Endoscopic versus surgical resection for early colorectal cancer—a systematic review and meta-analysis

Abstract

Background: To investigate the available data on the treatment of early colorectal cancer (CRC), either endoscopically or surgically.Methods: Two independent reviewers searched MEDLINE, EMBASE, CENTRAL COCHRANE, LILACS and EBSCO for articles published up to August 2015. No language or dates filters were applied.Inclusion criteria were studies with published data about patients with early colonic or rectal cancer undergoing either endoscopic resection (i.e., mucosectomy or submucosal dissection) or surgical resection (i.e., open or laparoscopic). Extracted data items undergoing meta-analysis were en bloc resection rate, curative resection rate, and complications. A complementary analysis was performed on procedure time. The risk of bias among studies was evaluated with funnel-plot expressions, and sensitivity analyses were carried out whenever a high heterogeneity was found. The risk of bias within studies was assessed with the Newcastle score.Results: A total of 12,819 articles were identified in the preliminary search. After applying inclusion and exclusion criteria, three cohort studies with a total of 768 patients undergoing endoscopic resection and 552 patients undergoing surgical resection were included. The en bloc resection rate risk difference was −11% Conclusions: According to the current available data, the treatment of early CRC by surgical resection is associated with higher curative resection rates and higher en bloc resection rates, despite of higher complications rates, as compared to endoscopic resection. Shorter procedure times are associated with the endoscopic methods of treatment, however high heterogeneity levels limit this conclusion.

Is Piecemeal Endoscopic Resection Acceptable for Early Colorectal Cancers in Certain Situations? A Single-Center French Study

“…The excellent overall survival rate of ECC patients in our study (100%) was similar to that in the literature [19,36] and should motivate us to treat as conservatively as possible to achieve an extremely low rate of complications, but patients who did not undergo surgery by default can experience severe oncological consequences.…”

Depletion of insulin-like growth factor 1 receptor increases radiosensitivity in colorectal cancer

“…Cells were cultured in 6 cm dishes at a density of approximately 1×10 4 cells per dish for overnight, and were irradiated with different doses of ionizing radiation (2,4,6, and 8 Gy), using a Faxitron 43855 F X-ray radiometer (Faxitron, USA). The radiation parameters were 160 kV and 6.3 mA.…”

“…Colorectal cancer (CRC) remains a common lethal disease (1). Following surgical treatment, the cure rate is correlated with the overall resection rate (2). However, in patients with more advanced colorectal cancer, the mortality rate is high (3).…”

Minimally invasive surgery for colorectal cancer in advanced age patients

“…На сегодняшний день во многих странах мира отмечается существенный рост заболеваемости колоректальным раком, в то числе его осложненных форм, причем есть данные, что этот рост продолжится [1][2][3][4][5][6][7]. Объективным является повышение в составе населения удельного веса представителей старших возрастных групп, на которые приходится пик заболеваемости раком толстой кишки.…”