Endoscopic submucosal dissection of papillary adenocarcinoma of stomach; protocol for a systematic review and meta-analysis

Bang, Chang Seok; Choi, Jae Ho; Lee, Jae Jun; Baik, Gwang Ho

doi:10.1097/md.0000000000013905

Cited by 3 publications

(3 citation statements)

References 25 publications

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“…[ 15 , 16 ] Advantages of ESD include that it enables en bloc resection even of extensive lesions and accurate pathological evaluation. [ 17 – 22 ] Furthermore, the aging of the population is associated with an increased number of cases in which the selection of minimally invasive surgery is recommended for elderly patients from various perspectives, including postoperative quality of life (QOL) and procedural accidents. [ 23 – 25 ] Compared to open surgical procedures, ESD is minimally invasive, and has thus been established at various institutions as a highly effective endoscopic treatment for elderly patients.…”

Section: Discussionmentioning

confidence: 99%

Impact of gastric endoscopic submucosal dissection in elderly patients

Yamaguchi¹,

Fukuzawa²,

Kawai

et al. 2019

Medicine

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With the increase in the elderly population, we are witnessing an increase in the rate of patients with underlying diseases and those under treatment with antithrombotic drugs.In this study, we compared the treatment outcomes of endoscopic submucosal dissection (ESD) and other parameters in the following 3 groups: super-elderly, elderly, and nonelderly.Compared with the other groups, the super-elderly group showed a significantly higher incidence of underlying diseases and the rate of antithrombotic treatment (P < .05). However, we observed no significant difference in the rate of curative resection or incidence of complications among the 3 groups. ESD is a relatively safe technique when performed on super-elderly patients. However, we have identified some cases in the super-elderly group, for which ESD was selected as a minimally invasive treatment for lesions that did not meet the inclusion criteria for open surgery as well as for which follow-up observations were selected rather than additional surgery for noncurative resections.Further investigations concerning ESD are required, focusing on aspects such as indications, additional surgery, and informed consent of the patient or family, particularly when ESD is performed for super-elderly patients.

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Section: Discussionmentioning

confidence: 99%

Impact of gastric endoscopic submucosal dissection in elderly patients

Yamaguchi¹,

Fukuzawa²,

Kawai

et al. 2019

Medicine

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“…The protocol of this study was registered in the International Prospective Register of Systematic Reviews (PROSPERO) in 2018 (CRD42018115575). The institutional review board approval was waived (collecting data from published studies) [12].…”

Section: Methodsmentioning

confidence: 99%

“…This tool contains 7 domains and each was rated to exhibit a low, moderate, serious, or critical risk of bias. Overall risk of bias judgement was determined based on the interpretation of each domain level [12,13].…”

Section: Assessment Of Quality In Methodologymentioning

confidence: 99%

Endoscopic Submucosal Dissection of Papillary Gastric Adenocarcinoma; Systematic Review

Bang

Lee

Baik

2020

JCM

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This study evaluated the possibility of endoscopic submucosal dissection (ESD) for early gastric cancer with papillary adenocarcinoma (EGC-PAC). PAC, an uncommon pathologic type of stomach cancer, is classified into differentiated-type histology. However, aggressive features, including a high rate of submucosal invasion, lymphovascular invasion (LVI), and lymph node metastasis (LNM), have been reported in studies with surgical specimens. Treatment outcomes of ESD for EGC-PAC have not been precisely demonstrated. Core databases were sought for the following inclusion criteria: studies of endoscopic resection or surgery of EGC-PAC presenting the following therapeutic indicators; en bloc resection, complete resection, curative resection, recurrence, complications associated with procedures, LVI, or LNM that enabled an analysis of ESD possibility. Overall, 15 studies were included for systematic review. Frequent submucosal invasion and high LVI were noted in EGC-PAC. However, PAC was not significantly associated with LNM. Pooled en bloc resection, complete resection, and curative resection rates were 89.7% (95% confidence interval: 55.3%–98.4%), 85.3% (67.7%–94.2%), and 67% (43%–84.5%), respectively. No LNM was observed if EGC-PAC satisfied the curative resection criteria. ESD seems technically feasible, although a high LVI rate results in a lower rate of curative resection.

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A Retrospective Cohort Study of Factors Influencing Lymph Node Metastasis in Patients With Early Gastric Papillary Adenocarcinoma

Zheng

Tang

et al. 2022

Clin Transl Gastroenterol

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INTRODUCTION: High risk of lymph node metastasis (LNM) in gastric papillary adenocarcinoma causes endoscopists to worry about the suitability of endoscopic resection for early gastric papillary adenocarcinoma (EPAC). We compared risk factors and attempted to establish a scoring system to stratify LNM risk in patients with EPAC. METHODS: A retrospective analysis was performed on 2,513 patients with early gastric carcinoma (EGC) who underwent radical resection in 4 tertiary hospitals in China. Univariate and multivariate analyses were performed to compare the invasiveness in EPAC and other types of EGC and to evaluate potential factors in predicting LNM risk in EPAC groups. RESULTS: Three hundred thirty-five patients with EPAC were enrolled in our study, of which 62 patients were found to have LNM. After comparing clinicopathological characteristics of EPAC with and without LNM, the following factors were included in the risk scoring system: 1 point each for lower stomach location and tumor size >2.0 cm, 3 points for lymphovascular invasion, and 4 points for submucosal invasion; the risk scoring system was validated in a small internal validation set with an area under the curve of 0.844. DISCUSSION: Our results suggested that EPAC was highly invasive compared with other EGCs, especially differentiated EGC types, and need to be treated more rigorously. This proposed risk scoring system could stratify LNM risk in patients with EPAC, and endoscopic resection may only be performed safely on the groups with a low LNM rate.

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Endoscopic submucosal dissection of papillary adenocarcinoma of stomach; protocol for a systematic review and meta-analysis

Cited by 3 publications

References 25 publications

Impact of gastric endoscopic submucosal dissection in elderly patients

Impact of gastric endoscopic submucosal dissection in elderly patients

Endoscopic Submucosal Dissection of Papillary Gastric Adenocarcinoma; Systematic Review

A Retrospective Cohort Study of Factors Influencing Lymph Node Metastasis in Patients With Early Gastric Papillary Adenocarcinoma

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