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Comparative Study
Journal Article
Meta-Analysis
Review
Systematic Review
Endoscopic Resection Compared with Gastrectomy to Treat Early Gastric Cancer: A Systematic Review and Meta-Analysis.
PloS One 2015
BACKGROUND: Endoscopic resection and gastrectomy are treatment modalities for early gastric cancer, but their relative benefits and risks are unclear. We conducted a systematic review and meta-analysis to compare endoscopic resection and gastrectomy for treating early gastric cancer.
METHODS: We searched PubMed, Embase, and the Cochrane Library until April 2015 for studies comparing endoscopic resection with gastrectomy for treatment of early gastric cancer. Outcome measures were five-year overall survival (OS), length of hospital stay and postoperative morbidity. We calculated pooled hazard ratio (HR), weighted mean difference (WMD) and odds ratio (OR) using random effects models.
RESULTS: Six studies comprising 1,466 patients (618 endoscopic resection and 848 gastrectomy) met inclusion criteria. Five-year OS was similar between endoscopic resection and gastrectomy (HR, 1.06; 95% CI: 0.61 to 1.83). Endoscopic resection was associated with shorter hospital stays (WMD, -6.94; 95% CI: -7.59 to -6.29) and reduced overall postoperative morbidity (OR, 0.36; 95% CI: 0.17 to 0.74).
CONCLUSIONS: While five-year OS is similar between endoscopic resection and gastrectomy, endoscopic resection offers a shorter hospital stay and fewer complications than gastrectomy for treating early gastric cancer. Endoscopic resection is a reasonable treatment for early gastric cancer with a negligible risk of lymph node metastasis.
METHODS: We searched PubMed, Embase, and the Cochrane Library until April 2015 for studies comparing endoscopic resection with gastrectomy for treatment of early gastric cancer. Outcome measures were five-year overall survival (OS), length of hospital stay and postoperative morbidity. We calculated pooled hazard ratio (HR), weighted mean difference (WMD) and odds ratio (OR) using random effects models.
RESULTS: Six studies comprising 1,466 patients (618 endoscopic resection and 848 gastrectomy) met inclusion criteria. Five-year OS was similar between endoscopic resection and gastrectomy (HR, 1.06; 95% CI: 0.61 to 1.83). Endoscopic resection was associated with shorter hospital stays (WMD, -6.94; 95% CI: -7.59 to -6.29) and reduced overall postoperative morbidity (OR, 0.36; 95% CI: 0.17 to 0.74).
CONCLUSIONS: While five-year OS is similar between endoscopic resection and gastrectomy, endoscopic resection offers a shorter hospital stay and fewer complications than gastrectomy for treating early gastric cancer. Endoscopic resection is a reasonable treatment for early gastric cancer with a negligible risk of lymph node metastasis.
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