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Vol. 1 (2023)
Open Access Journal Article

A meta-analysis of the impact on gastrectomy versus endoscopic submucosal dissection for early stomach cancer

by Rajesh K. Singh 1
1
Department of Pharmaceutical Chemistry, Shivalik College of Pharmacy, Nangal, Ropar, 140126, Punjab, India
*
Author to whom correspondence should be addressed.
IJCMR  2023, 11; 1(3), 11; https://doi.org/10.61466/ijcmr1030011
Received: 4 September 2023 / Accepted: 9 October 2023 / Published Online: 10 October 2023
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Abstract

Background:

We conducted a meta-analysis to assess the impact of gastrectomy versus endoscopic submucosal dissection for early stomach cancer.

There are-now-a-variety-of-viewpoints-on-gastrectomy-versus-endoscopic-submucosal-dissection-for-early-stomach-cancer,-and-there-are-not-many-thorough-assessments-that-are-pertinent.

Methods:

A-systematic-literature-search-up-to-July-2022-was-performed-and-2456-related-studies-were-evaluated.-The-chosen-studies-comprised-15461-early-stomach-cancer-subjects-who-participated-in-the-selected-studies'-baseline-trials;-6503-of-them-used-the-endoscopic-submucosal-dissection, while 8958 used gastrectomy. Odds ratio (OR), and mean difference (MD) with 95% confidence intervals (CIs) were calculated to assess the effect of the gastrectomy versus endoscopic submucosal dissection for early stomach cancer by the dichotomous, and contentious methods with a random or fixed effect model.

Results:

The use of endoscopic submucosal dissection resulted in significantly lower 5-year overall survivals (OR, 0.59; 95% CI, 0.45-0.77, p<0.001), lower the 5-year overall survival in propensity score-matched patients (OR, 0.49; 95% CI, 0.41-0.59, p<0.001), higher recurrences (OR, 6.99; 95% CI, 5,03-9.70, p<0.001), and higher synchronous lesion (OR, 7.24; 95% CI, 2.78-18.83, p<0.001), and higher metachronous lesion (OR,10.05; 95% CI, 6.44-15.67, p<0.001) compared to the gastrectomy for early stomach cancer.

However, no significant difference was found between submucosal dissection and gastrectomy for early stomach cancer in recurrence-free survival (OR, 0.74; 95% CI, 0.54-1.00, p=0.05), disease-free survival (OR, 0.43; 95% CI, 0.16-1.16, p=0.10), and disease-specific survival (OR, 1.05; 95% CI, 0.38-2.89, p=0.92).

Conclusions:

The use of endoscopic submucosal dissection resulted in significantly lower 5-year overall survival, lower 5-year overall survival in propensity score-matched patients, higher recurrences, higher-synchronous lesion, and higher metachronous lesion, however, no significant difference was found in recurrence-free survival, disease-free survival, and disease-specific survival compared to the gastrectomy for early stomach cancer. The small number of studies in several comparisons calls for care when analyzing the results.

Keywords: synchronous lesion; endoscopic submucosal dissection; 5-year overall survival; disease-free survival; disease-specific survival; recurrence; recurrence-free survival; and metachronous lesion;
Copyright: © 2023 by Singh. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY) (Creative Commons Attribution 4.0 International License). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.