Κατεύθυνση Χειρουργική Ογκολογία
Library of the School of Health Sciences

2021-03-13

2021

Karatzias Vasileios

Διονύσιος Βώρος, Ομότιμος Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ, Επιβλέπων
Θεοδόσιος Θεοδοσόπουλος, Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Δημήτριος Θεοδώρου, Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ

Μελέτη της ποιότητας ζωής μετά από επεμβάσεις γαστρεκτομής στον καρκίνο του στομάχου

Greek

Study for the quality of life after gastrectomy in gastric cancer

BACKGROUND-PURPOSE
Surgical resection is the gold standard method for gastric cancer treatment. Endoscopic resection (ER) is an alternative method for treating early gastric cancer (EGC) with low risk of lymph node metastasis, offering arguably a better quality of life. ER and surgical resection have equal therapeutic results in EGCs within absolute indications. As regards EGC’s within expanded indications treatment, the role of endoscopic submucosal dissection is unclear.
The purpose of this work is to study the safety and oncological outcome of ESD in the treatment of EGC within expanded indications. A systematic review of the literature and meta-analysis of articles comparing the results of ESD versus the surgical resection were carried out.
MATERIAL-METHOD
A search for articles comparing endoscopic to surgical resection in EGC, was carried out within international databases. The quality of the articles was assessed using the Newcastle-Ottawa Quality Assessment Scale. The STATA statistical package was used to analyze the data. According to the degree of heterogeneity of the articles, fixed-effects models or random-effects models were used in order to extract the results.
RESULTS
A total of 6 articles were selected for meta-analysis, based on the inclusion and exclusion criteria, concluding 2024 patients, from Eastern Asia. The Overall survival (OS) was greater for the ESD group (statistically non-significant). The Disease-free survival (DFS) and disease specific survival (DSS) were also greater in the ESD group (statistically non-significant differences). In the surgery group a statistically significant lower rate for local recurrence and metachronous cancer was found. Finally, surgical resection had a statistically significant greater risk for complications.
CONCLUSIONS
The overall survival (OS) of patients with EGC within expanded indications was not affected by using ESD. More frequent recurrence after ESD makes close monitoring imperative. The method ensures a better quality of life, is cheaper, less invasive, with less morbidity and can be an alternative treatment of EGC instead of surgery. Multicenter studies from Western countries are needed to identify possibly similar results.

Health Sciences

Early gastric cancer, Endoscopic submucosal dissection, Gastrectomy, Meta-analysis

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Yes

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https://pergamos.lib.uoa.gr/uoa/dl/object/2938689