PMID- 35903707
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20231105
IS  - 2234-943X (Print)
IS  - 2234-943X (Electronic)
IS  - 2234-943X (Linking)
VI  - 12
DP  - 2022
TI  - Endoscopic Resection Versus Surgery in the Treatment of Early Gastric Cancer: A 
      Systematic Review and Meta-Analysis.
PG  - 939244
LID - 10.3389/fonc.2022.939244 [doi]
LID - 939244
AB  - BACKGROUND AND AIM: Endoscopic resection (ER) is the preferred approach to treat 
      early gastric cancer (EGC) in patients without suspected lymph node involvement 
      and that meet the criteria for ER. Surgery is a more aggressive treatment, but it 
      may be associated with less recurrence and the need for reintervention. Previous 
      meta-analyses comparing ER with surgery for EGC did not incorporate the most 
      recent studies, making accurate conclusions not possible. METHODS: This 
      systematic review and meta-analysis aimed to examine complete resection, length 
      of hospital stay (LOHS), adverse events (AEs), serious AEs, recurrence, 5-year 
      overall survival (OS), and 5-year cancer-specific survival (CSS) in patients with 
      EGC. RESULTS: A total of 29 cohorts studies involving 20559 patients were 
      included. The ER (n = 7709) group was associated with a lower incidence of AEs 
      (RD = -0.07, 95%CI = -0.1, -0.04, p < 0.0001) and shorter LOHS (95% CI -5.89, 
      -5.32; p < 0,00001) compared to surgery (n = 12850). However, ER was associated 
      with lower complete resection rates (RD = -0.1, 95%CI = -0.15, -0.06; p < 
      0.00001) and higher rates of recurrence (RD = 0.07, 95%CI = 0.06; p < 0.00001). 
      There were no significant differences between surgery and ER in 5-year OS (RD = 
      -0.01, 95%CI = -0.04, 0.02; p = 0.38), 5-year CSS (RD = 0.01, 95%CI = 0.00, 0.02; 
      p < 0.17), and incidence of serious AEs (RD = -0.03, 95%CI = -0.08, 0.01; p = 
      0.13). CONCLUSIONS: ER and surgery are safe and effective treatments for EGC. ER 
      provides lower rates of AEs and shorter LOHS compared to surgery. Although ER is 
      associated with lower complete resection rates and a higher risk of recurrence, 
      the OS and CSS were similar between both approaches. SYSTEMATIC REVIEW 
      REGISTRATION: https://www.crd.york.ac.uk/PROSPERO/, identifier CRD42021255328.
CI  - Copyright (c) 2022 Bestetti, de Moura, Proenca, Junior, Ribeiro, Sasso, Kum, 
      Sanchez-Luna, Marques Bernardo and de Moura.
FAU - Bestetti, Alexandre Moraes
AU  - Bestetti AM
AD  - Servico de Endoscopia Gastrointestinal do Hospital das Clinicas Hospital das 
      Clinicas da Faculdade de Medicina da Universidade de Sao Paulo (HCFMUSP), 
      Departamento de Gastroenterologia, Faculdade de Medicina, Universidade de Sao 
      Paulo, Sao Paulo, SP, Brazil.
FAU - de Moura, Diogo Turiani Hourneaux
AU  - de Moura DTH
AD  - Servico de Endoscopia Gastrointestinal do Hospital das Clinicas Hospital das 
      Clinicas da Faculdade de Medicina da Universidade de Sao Paulo (HCFMUSP), 
      Departamento de Gastroenterologia, Faculdade de Medicina, Universidade de Sao 
      Paulo, Sao Paulo, SP, Brazil.
FAU - Proenca, Igor Mendonca
AU  - Proenca IM
AD  - Servico de Endoscopia Gastrointestinal do Hospital das Clinicas Hospital das 
      Clinicas da Faculdade de Medicina da Universidade de Sao Paulo (HCFMUSP), 
      Departamento de Gastroenterologia, Faculdade de Medicina, Universidade de Sao 
      Paulo, Sao Paulo, SP, Brazil.
FAU - Junior, Epifanio Silvino do Monte
AU  - Junior ESDM
AD  - Servico de Endoscopia Gastrointestinal do Hospital das Clinicas Hospital das 
      Clinicas da Faculdade de Medicina da Universidade de Sao Paulo (HCFMUSP), 
      Departamento de Gastroenterologia, Faculdade de Medicina, Universidade de Sao 
      Paulo, Sao Paulo, SP, Brazil.
FAU - Ribeiro, Igor Braga
AU  - Ribeiro IB
AD  - Servico de Endoscopia Gastrointestinal do Hospital das Clinicas Hospital das 
      Clinicas da Faculdade de Medicina da Universidade de Sao Paulo (HCFMUSP), 
      Departamento de Gastroenterologia, Faculdade de Medicina, Universidade de Sao 
      Paulo, Sao Paulo, SP, Brazil.
FAU - Sasso, Joao Guilherme Ribeiro Jordao
AU  - Sasso JGRJ
AD  - Servico de Endoscopia Gastrointestinal do Hospital das Clinicas Hospital das 
      Clinicas da Faculdade de Medicina da Universidade de Sao Paulo (HCFMUSP), 
      Departamento de Gastroenterologia, Faculdade de Medicina, Universidade de Sao 
      Paulo, Sao Paulo, SP, Brazil.
FAU - Kum, Angelo So Taa
AU  - Kum AST
AD  - Servico de Endoscopia Gastrointestinal do Hospital das Clinicas Hospital das 
      Clinicas da Faculdade de Medicina da Universidade de Sao Paulo (HCFMUSP), 
      Departamento de Gastroenterologia, Faculdade de Medicina, Universidade de Sao 
      Paulo, Sao Paulo, SP, Brazil.
FAU - Sanchez-Luna, Sergio A
AU  - Sanchez-Luna SA
AD  - Basil I. Hirschowitz Endoscopic Center of Excellence, Division of 
      Gastroenterology & Hepatology, Department of Internal Medicine, The University of 
      Alabama at Birmingham Heersink School of Medicine, Birmingham, AL, United States.
FAU - Marques Bernardo, Wanderley
AU  - Marques Bernardo W
AD  - Servico de Endoscopia Gastrointestinal do Hospital das Clinicas Hospital das 
      Clinicas da Faculdade de Medicina da Universidade de Sao Paulo (HCFMUSP), 
      Departamento de Gastroenterologia, Faculdade de Medicina, Universidade de Sao 
      Paulo, Sao Paulo, SP, Brazil.
FAU - de Moura, Eduardo Guimaraes Hourneaux
AU  - de Moura EGH
AD  - Servico de Endoscopia Gastrointestinal do Hospital das Clinicas Hospital das 
      Clinicas da Faculdade de Medicina da Universidade de Sao Paulo (HCFMUSP), 
      Departamento de Gastroenterologia, Faculdade de Medicina, Universidade de Sao 
      Paulo, Sao Paulo, SP, Brazil.
LA  - eng
PT  - Systematic Review
DEP - 20220712
PL  - Switzerland
TA  - Front Oncol
JT  - Frontiers in oncology
JID - 101568867
PMC - PMC9314734
OTO - NOTNLM
OT  - EMR
OT  - ESD
OT  - early gastric cancer
OT  - endoscopy
OT  - gastrectomy
OT  - gastric cancer
COIS- The authors declare that the research was conducted in the absence of any 
      commercial or financial relationships that could be construed as a potential 
      conflict of interest. The reviewer DS declared a shared affiliation with the 
      authors AB, DM, IM, ES, IB, JR, AS, WB, and EG to the handling editor at the time 
      of the review.
EDAT- 2022/07/30 06:00
MHDA- 2022/07/30 06:01
PMCR- 2022/01/01
CRDT- 2022/07/29 02:06
PHST- 2022/05/08 00:00 [received]
PHST- 2022/06/20 00:00 [accepted]
PHST- 2022/07/29 02:06 [entrez]
PHST- 2022/07/30 06:00 [pubmed]
PHST- 2022/07/30 06:01 [medline]
PHST- 2022/01/01 00:00 [pmc-release]
AID - 10.3389/fonc.2022.939244 [doi]
PST - epublish
SO  - Front Oncol. 2022 Jul 12;12:939244. doi: 10.3389/fonc.2022.939244. eCollection 
      2022.