Comparison of endoscopic submucosal dissection versus surgery for early gastric cancer in the elderly: a pooled analysis
Abstract 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, Em...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2023-09-01
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| Series: | World Journal of Surgical Oncology |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12957-023-03167-7 |
| _version_ | 1797559364324687872 |
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| author | Fei Liu Ze-Lin Wen Xu-Rui Liu Zi-Wei Li Quan Lv Wei Zhang Dong Peng |
| author_facet | Fei Liu Ze-Lin Wen Xu-Rui Liu Zi-Wei Li Quan Lv Wei Zhang Dong Peng |
| author_sort | Fei Liu |
| collection | DOAJ |
| description | Abstract 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. |
| first_indexed | 2024-03-10T17:44:19Z |
| format | Article |
| id | doaj.art-dacdfa4768874265b93d354cf17053e8 |
| institution | Directory Open Access Journal |
| issn | 1477-7819 |
| language | English |
| last_indexed | 2024-03-10T17:44:19Z |
| publishDate | 2023-09-01 |
| publisher | BMC |
| record_format | Article |
| series | World Journal of Surgical Oncology |
| spelling | doaj.art-dacdfa4768874265b93d354cf17053e82023-11-20T09:37:08ZengBMCWorld Journal of Surgical Oncology1477-78192023-09-012111810.1186/s12957-023-03167-7Comparison of endoscopic submucosal dissection versus surgery for early gastric cancer in the elderly: a pooled analysisFei Liu0Ze-Lin Wen1Xu-Rui Liu2Zi-Wei Li3Quan Lv4Wei Zhang5Dong Peng6Department of Gastrointestinal Surgery, the First Affiliated Hospital of Chongqing Medical UniversityDepartment of Gastrointestinal Surgery, Chongqing Medical University, Yongchuan HospitalDepartment of Gastrointestinal Surgery, the First Affiliated Hospital of Chongqing Medical UniversityDepartment of Gastrointestinal Surgery, the First Affiliated Hospital of Chongqing Medical UniversityDepartment of Gastrointestinal Surgery, the First Affiliated Hospital of Chongqing Medical UniversityDepartment of Gastrointestinal Surgery, the First Affiliated Hospital of Chongqing Medical UniversityDepartment of Gastrointestinal Surgery, the First Affiliated Hospital of Chongqing Medical UniversityAbstract 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.https://doi.org/10.1186/s12957-023-03167-7Early gastric cancerElderly patientEndoscopic submucosal dissectionOverall survival |
| spellingShingle | Fei Liu Ze-Lin Wen Xu-Rui Liu Zi-Wei Li Quan Lv Wei Zhang Dong Peng Comparison of endoscopic submucosal dissection versus surgery for early gastric cancer in the elderly: a pooled analysis World Journal of Surgical Oncology Early gastric cancer Elderly patient Endoscopic submucosal dissection Overall survival |
| title | Comparison of endoscopic submucosal dissection versus surgery for early gastric cancer in the elderly: a pooled analysis |
| title_full | Comparison of endoscopic submucosal dissection versus surgery for early gastric cancer in the elderly: a pooled analysis |
| title_fullStr | Comparison of endoscopic submucosal dissection versus surgery for early gastric cancer in the elderly: a pooled analysis |
| title_full_unstemmed | Comparison of endoscopic submucosal dissection versus surgery for early gastric cancer in the elderly: a pooled analysis |
| title_short | Comparison of endoscopic submucosal dissection versus surgery for early gastric cancer in the elderly: a pooled analysis |
| title_sort | comparison of endoscopic submucosal dissection versus surgery for early gastric cancer in the elderly a pooled analysis |
| topic | Early gastric cancer Elderly patient Endoscopic submucosal dissection Overall survival |
| url | https://doi.org/10.1186/s12957-023-03167-7 |
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