Endoscopic submucosal dissection for early gastric cancer with undifferentiated-type histology: A meta-analysis.

Bang, Chang Seok; Baik, Gwang Ho; Shin, In Soo; Kim, Jing Bong; Suk, Ki Tae; Yoon, Jai Hoon; Kim, Yeon Soo; Kim, Dong Joon; Shin, Woon Geon; Kim, Kyung Ho; Kim, Hak Yang; Lim, Hyun; Kang, Ho Seok; Kim, Jong Hyeok; Kim, Jin Bae; Jung, Sung Won; Kae, Sea Hyub; Jang, Hyun Joo; Choi, Min Ho
World journal of gastroenterology
2015May ; 21 ( 19 ) :6032-43.
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Bang, Chang Seok - Chang Seok Bang, Gwang Ho Baik, Jing Bong Kim, Ki Tae Suk, Jai Hoon Yoon, Yeon Soo Kim, Dong Joon Kim, Woon Geon Shin, Kyung Ho Kim, Hak Yang Kim, Hyun Lim, Ho Seok Kang, Jong Hyeok Kim, Jin Bae Kim, Sung Won Jung, Sea Hyub Kae, Hyun Joo Jang, Min Ho Choi, Department of Internal Medicine, Hallym University College of Medicine, Chuncheon 200-704, South Korea.
Baik, Gwang Ho - Chang Seok Bang, Gwang Ho Baik, Jing Bong Kim, Ki Tae Suk, Jai Hoon Yoon, Yeon Soo Kim, Dong Joon Kim, Woon Geon Shin, Kyung Ho Kim, Hak Yang Kim, Hyun Lim, Ho Seok Kang, Jong Hyeok Kim, Jin Bae Kim, Sung Won Jung, Sea Hyub Kae, Hyun Joo Jang, Min Ho Choi, Department of Internal Medicine, Hallym University College of Medicine, Chuncheon 200-704, South Korea.
Shin, In Soo - Chang Seok Bang, Gwang Ho Baik, Jing Bong Kim, Ki Tae Suk, Jai Hoon Yoon, Yeon Soo Kim, Dong Joon Kim, Woon Geon Shin, Kyung Ho Kim, Hak Yang Kim, Hyun Lim, Ho Seok Kang, Jong Hyeok Kim, Jin Bae Kim, Sung Won Jung, Sea Hyub Kae, Hyun Joo Jang, Min Ho Choi, Department of Internal Medicine, Hallym University College of Medicine, Chuncheon 200-704, South Korea.
Kim, Jing Bong - Chang Seok Bang, Gwang Ho Baik, Jing Bong Kim, Ki Tae Suk, Jai Hoon Yoon, Yeon Soo Kim, Dong Joon Kim, Woon Geon Shin, Kyung Ho Kim, Hak Yang Kim, Hyun Lim, Ho Seok Kang, Jong Hyeok Kim, Jin Bae Kim, Sung Won Jung, Sea Hyub Kae, Hyun Joo Jang, Min Ho Choi, Department of Internal Medicine, Hallym University College of Medicine, Chuncheon 200-704, South Korea.
Suk, Ki Tae - Chang Seok Bang, Gwang Ho Baik, Jing Bong Kim, Ki Tae Suk, Jai Hoon Yoon, Yeon Soo Kim, Dong Joon Kim, Woon Geon Shin, Kyung Ho Kim, Hak Yang Kim, Hyun Lim, Ho Seok Kang, Jong Hyeok Kim, Jin Bae Kim, Sung Won Jung, Sea Hyub Kae, Hyun Joo Jang, Min Ho Choi, Department of Internal Medicine, Hallym University College of Medicine, Chuncheon 200-704, South Korea.
Yoon, Jai Hoon - Chang Seok Bang, Gwang Ho Baik, Jing Bong Kim, Ki Tae Suk, Jai Hoon Yoon, Yeon Soo Kim, Dong Joon Kim, Woon Geon Shin, Kyung Ho Kim, Hak Yang Kim, Hyun Lim, Ho Seok Kang, Jong Hyeok Kim, Jin Bae Kim, Sung Won Jung, Sea Hyub Kae, Hyun Joo Jang, Min Ho Choi, Department of Internal Medicine, Hallym University College of Medicine, Chuncheon 200-704, South Korea.
Kim, Yeon Soo - Chang Seok Bang, Gwang Ho Baik, Jing Bong Kim, Ki Tae Suk, Jai Hoon Yoon, Yeon Soo Kim, Dong Joon Kim, Woon Geon Shin, Kyung Ho Kim, Hak Yang Kim, Hyun Lim, Ho Seok Kang, Jong Hyeok Kim, Jin Bae Kim, Sung Won Jung, Sea Hyub Kae, Hyun Joo Jang, Min Ho Choi, Department of Internal Medicine, Hallym University College of Medicine, Chuncheon 200-704, South Korea.
Kim, Dong Joon - Chang Seok Bang, Gwang Ho Baik, Jing Bong Kim, Ki Tae Suk, Jai Hoon Yoon, Yeon Soo Kim, Dong Joon Kim, Woon Geon Shin, Kyung Ho Kim, Hak Yang Kim, Hyun Lim, Ho Seok Kang, Jong Hyeok Kim, Jin Bae Kim, Sung Won Jung, Sea Hyub Kae, Hyun Joo Jang, Min Ho Choi, Department of Internal Medicine, Hallym University College of Medicine, Chuncheon 200-704, South Korea.
Shin, Woon Geon - Chang Seok Bang, Gwang Ho Baik, Jing Bong Kim, Ki Tae Suk, Jai Hoon Yoon, Yeon Soo Kim, Dong Joon Kim, Woon Geon Shin, Kyung Ho Kim, Hak Yang Kim, Hyun Lim, Ho Seok Kang, Jong Hyeok Kim, Jin Bae Kim, Sung Won Jung, Sea Hyub Kae, Hyun Joo Jang, Min Ho Choi, Department of Internal Medicine, Hallym University College of Medicine, Chuncheon 200-704, South Korea.
Kim, Kyung Ho - Chang Seok Bang, Gwang Ho Baik, Jing Bong Kim, Ki Tae Suk, Jai Hoon Yoon, Yeon Soo Kim, Dong Joon Kim, Woon Geon Shin, Kyung Ho Kim, Hak Yang Kim, Hyun Lim, Ho Seok Kang, Jong Hyeok Kim, Jin Bae Kim, Sung Won Jung, Sea Hyub Kae, Hyun Joo Jang, Min Ho Choi, Department of Internal Medicine, Hallym University College of Medicine, Chuncheon 200-704, South Korea.
Kim, Hak Yang - Chang Seok Bang, Gwang Ho Baik, Jing Bong Kim, Ki Tae Suk, Jai Hoon Yoon, Yeon Soo Kim, Dong Joon Kim, Woon Geon Shin, Kyung Ho Kim, Hak Yang Kim, Hyun Lim, Ho Seok Kang, Jong Hyeok Kim, Jin Bae Kim, Sung Won Jung, Sea Hyub Kae, Hyun Joo Jang, Min Ho Choi, Department of Internal Medicine, Hallym University College of Medicine, Chuncheon 200-704, South Korea.
Lim, Hyun - Chang Seok Bang, Gwang Ho Baik, Jing Bong Kim, Ki Tae Suk, Jai Hoon Yoon, Yeon Soo Kim, Dong Joon Kim, Woon Geon Shin, Kyung Ho Kim, Hak Yang Kim, Hyun Lim, Ho Seok Kang, Jong Hyeok Kim, Jin Bae Kim, Sung Won Jung, Sea Hyub Kae, Hyun Joo Jang, Min Ho Choi, Department of Internal Medicine, Hallym University College of Medicine, Chuncheon 200-704, South Korea.
Kang, Ho Seok - Chang Seok Bang, Gwang Ho Baik, Jing Bong Kim, Ki Tae Suk, Jai Hoon Yoon, Yeon Soo Kim, Dong Joon Kim, Woon Geon Shin, Kyung Ho Kim, Hak Yang Kim, Hyun Lim, Ho Seok Kang, Jong Hyeok Kim, Jin Bae Kim, Sung Won Jung, Sea Hyub Kae, Hyun Joo Jang, Min Ho Choi, Department of Internal Medicine, Hallym University College of Medicine, Chuncheon 200-704, South Korea.
Kim, Jong Hyeok - Chang Seok Bang, Gwang Ho Baik, Jing Bong Kim, Ki Tae Suk, Jai Hoon Yoon, Yeon Soo Kim, Dong Joon Kim, Woon Geon Shin, Kyung Ho Kim, Hak Yang Kim, Hyun Lim, Ho Seok Kang, Jong Hyeok Kim, Jin Bae Kim, Sung Won Jung, Sea Hyub Kae, Hyun Joo Jang, Min Ho Choi, Department of Internal Medicine, Hallym University College of Medicine, Chuncheon 200-704, South Korea.
Kim, Jin Bae - Chang Seok Bang, Gwang Ho Baik, Jing Bong Kim, Ki Tae Suk, Jai Hoon Yoon, Yeon Soo Kim, Dong Joon Kim, Woon Geon Shin, Kyung Ho Kim, Hak Yang Kim, Hyun Lim, Ho Seok Kang, Jong Hyeok Kim, Jin Bae Kim, Sung Won Jung, Sea Hyub Kae, Hyun Joo Jang, Min Ho Choi, Department of Internal Medicine, Hallym University College of Medicine, Chuncheon 200-704, South Korea.
Jung, Sung Won - Chang Seok Bang, Gwang Ho Baik, Jing Bong Kim, Ki Tae Suk, Jai Hoon Yoon, Yeon Soo Kim, Dong Joon Kim, Woon Geon Shin, Kyung Ho Kim, Hak Yang Kim, Hyun Lim, Ho Seok Kang, Jong Hyeok Kim, Jin Bae Kim, Sung Won Jung, Sea Hyub Kae, Hyun Joo Jang, Min Ho Choi, Department of Internal Medicine, Hallym University College of Medicine, Chuncheon 200-704, South Korea.
Kae, Sea Hyub - Chang Seok Bang, Gwang Ho Baik, Jing Bong Kim, Ki Tae Suk, Jai Hoon Yoon, Yeon Soo Kim, Dong Joon Kim, Woon Geon Shin, Kyung Ho Kim, Hak Yang Kim, Hyun Lim, Ho Seok Kang, Jong Hyeok Kim, Jin Bae Kim, Sung Won Jung, Sea Hyub Kae, Hyun Joo Jang, Min Ho Choi, Department of Internal Medicine, Hallym University College of Medicine, Chuncheon 200-704, South Korea.
Jang, Hyun Joo - Chang Seok Bang, Gwang Ho Baik, Jing Bong Kim, Ki Tae Suk, Jai Hoon Yoon, Yeon Soo Kim, Dong Joon Kim, Woon Geon Shin, Kyung Ho Kim, Hak Yang Kim, Hyun Lim, Ho Seok Kang, Jong Hyeok Kim, Jin Bae Kim, Sung Won Jung, Sea Hyub Kae, Hyun Joo Jang, Min Ho Choi, Department of Internal Medicine, Hallym University College of Medicine, Chuncheon 200-704, South Korea.
Choi, Min Ho - Chang Seok Bang, Gwang Ho Baik, Jing Bong Kim, Ki Tae Suk, Jai Hoon Yoon, Yeon Soo Kim, Dong Joon Kim, Woon Geon Shin, Kyung Ho Kim, Hak Yang Kim, Hyun Lim, Ho Seok Kang, Jong Hyeok Kim, Jin Bae Kim, Sung Won Jung, Sea Hyub Kae, Hyun Joo Jang, Min Ho Choi, Department of Internal Medicine, Hallym University College of Medicine, Chuncheon 200-704, South Korea.
ABSTRACT
AIM: To evaluate the efficacy and safety of endoscopic submucosal dissection (ESD) for early gastric cancer (EGC) with undifferentiated-type histology.

METHODS: A systematic literature review was conducted using the core databases. Complete resection, curative resection, en bloc resection, recurrence and adverse event rate were extracted and analyzed. A random effect model was applied. The methodological quality of the enrolled studies was assessed using the Newcastle-Ottawa Scale. Publication bias was evaluated using a funnel plot, the trim and fill method, Egger's test, and a rank correlation test.

RESULTS: Fourteen retrospective studies between 2009 and 2014 were identified (972 EGC lesions with undifferentiated-type histology). The total en bloc and complete resection rates were estimated as 92.1% (95%CI: 87.4%-95.2%) and 77.5% (95%CI: 69.3%-84%), respectively. The total curative resection rate was 61.4% (95%CI: 44.5%-75.9%). The overall recurrence rate was 7.6% (95%CI: 3.4%-16%). Limited to histologically diagnosed expanded-criteria lesions, the en bloc and complete resection rates were 91.2% and 85.6%, respectively. The curative resection rate was 79.8%. CONCLUSION: In this analysis, ESD is a technically feasible treatment modality for EGC with undifferentiated-type histology. Long-term studies are needed to confirm these therapeutic outcomes.
keyword
Carcinoma; Endoscopic submucosal dissection; Endoscopy; Gastric cancer; Meta-analysis
MESH
*Cell Differentiation, Chi-Square Distribution, Dissection/adverse effects/*methods, Gastrectomy/adverse effects/*methods, Gastric Mucosa/pathology/*surgery, Gastroscopy/adverse effects/*methods, Humans, Neoplasm Staging, Odds Ratio, Risk Assessment, Risk Factors, Stomach Neoplasms/pathology/*surgery, Treatment Outcome
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ESD is a technically feasible treatment modality for EGC with undifferentiated-type histology.
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DOI
10.3748/wjg.v21.i19.6032.
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ICD 03
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