Yuan Tian1, Long Rong2, Yongchen Ma1. 1. Department of Endoscopy Center, Peking University First Hospital, No. 8 Xishiku street, Xicheng District, Beijing, 100034, China. 2. Department of Endoscopy Center, Peking University First Hospital, No. 8 Xishiku street, Xicheng District, Beijing, 100034, China. ronglong@pku.edu.cn.
Abstract
PURPOSE: Additional surgical resection (ASR) after endoscopic resection (ER) in patients with colorectal cancer (CRC) allows a complete staging and may decrease the recurrence rate, but no meta-analysis is available. This study aimed to compare the effectiveness of ER vs. ER + ASR as a treatment for patients with T1 (stage 1) CRC. METHODS: We performed a systematic search from databases (PubMed, Embase, and Cochrane library) for cohort studies published up to November 2019. The outcomes were overall survival (OS), local recurrence, recurrence, disease-specific survival, recurrence-free survival, and metastasis. RESULTS: Seven studies were included. There were 1205 patients in the ASR group and 993 patients in the ER group. Compared with ER, ASR was associated with better OS (OR = 0.31, 95% CI: 0.18-0.53, P < 0.001) and a borderline significant difference in lower local recurrence rates (OR = 0.29, 95% CI: 0.08-1.01, P = 0.052), but no differences were observed in recurrences, disease-specific survival, recurrence-free survival, and distant metastasis. A sensitivity analysis was performed; excluding each study sequentially from the pooled analysis did not affect the overall conclusion of the study. CONCLUSION: Compared with ER, ASR after ER could improve the overall survival for patients with T1 CRC.
PURPOSE: Additional surgical resection (ASR) after endoscopic resection (ER) in patients with colorectal cancer (CRC) allows a complete staging and may decrease the recurrence rate, but no meta-analysis is available. This study aimed to compare the effectiveness of ER vs. ER + ASR as a treatment for patients with T1 (stage 1) CRC. METHODS: We performed a systematic search from databases (PubMed, Embase, and Cochrane library) for cohort studies published up to November 2019. The outcomes were overall survival (OS), local recurrence, recurrence, disease-specific survival, recurrence-free survival, and metastasis. RESULTS: Seven studies were included. There were 1205 patients in the ASR group and 993 patients in the ER group. Compared with ER, ASR was associated with better OS (OR = 0.31, 95% CI: 0.18-0.53, P < 0.001) and a borderline significant difference in lower local recurrence rates (OR = 0.29, 95% CI: 0.08-1.01, P = 0.052), but no differences were observed in recurrences, disease-specific survival, recurrence-free survival, and distant metastasis. A sensitivity analysis was performed; excluding each study sequentially from the pooled analysis did not affect the overall conclusion of the study. CONCLUSION: Compared with ER, ASR after ER could improve the overall survival for patients with T1 CRC.
Entities:
Keywords:
Cancer surgery; Colorectal cancer; Endoscopic resection; Lymph nodes; Survival
Authors: S Tanaka; K Haruma; H Oh-E; S Nagata; Y Hirota; A Furudoi; T Amioka; Y Kitadai; M Yoshihara; F Shimamoto Journal: Oncol Rep Date: 2000 Jul-Aug Impact factor: 3.906
Authors: Ernst J Kuipers; William M Grady; David Lieberman; Thomas Seufferlein; Joseph J Sung; Petra G Boelens; Cornelis J H van de Velde; Toshiaki Watanabe Journal: Nat Rev Dis Primers Date: 2015-11-05 Impact factor: 52.329