Comparison of endoscopic submucosal dissection with surgical gastrectomy for early gastric cancer: An updated meta-analysis
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摘要
BACKGROUND There are several surgical options for treating early gastric cancers(EGCs), such as endoscopic resection, laparoscopic or open gastrectomy with D1 or D2 lymphadenectomy. Endoscopic resection for EGC with low risk of lymph node metastasis has been widely accepted as a therapeutic alternative. The role of endoscopic submucosal dissection(ESD) in treating EGC is not well established,especially when compared with resection surgery cases in a long-term follow-up scope.AIM To compare the safety and efficacy of the short-and long-term outcomes between ESD and resection surgery.METHODS We searched the databases of PubMed, EMBASE, Web of Science, and the Cochrane Library from January 1990 to June 2018, enrolling studies reporting short-or long-term outcomes of ESD in comparison with resection surgery for EGC. The quality of the studies was assessed by the Newcastle-Ottawa Quality Assessment Scale. Stata software(version 12.0) was used for the analysis. Pooling analysis was conducted using either fixed-or random-effects models depending on heterogeneity across studies.RESULTS Fourteen studies comprising 5112 patients were eligible for analysis(2402 for EGC and 2710 for radical surgery). Our meta-analysis demonstrated that the ESD approach showed advantages through decreased operation time [weighted mean difference(WMD):-140.02 min, 95%CI:-254.23 to-34.82 min, P = 0.009], shorter hospital stay(WMD:-5.41 d, 95% CI:-5.93 to-4.89 d, P < 0.001), and lowerpostoperative complication rate [Odds ratio(OR) = 0.39, 95%CI: 0.28-0.55, P <0.001). Meanwhile, EGC patients who underwent ESD had higher recurrence rate(OR = 9.24, 95%CI: 5.94-14.36, P < 0.001) than resection surgery patients.However, the long-term survival including overall survival [Hazard ratio(HR) =0.51, 95%CI: 0.26-1.00, P = 0.05] and event-free survival(HR = 1.59, 95%CI: 0.66-9.81, P = 0.300) showed no significant differences between these two groups.CONCLUSION In the treatment of EGC, ESD was safe and feasible in comparison with resection surgery, with advantages in several surgical and post-operative recovery parameters. Although the recurrence rate was higher in ESD group, the longterm survival was still comparable in these two groups, suggesting ESD could be recommended as standard treatment for EGC with indications.
BACKGROUND There are several surgical options for treating early gastric cancers(EGCs), such as endoscopic resection, laparoscopic or open gastrectomy with D1 or D2 lymphadenectomy. Endoscopic resection for EGC with low risk of lymph node metastasis has been widely accepted as a therapeutic alternative. The role of endoscopic submucosal dissection(ESD) in treating EGC is not well established,especially when compared with resection surgery cases in a long-term follow-up scope.AIM To compare the safety and efficacy of the short-and long-term outcomes between ESD and resection surgery.METHODS We searched the databases of PubMed, EMBASE, Web of Science, and the Cochrane Library from January 1990 to June 2018, enrolling studies reporting short-or long-term outcomes of ESD in comparison with resection surgery for EGC. The quality of the studies was assessed by the Newcastle-Ottawa Quality Assessment Scale. Stata software(version 12.0) was used for the analysis. Pooling analysis was conducted using either fixed-or random-effects models depending on heterogeneity across studies.RESULTS Fourteen studies comprising 5112 patients were eligible for analysis(2402 for EGC and 2710 for radical surgery). Our meta-analysis demonstrated that the ESD approach showed advantages through decreased operation time [weighted mean difference(WMD):-140.02 min, 95%CI:-254.23 to-34.82 min, P = 0.009], shorter hospital stay(WMD:-5.41 d, 95% CI:-5.93 to-4.89 d, P < 0.001), and lowerpostoperative complication rate [Odds ratio(OR) = 0.39, 95%CI: 0.28-0.55, P <0.001). Meanwhile, EGC patients who underwent ESD had higher recurrence rate(OR = 9.24, 95%CI: 5.94-14.36, P < 0.001) than resection surgery patients.However, the long-term survival including overall survival [Hazard ratio(HR) =0.51, 95%CI: 0.26-1.00, P = 0.05] and event-free survival(HR = 1.59, 95%CI: 0.66-9.81, P = 0.300) showed no significant differences between these two groups.CONCLUSION In the treatment of EGC, ESD was safe and feasible in comparison with resection surgery, with advantages in several surgical and post-operative recovery parameters. Although the recurrence rate was higher in ESD group, the longterm survival was still comparable in these two groups, suggesting ESD could be recommended as standard treatment for EGC with indications.
BACKGROUND There are several surgical options for treating early gastric cancers(EGCs), such as endoscopic resection, laparoscopic or open gastrectomy with D1 or D2 lymphadenectomy. Endoscopic resection for EGC with low risk of lymph node metastasis has been widely accepted as a therapeutic alternative. The role of endoscopic submucosal dissection(ESD) in treating EGC is not well established,especially when compared with resection surgery cases in a long-term follow-up scope.AIM To compare the safety and efficacy of the short-and long-term outcomes between ESD and resection surgery.METHODS We searched the databases of PubMed, EMBASE, Web of Science, and the Cochrane Library from January 1990 to June 2018, enrolling studies reporting short-or long-term outcomes of ESD in comparison with resection surgery for EGC. The quality of the studies was assessed by the Newcastle-Ottawa Quality Assessment Scale. Stata software(version 12.0) was used for the analysis. Pooling analysis was conducted using either fixed-or random-effects models depending on heterogeneity across studies.RESULTS Fourteen studies comprising 5112 patients were eligible for analysis(2402 for EGC and 2710 for radical surgery). Our meta-analysis demonstrated that the ESD approach showed advantages through decreased operation time [weighted mean difference(WMD):-140.02 min, 95%CI:-254.23 to-34.82 min, P = 0.009], shorter hospital stay(WMD:-5.41 d, 95% CI:-5.93 to-4.89 d, P < 0.001), and lowerpostoperative complication rate [Odds ratio(OR) = 0.39, 95%CI: 0.28-0.55, P <0.001). Meanwhile, EGC patients who underwent ESD had higher recurrence rate(OR = 9.24, 95%CI: 5.94-14.36, P < 0.001) than resection surgery patients.However, the long-term survival including overall survival [Hazard ratio(HR) =0.51, 95%CI: 0.26-1.00, P = 0.05] and event-free survival(HR = 1.59, 95%CI: 0.66-9.81, P = 0.300) showed no significant differences between these two groups.CONCLUSION In the treatment of EGC, ESD was safe and feasible in comparison with resection surgery, with advantages in several surgical and post-operative recovery parameters. Although the recurrence rate was higher in ESD group, the longterm survival was still comparable in these two groups, suggesting ESD could be recommended as standard treatment for EGC with indications.
引文
1 Bray F,Ferlay J,Soerjomataram I,Siegel RL,Torre LA,Jemal A.Global cancer statistics 2018:GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries.CA Cancer J Clin 2018;68:394-424[PMID:30207593 DOI:10.3322/caac.21492]
2 Leung WK,Wu MS,Kakugawa Y,Kim JJ,Yeoh KG,Goh KL,Wu KC,Wu DC,Sollano J,Kachintorn U,Gotoda T,Lin JT,You WC,Ng EK,Sung JJ;Asia Pacific Working Group on Gastric Cancer.Screening for gastric cancer in Asia:current evidence and practice.Lancet Oncol 2008;9:279-287[PMID:18308253 DOI:10.1016/S1470-2045(08)70072-X]
3 Japanese Gastric Cancer Association.Japanese classification of gastric carcinoma:3rd English edition.Gastric Cancer 2011;14:101-112[PMID:21573743 DOI:10.1007/s10120-011-0041-5]
4 Ono H,Kondo H,Gotoda T,Shirao K,Yamaguchi H,Saito D,Hosokawa K,Shimoda T,Yoshida S.Endoscopic mucosal resection for treatment of early gastric cancer.Gut 2001;48:225-229[PMID:11156645 DOI:10.1136/gut.48.2.225]
5 Lian J,Chen S,Zhang Y,Qiu F.A meta-analysis of endoscopic submucosal dissection and EMR for early gastric cancer.Gastrointest Endosc 2012;76:763-770[PMID:22884100 DOI:10.1016/j.gie.2012.06.014]
6 Kim YI,Kim YW,Choi IJ,Kim CG,Lee JY,Cho SJ,Eom BW,Yoon HM,Ryu KW,Kook MC.Longterm survival after endoscopic resection versus surgery in early gastric cancers.Endoscopy 2015;47:293-301[PMID:25625697 DOI:10.1055/s-0034-1391284]
7 Ahn JY,Jung HY,Choi KD,Choi JY,Kim MY,Lee JH,Choi KS,Kim DH,Song HJ,Lee GH,Kim JH,Park YS.Endoscopic and oncologic outcomes after endoscopic resection for early gastric cancer:1370cases of absolute and extended indications.Gastrointest Endosc 2011;74:485-493[PMID:21741645DOI:10.1016/j.gie.2011.04.038]
8 Kim MY,Cho JH,Cho JY.Ever-changing endoscopic treatment for early gastric cancer:yesterday-todaytomorrow.World J Gastroenterol 2014;20:13273-13283[PMID:25309064 DOI:10.3748/wjg.v20.i37.13273]
9 Cao Y,Liao C,Tan A,Gao Y,Mo Z,Gao F.Meta-analysis of endoscopic submucosal dissection versus endoscopic mucosal resection for tumors of the gastrointestinal tract.Endoscopy 2009;41:751-757[PMID:19693750 DOI:10.1055/s-0029-1215053]
10 Hu J,Zhao Y,Ren M,Li Y,Lu X,Lu G,Zhang D,Chu D,He S.The Comparison between Endoscopic Submucosal Dissection and Surgery in Gastric Cancer:A Systematic Review and Meta-Analysis.Gastroenterol Res Pract 2018;2018:4378945[PMID:29670651 DOI:10.1155/2018/4378945]
11 Meng FS,Zhang ZH,Wang YM,Lu L,Zhu JZ,Ji F.Comparison of endoscopic resection and gastrectomy for the treatment of early gastric cancer:a meta-analysis.Surg Endosc 2016;30:3673-3683[PMID:26659235 DOI:10.1007/s00464-015-4681-0]
12 Stang A.Critical evaluation of the Newcastle-Ottawa scale for the assessment of the quality of nonrandomized studies in meta-analyses.Eur J Epidemiol 2010;25:603-605[PMID:20652370 DOI:10.1007/s10654-010-9491-z]
13 Chiu PW,Teoh AY,To KF,Wong SK,Liu SY,Lam CC,Yung MY,Chan FK,Lau JY,Ng EK.Endoscopic submucosal dissection(ESD)compared with gastrectomy for treatment of early gastric neoplasia:a retrospective cohort study.Surg Endosc 2012;26:3584-3591[PMID:22678176 DOI:10.1007/s00464-012-2371-8]
14 Park CH,Lee H,Kim DW,Chung H,Park JC,Shin SK,Hyung WJ,Lee SK,Lee YC,Noh SH.Clinical safety of endoscopic submucosal dissection compared with surgery in elderly patients with early gastric cancer:a propensity-matched analysis.Gastrointest Endosc 2014;80:599-609[PMID:24973177 DOI:10.1016/j.gie.2014.04.042]
15 Kim DY,Hong SJ,Cho GS,Jeong GA,Kim HK,Han JP,Lee YN,Ko BM,Lee MS.Long-term efficacy of endoscopic submucosal dissection compared with surgery for early gastric cancer:a retrospective cohort study.Gut Liver 2014;8:519-525[PMID:25228976 DOI:10.5009/gnl13061]
16 Cho JH,Cha SW,Kim HG,Lee TH,Cho JY,Ko WJ,Jin SY,Park S.Long-term outcomes of endoscopic submucosal dissection for early gastric cancer:a comparison study to surgery using propensity scorematched analysis.Surg Endosc 2016;30:3762-3773[PMID:26659226 DOI:10.1007/s00464-015-4672-1]
17 Song WC,Qiao XL,Gao XZ.A comparison of endoscopic submucosal dissection(ESD)and radical surgery for early gastric cancer:a retrospective study.World J Surg Oncol 2015;13:309[PMID:26537433 DOI:10.1186/s12957-015-0724-1]
18 Fukunaga S,Nagami Y,Shiba M,Ominami M,Tanigawa T,Yamagami H,Tanaka H,Muguruma K,Watanabe T,Tominaga K,Fujiwara Y,Ohira M,Hirakawa K,Arakawa T.Long-term prognosis of expanded-indication differentiated-type early gastric cancer treated with endoscopic submucosal dissection or surgery using propensity score analysis.Gastrointest Endosc 2017;85:143-152[PMID:27365265DOI:10.1016/j.gie.2016.06.049]
19 Gong EJ,Kim DH,Ahn JY,Jung KW,Lee JH,Choi KD,Song HJ,Lee GH,Jung HY,Kim HS,Lee IS,Kim BS,Yoo MW,Oh ST,Yook JH,Kim BS.Comparison of long-term outcomes of endoscopic submucosal dissection and surgery for esophagogastric junction adenocarcinoma.Gastric Cancer 2017;20:84-91[PMID:27995482 DOI:10.1007/s10120-016-0679-0]
20 Ryu SJ,Kim BW,Kim BG,Kim JH,Kim JS,Kim JI,Park JM,Oh JH,Kim TH,Kim JJ,Park SM,Park CH,Song KY,Lee JH,Kim SG,Kim DJ,Kim W.Endoscopic submucosal dissection versus surgical resection for early gastric cancer:a retrospective multicenter study on immediate and long-term outcome over 5 years.Surg Endosc 2016;30:5283-5289[PMID:27338583 DOI:10.1007/s00464-016-4877-y]
21 Najmeh S,Cools-Lartigue J,Mueller C,Ferri LE.Comparing Laparoscopic to Endoscopic Resections for Early Gastric Cancer in a High Volume North American Center.J Gastrointest Surg 2016;20:1547-1553[PMID:27282756 DOI:10.1007/s11605-016-3176-1]
22 Shin DW,Hwang HY,Jeon SW.Comparison of Endoscopic Submucosal Dissection and Surgery for Differentiated Type Early Gastric Cancer within the Expanded Criteria.Clin Endosc 2017;50:170-178[PMID:27157856 DOI:10.5946/ce.2016.017]
23 Jeon HK,Kim GH,Lee BE,Park DY,Song GA,Kim DH,Jeon TY.Long-term outcome of endoscopic submucosal dissection is comparable to that of surgery for early gastric cancer:a propensity-matched analysis.Gastric Cancer 2018;21:133-143[PMID:28397011 DOI:10.1007/s10120-017-0719-4]
24 Park JC,Lee YK,Kim SY,Roh Y,Hahn KY,Shin SK,Lee SK,Lee YC,Kim HI,Cheong JH,Hyung WJ,Noh SH.Long-term outcomes of endoscopic submucosal dissection in comparison to surgery in undifferentiated-type intramucosal gastric cancer using propensity score analysis.Surg Endosc 2018;32:2046-2057[PMID:29052072 DOI:10.1007/s00464-017-5901-6]
25 Hahn KY,Park CH,Lee YK,Chung H,Park JC,Shin SK,Lee YC,Kim HI,Cheong JH,Hyung WJ,Noh SH,Lee SK.Comparative study between endoscopic submucosal dissection and surgery in patients with early gastric cancer.Surg Endosc 2018;32:73-86[PMID:28639042 DOI:10.1007/s00464-017-5640-8]
26 Lee S,Choi KD,Han M,Na HK,Ahn JY,Jung KW,Lee JH,Kim DH,Song HJ,Lee GH,Yook JH,Kim BS,Jung HY.Long-term outcomes of endoscopic submucosal dissection versus surgery in early gastric cancer meeting expanded indication including undifferentiated-type tumors:a criteria-based analysis.Gastric Cancer 2018;21:490-499[PMID:29052052 DOI:10.1007/s10120-017-0772-z]
27 Nagata K,Shimizu M.Pathological evaluation of gastrointestinal endoscopic submucosal dissection materials based on Japanese guidelines.World J Gastrointest Endosc 2012;4:489-499[PMID:23189220DOI:10.4253/wjge.v4.i11.489]
28 Oka S,Tanaka S,Kaneko I,Mouri R,Hirata M,Kawamura T,Yoshihara M,Chayama K.Advantage of endoscopic submucosal dissection compared with EMR for early gastric cancer.Gastrointest Endosc 2006;64:877-883[PMID:17140890 DOI:10.1016/j.gie.2006.03.932]
29 Choi IJ,Lee JH,Kim YI,Kim CG,Cho SJ,Lee JY,Ryu KW,Nam BH,Kook MC,Kim YW.Long-term outcome comparison of endoscopic resection and surgery in early gastric cancer meeting the absolute indication for endoscopic resection.Gastrointest Endosc 2015;81:333-41.e1[PMID:25281498 DOI:10.1016/j.gie.2014.07.047]
30 Pyo JH,Lee H,Min BH,Lee JH,Choi MG,Lee JH,Sohn TS,Bae JM,Kim KM,Ahn JH,Carriere KC,Kim JJ,Kim S.Long-Term Outcome of Endoscopic Resection vs.Surgery for Early Gastric Cancer:ANon-inferiority-Matched Cohort Study.Am J Gastroenterol 2016;111:240-249[PMID:26782817 DOI:10.1038/ajg.2015.427]
31 Nasu J,Doi T,Endo H,Nishina T,Hirasaki S,Hyodo I.Characteristics of metachronous multiple early gastric cancers after endoscopic mucosal resection.Endoscopy 2005;37:990-993[PMID:16189772 DOI:10.1055/s-2005-870198]
32 Kato M,Nishida T,Yamamoto K,Hayashi S,Kitamura S,Yabuta T,Yoshio T,Nakamura T,Komori M,Kawai N,Nishihara A,Nakanishi F,Nakahara M,Ogiyama H,Kinoshita K,Yamada T,Iijima H,Tsujii M,Takehara T.Scheduled endoscopic surveillance controls secondary cancer after curative endoscopic resection for early gastric cancer:a multicentre retrospective cohort study by Osaka University ESD study group.Gut 2013;62:1425-1432[PMID:22914298 DOI:10.1136/gutjnl-2011-301647]
33 Lee JH,Kim JG,Jung HK,Kim JH,Jeong WK,Jeon TJ,Kim JM,Kim YI,Ryu KW,Kong SH,Kim HI,Jung HY,Kim YS,Zang DY,Cho JY,Park JO,Lim DH,Jung ES,Ahn HS,Kim HJ.Clinical practice guidelines for gastric cancer in Korea:an evidence-based approach.J Gastric Cancer 2014;14:87-104[PMID:25061536 DOI:10.5230/jgc.2014.14.2.87]
34 Japanese Gastric Cancer Association.Japanese gastric cancer treatment guidelines 2014(ver.4).Gastric Cancer 2017;20:1-19[PMID:27342689 DOI:10.1007/s10120-016-0622-4]
2 Leung WK,Wu MS,Kakugawa Y,Kim JJ,Yeoh KG,Goh KL,Wu KC,Wu DC,Sollano J,Kachintorn U,Gotoda T,Lin JT,You WC,Ng EK,Sung JJ;Asia Pacific Working Group on Gastric Cancer.Screening for gastric cancer in Asia:current evidence and practice.Lancet Oncol 2008;9:279-287[PMID:18308253 DOI:10.1016/S1470-2045(08)70072-X]
3 Japanese Gastric Cancer Association.Japanese classification of gastric carcinoma:3rd English edition.Gastric Cancer 2011;14:101-112[PMID:21573743 DOI:10.1007/s10120-011-0041-5]
4 Ono H,Kondo H,Gotoda T,Shirao K,Yamaguchi H,Saito D,Hosokawa K,Shimoda T,Yoshida S.Endoscopic mucosal resection for treatment of early gastric cancer.Gut 2001;48:225-229[PMID:11156645 DOI:10.1136/gut.48.2.225]
5 Lian J,Chen S,Zhang Y,Qiu F.A meta-analysis of endoscopic submucosal dissection and EMR for early gastric cancer.Gastrointest Endosc 2012;76:763-770[PMID:22884100 DOI:10.1016/j.gie.2012.06.014]
6 Kim YI,Kim YW,Choi IJ,Kim CG,Lee JY,Cho SJ,Eom BW,Yoon HM,Ryu KW,Kook MC.Longterm survival after endoscopic resection versus surgery in early gastric cancers.Endoscopy 2015;47:293-301[PMID:25625697 DOI:10.1055/s-0034-1391284]
7 Ahn JY,Jung HY,Choi KD,Choi JY,Kim MY,Lee JH,Choi KS,Kim DH,Song HJ,Lee GH,Kim JH,Park YS.Endoscopic and oncologic outcomes after endoscopic resection for early gastric cancer:1370cases of absolute and extended indications.Gastrointest Endosc 2011;74:485-493[PMID:21741645DOI:10.1016/j.gie.2011.04.038]
8 Kim MY,Cho JH,Cho JY.Ever-changing endoscopic treatment for early gastric cancer:yesterday-todaytomorrow.World J Gastroenterol 2014;20:13273-13283[PMID:25309064 DOI:10.3748/wjg.v20.i37.13273]
9 Cao Y,Liao C,Tan A,Gao Y,Mo Z,Gao F.Meta-analysis of endoscopic submucosal dissection versus endoscopic mucosal resection for tumors of the gastrointestinal tract.Endoscopy 2009;41:751-757[PMID:19693750 DOI:10.1055/s-0029-1215053]
10 Hu J,Zhao Y,Ren M,Li Y,Lu X,Lu G,Zhang D,Chu D,He S.The Comparison between Endoscopic Submucosal Dissection and Surgery in Gastric Cancer:A Systematic Review and Meta-Analysis.Gastroenterol Res Pract 2018;2018:4378945[PMID:29670651 DOI:10.1155/2018/4378945]
11 Meng FS,Zhang ZH,Wang YM,Lu L,Zhu JZ,Ji F.Comparison of endoscopic resection and gastrectomy for the treatment of early gastric cancer:a meta-analysis.Surg Endosc 2016;30:3673-3683[PMID:26659235 DOI:10.1007/s00464-015-4681-0]
12 Stang A.Critical evaluation of the Newcastle-Ottawa scale for the assessment of the quality of nonrandomized studies in meta-analyses.Eur J Epidemiol 2010;25:603-605[PMID:20652370 DOI:10.1007/s10654-010-9491-z]
13 Chiu PW,Teoh AY,To KF,Wong SK,Liu SY,Lam CC,Yung MY,Chan FK,Lau JY,Ng EK.Endoscopic submucosal dissection(ESD)compared with gastrectomy for treatment of early gastric neoplasia:a retrospective cohort study.Surg Endosc 2012;26:3584-3591[PMID:22678176 DOI:10.1007/s00464-012-2371-8]
14 Park CH,Lee H,Kim DW,Chung H,Park JC,Shin SK,Hyung WJ,Lee SK,Lee YC,Noh SH.Clinical safety of endoscopic submucosal dissection compared with surgery in elderly patients with early gastric cancer:a propensity-matched analysis.Gastrointest Endosc 2014;80:599-609[PMID:24973177 DOI:10.1016/j.gie.2014.04.042]
15 Kim DY,Hong SJ,Cho GS,Jeong GA,Kim HK,Han JP,Lee YN,Ko BM,Lee MS.Long-term efficacy of endoscopic submucosal dissection compared with surgery for early gastric cancer:a retrospective cohort study.Gut Liver 2014;8:519-525[PMID:25228976 DOI:10.5009/gnl13061]
16 Cho JH,Cha SW,Kim HG,Lee TH,Cho JY,Ko WJ,Jin SY,Park S.Long-term outcomes of endoscopic submucosal dissection for early gastric cancer:a comparison study to surgery using propensity scorematched analysis.Surg Endosc 2016;30:3762-3773[PMID:26659226 DOI:10.1007/s00464-015-4672-1]
17 Song WC,Qiao XL,Gao XZ.A comparison of endoscopic submucosal dissection(ESD)and radical surgery for early gastric cancer:a retrospective study.World J Surg Oncol 2015;13:309[PMID:26537433 DOI:10.1186/s12957-015-0724-1]
18 Fukunaga S,Nagami Y,Shiba M,Ominami M,Tanigawa T,Yamagami H,Tanaka H,Muguruma K,Watanabe T,Tominaga K,Fujiwara Y,Ohira M,Hirakawa K,Arakawa T.Long-term prognosis of expanded-indication differentiated-type early gastric cancer treated with endoscopic submucosal dissection or surgery using propensity score analysis.Gastrointest Endosc 2017;85:143-152[PMID:27365265DOI:10.1016/j.gie.2016.06.049]
19 Gong EJ,Kim DH,Ahn JY,Jung KW,Lee JH,Choi KD,Song HJ,Lee GH,Jung HY,Kim HS,Lee IS,Kim BS,Yoo MW,Oh ST,Yook JH,Kim BS.Comparison of long-term outcomes of endoscopic submucosal dissection and surgery for esophagogastric junction adenocarcinoma.Gastric Cancer 2017;20:84-91[PMID:27995482 DOI:10.1007/s10120-016-0679-0]
20 Ryu SJ,Kim BW,Kim BG,Kim JH,Kim JS,Kim JI,Park JM,Oh JH,Kim TH,Kim JJ,Park SM,Park CH,Song KY,Lee JH,Kim SG,Kim DJ,Kim W.Endoscopic submucosal dissection versus surgical resection for early gastric cancer:a retrospective multicenter study on immediate and long-term outcome over 5 years.Surg Endosc 2016;30:5283-5289[PMID:27338583 DOI:10.1007/s00464-016-4877-y]
21 Najmeh S,Cools-Lartigue J,Mueller C,Ferri LE.Comparing Laparoscopic to Endoscopic Resections for Early Gastric Cancer in a High Volume North American Center.J Gastrointest Surg 2016;20:1547-1553[PMID:27282756 DOI:10.1007/s11605-016-3176-1]
22 Shin DW,Hwang HY,Jeon SW.Comparison of Endoscopic Submucosal Dissection and Surgery for Differentiated Type Early Gastric Cancer within the Expanded Criteria.Clin Endosc 2017;50:170-178[PMID:27157856 DOI:10.5946/ce.2016.017]
23 Jeon HK,Kim GH,Lee BE,Park DY,Song GA,Kim DH,Jeon TY.Long-term outcome of endoscopic submucosal dissection is comparable to that of surgery for early gastric cancer:a propensity-matched analysis.Gastric Cancer 2018;21:133-143[PMID:28397011 DOI:10.1007/s10120-017-0719-4]
24 Park JC,Lee YK,Kim SY,Roh Y,Hahn KY,Shin SK,Lee SK,Lee YC,Kim HI,Cheong JH,Hyung WJ,Noh SH.Long-term outcomes of endoscopic submucosal dissection in comparison to surgery in undifferentiated-type intramucosal gastric cancer using propensity score analysis.Surg Endosc 2018;32:2046-2057[PMID:29052072 DOI:10.1007/s00464-017-5901-6]
25 Hahn KY,Park CH,Lee YK,Chung H,Park JC,Shin SK,Lee YC,Kim HI,Cheong JH,Hyung WJ,Noh SH,Lee SK.Comparative study between endoscopic submucosal dissection and surgery in patients with early gastric cancer.Surg Endosc 2018;32:73-86[PMID:28639042 DOI:10.1007/s00464-017-5640-8]
26 Lee S,Choi KD,Han M,Na HK,Ahn JY,Jung KW,Lee JH,Kim DH,Song HJ,Lee GH,Yook JH,Kim BS,Jung HY.Long-term outcomes of endoscopic submucosal dissection versus surgery in early gastric cancer meeting expanded indication including undifferentiated-type tumors:a criteria-based analysis.Gastric Cancer 2018;21:490-499[PMID:29052052 DOI:10.1007/s10120-017-0772-z]
27 Nagata K,Shimizu M.Pathological evaluation of gastrointestinal endoscopic submucosal dissection materials based on Japanese guidelines.World J Gastrointest Endosc 2012;4:489-499[PMID:23189220DOI:10.4253/wjge.v4.i11.489]
28 Oka S,Tanaka S,Kaneko I,Mouri R,Hirata M,Kawamura T,Yoshihara M,Chayama K.Advantage of endoscopic submucosal dissection compared with EMR for early gastric cancer.Gastrointest Endosc 2006;64:877-883[PMID:17140890 DOI:10.1016/j.gie.2006.03.932]
29 Choi IJ,Lee JH,Kim YI,Kim CG,Cho SJ,Lee JY,Ryu KW,Nam BH,Kook MC,Kim YW.Long-term outcome comparison of endoscopic resection and surgery in early gastric cancer meeting the absolute indication for endoscopic resection.Gastrointest Endosc 2015;81:333-41.e1[PMID:25281498 DOI:10.1016/j.gie.2014.07.047]
30 Pyo JH,Lee H,Min BH,Lee JH,Choi MG,Lee JH,Sohn TS,Bae JM,Kim KM,Ahn JH,Carriere KC,Kim JJ,Kim S.Long-Term Outcome of Endoscopic Resection vs.Surgery for Early Gastric Cancer:ANon-inferiority-Matched Cohort Study.Am J Gastroenterol 2016;111:240-249[PMID:26782817 DOI:10.1038/ajg.2015.427]
31 Nasu J,Doi T,Endo H,Nishina T,Hirasaki S,Hyodo I.Characteristics of metachronous multiple early gastric cancers after endoscopic mucosal resection.Endoscopy 2005;37:990-993[PMID:16189772 DOI:10.1055/s-2005-870198]
32 Kato M,Nishida T,Yamamoto K,Hayashi S,Kitamura S,Yabuta T,Yoshio T,Nakamura T,Komori M,Kawai N,Nishihara A,Nakanishi F,Nakahara M,Ogiyama H,Kinoshita K,Yamada T,Iijima H,Tsujii M,Takehara T.Scheduled endoscopic surveillance controls secondary cancer after curative endoscopic resection for early gastric cancer:a multicentre retrospective cohort study by Osaka University ESD study group.Gut 2013;62:1425-1432[PMID:22914298 DOI:10.1136/gutjnl-2011-301647]
33 Lee JH,Kim JG,Jung HK,Kim JH,Jeong WK,Jeon TJ,Kim JM,Kim YI,Ryu KW,Kong SH,Kim HI,Jung HY,Kim YS,Zang DY,Cho JY,Park JO,Lim DH,Jung ES,Ahn HS,Kim HJ.Clinical practice guidelines for gastric cancer in Korea:an evidence-based approach.J Gastric Cancer 2014;14:87-104[PMID:25061536 DOI:10.5230/jgc.2014.14.2.87]
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