TY - JOUR
T1 - Short-term outcomes of endoscopic submucosal dissection for the treatment of superficial gastric neoplasms in non-Asian countries
T2 - a systematic review and meta-analysis
AU - Benites-Goñi, Harold
AU - Palacios-Salas, Fernando
AU - Marín-Calderón, Luis
AU - Diaz-Arocutipa, Carlos
AU - Piscoya, Alejandro
AU - Hernandez, Adrian V.
N1 - Publisher Copyright:
© 2023 Hellenic Society of Gastroenterology.
PY - 2023/3/2
Y1 - 2023/3/2
N2 - Background Endoscopic submucosal dissection (ESD) is now considered the standard treatment for early gastric cancer (EGC). However, the widespread adoption of ESD in western countries has been slow. We performed a systematic review to evaluate short-term outcomes of ESD for EGC in non-Asian countries. Methods We searched 3 electronic databases from inception until October 26, 2022. Primary outcomes were en bloc, R0 and curative resections rate by region. Secondary outcomes were overall complications, bleeding, and perforation rate by region. The proportion of each outcome, with the 95% confidence interval (CI), was pooled using a random-effects model with the Freeman-Tukey double arcsine transformation. Results Twenty-seven studies from Europe (n=14), South America (n=11) and North America (n=2) were included, involving 1875 gastric lesions. Overall, en bloc, R0, and curative resection rates were achieved in 96% (95%CI 94-98%), 85% (95%CI 81-89%), and 77% (95%CI 73-81%) of cases, respectively. Considering only information from lesions with adenocarcinoma, the overall curative resection was 75% (95CI 70-80%). Bleeding and perforation were observed in 5% (95%CI 4-7%) and 2% (95%CI 1-4%) of cases, respectively. Conclusion Our results suggest that short-term outcomes of ESD for the treatment of EGC are acceptable in non-Asian countries.
AB - Background Endoscopic submucosal dissection (ESD) is now considered the standard treatment for early gastric cancer (EGC). However, the widespread adoption of ESD in western countries has been slow. We performed a systematic review to evaluate short-term outcomes of ESD for EGC in non-Asian countries. Methods We searched 3 electronic databases from inception until October 26, 2022. Primary outcomes were en bloc, R0 and curative resections rate by region. Secondary outcomes were overall complications, bleeding, and perforation rate by region. The proportion of each outcome, with the 95% confidence interval (CI), was pooled using a random-effects model with the Freeman-Tukey double arcsine transformation. Results Twenty-seven studies from Europe (n=14), South America (n=11) and North America (n=2) were included, involving 1875 gastric lesions. Overall, en bloc, R0, and curative resection rates were achieved in 96% (95%CI 94-98%), 85% (95%CI 81-89%), and 77% (95%CI 73-81%) of cases, respectively. Considering only information from lesions with adenocarcinoma, the overall curative resection was 75% (95CI 70-80%). Bleeding and perforation were observed in 5% (95%CI 4-7%) and 2% (95%CI 1-4%) of cases, respectively. Conclusion Our results suggest that short-term outcomes of ESD for the treatment of EGC are acceptable in non-Asian countries.
KW - Endoscopic submucosal dissection
KW - gastric cancer
KW - meta-analysis
UR - http://www.scopus.com/inward/record.url?scp=85149616846&partnerID=8YFLogxK
U2 - 10.20524/aog.2023.0777
DO - 10.20524/aog.2023.0777
M3 - Artículo
AN - SCOPUS:85149616846
SN - 1108-7471
VL - 36
SP - 167
EP - 177
JO - Annals of Gastroenterology
JF - Annals of Gastroenterology
IS - 2
ER -