Comparison of endoscopic submucosal dissection and surgery for early gastric cancer that is not indicated for endoscopic resection in elderly patients

Kang, Seokin; Lee, Jeong Hoon; Kim, Yuri; Park, Kwangbeom; Na, Hee Kyong; Ahn, Ji Yong; Jung, Kee Wook; Kim, Do Hoon; Choi, Kee Don; Song, Ho June; Lee, Gin Hyug; Jung, Hwoon‐Yong

doi:10.1007/s00464-023-09989-6

Cited by 4 publications

(4 citation statements)

References 29 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Some studies reported that the incidence of heterochronous lesions after ESD is higher than that after surgery [ 33 , 35 – 37 ]. Moreover, EGC still carries a risk of lymph node metastasis, and ESD does not allow the removal of potentially metastatic lymph nodes [ 17 – 19 ]. According to the data analysis, we found that the elderly patients with EGC in the ESD group had a worse OS than those in the surgery group.…”

Section: Discussionmentioning

confidence: 99%

“…However, there is still no definitive difference between ESD treatment and surgical treatment for elderly patients with EGC. Some studies revealed that the OS between the ESD group and the surgery group was not significantly different [17][18][19][20]. Kishida Y et al conducted a study of 417 elderly patients (114 in the ESD group; 303 in the surgery group) and found that the ESD group had worse OS than the surgery group [16].…”

Section: Discussionmentioning

confidence: 99%

“…After the titles and abstracts of the remaining 183 studies were viewed, 14 studies were left for full-text screening. Eight studies were determined to be eligible and thereby included in this analysis [16][17][18][19][20][25][26][27] (Fig. 1).…”

Section: Study Selectionmentioning

confidence: 99%

“…A study reported that ESD was associated with worse overall survival (OS) [16]. Other studies showed that there was no significant difference in OS between ESD and surgery [17][18][19][20]. Therefore, the aim of this study was to investigate whether there is a difference in OS between the ESD and surgery.…”

Section: Introductionmentioning

confidence: 97%

See 3 more Smart Citations

Comparison of endoscopic submucosal dissection versus surgery for early gastric cancer in the elderly: a pooled analysis

Liu,

Wen,

Liu

et al. 2023

World J Surg Onc

View full text Add to dashboard Cite

Purpose The aim of this study was to investigate whether there was a difference in overall survival (OS) between elderly patients with early gastric cancer (EGC) who underwent endoscopic submucosal dissection (ESD) and those who underwent surgery. Methods Four databases including PubMed, Embase, the Cochrane Library and CKNI were searched on March 20, 2023. The characteristics of the studies and the baseline information of the patients, including their medical histories, postoperative data, and prognoses, were recorded. Odds ratios (ORs) or mean differences (MDs), and 95% confidence intervals (CIs) were pooled up to calculate baseline information and postoperative information. Hazard ratios (HRs) and 95% CIs were used to calculate the prognosis of the patients. Stata V16.0 software was used for the data analysis. Results A total of eight studies involving 2334 patients were included for the data analysis in this study. After pooling up the data, we found that the ESD group had lower Eastern Cooperative Oncology Groupprevious (ECOG) scores (OR = 0.33, 95% CI = 0.17 to 0.65, I2 = 59.69%, P = 0.00 < 0.05) than the surgery group. There were significant differences in the operation time (MD = -3.38, 95% CI = -5.19 to -1.57, I2 = 98.31%, P = 0.00 < 0.05), length of hospital stay (MD = -3.01, 95% CI = -4.81 to -1.20, I2 = 98.83%, P = 0.00 < 0.05) and hospitalization expenses (MD = -2.67, 95% CI = -3.59 to -1.75, I2 = 93.21%, P = 0.00 < 0.05) between the two groups. The ESD group had a lower OS rate (HR = 2.81, 95% CI = 2.20 to 3.58, I2 = 12.28%, P = 0.00 < 0.05). Conclusion Elderly patients with EGC who underwent ESD had a significantly worse OS rate than those who underwent surgery. If the patient’s condition was suitable, surgery was still recommended for these patients.

show abstract