sans-serif; mso-ascii-theme-font: minor-bidi; mso-fareast-font-family: Calibri; mso-fareast-theme-font: minor-latin; mso-hansi-theme-font: minor-bidi; mso-bidi-theme-font: minor-bidi;"> and disease-specific survival (OR, 1.05; 95% CI, 0.38-2.89, p=0.92). Conclusions: <span style="font-size: 10.0pt; font-family: 'Arial',sans-serif; mso-ascii-theme-font: minor-bidi; mso-fareast-font-family: PMingLiU; mso-hansi-theme-font: minor-bidi; mso-bidi-theme-font: minor-bidi; mso-ansi-language: EN-US; mso-fareast-language: EN-US; mso-bidi-language: EN-US;">The use of endoscopic submucosal dissection resulted in significantly lower 5-year overall survival, lower 5-year overall survival in propensity score-matched patients, higher recurrences, higher-synchronous lesion, and higher metachronous lesion, however, no significant difference was found <span style="font-size: 10.0pt; font-family: 'Arial',sans-serif; mso-ascii-theme-font: minor-bidi; mso-fareast-font-family: Calibri; mso-fareast-theme-font: minor-latin; mso-hansi-theme-font: minor-bidi; mso-bidi-theme-font: minor-bidi; mso-ansi-language: EN-US; mso-fareast-language: EN-US; mso-bidi-language: EN-US;">in <span style="font-size: 10.0pt; font-family: 'Arial',sans-serif; mso-ascii-theme-font: minor-bidi; mso-fareast-font-family: PMingLiU; mso-hansi-theme-font: minor-bidi; mso-bidi-theme-font: minor-bidi; mso-ansi-language: EN-US; mso-fareast-language: EN-US; mso-bidi-language: EN-US;">recurrence-free survival, disease-free survival,<span style="font-size: 10.0pt; font-family: 'Arial',sans-serif; mso-ascii-theme-font: minor-bidi; mso-fareast-font-family: Calibri; mso-fareast-theme-font: minor-latin; mso-hansi-theme-font: minor-bidi; mso-bidi-theme-font: minor-bidi; mso-ansi-language: EN-US; mso-fareast-language: EN-US; mso-bidi-language: EN-US;"> and <span style="font-size: 10.0pt; font-family: 'Arial',sans-serif; mso-ascii-theme-font: minor-bidi; mso-fareast-font-family: PMingLiU; mso-hansi-theme-font: minor-bidi; mso-bidi-theme-font: minor-bidi; mso-ansi-language: EN-US; mso-fareast-language: EN-US; mso-bidi-language: EN-US;">disease-specific survival compared to the gastrectomy for early stomach cancer. The small number of studies in several comparisons calls for care when analyzing the results.

Publisher

Pharaoh Academy International Publishing Co., Limited

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