Review Article

The Comparison between Endoscopic Submucosal Dissection and Surgery in Gastric Cancer: A Systematic Review and Meta-Analysis

Table 1

Summary of published studies and the characteristic of patients.

AuthorCountryYearStudy designArticle typeNo. of patientsMedian age (years)Gender (male)Depth of invasion (%)
SM1
Tumor size (mm)Follow-up (months)Quality score

ChiuChina2012RetrospectiveFull textESD 74/surgery 40ESD66.3 (14–88)/surgery 67.0 (33–84)ESD 66.2%/surgery 57.5ESD 10.8%/surgery 52.5%ESD 18.5 (8–40)/surgery 24.7 (10–40)ESD 27.0 (range 1–65)/surgery 77.6 (range 1–180)7
ChoKorea2016RetrospectiveFull textESD 88/surgery 88ESD (61.8 ± 9.8)/surgery (61.3 ± 9.8)ESD 71.6%/surgery 70.5ESD 17.0%/surgery 20.5%ESD 21.8 ± 12.1/surgery 21.4 ± 10.1ESD 77 (range 18–107)/surgery 78 (range 1–113)7
ChoiKorea2015Cross-sectionalFull textESD 137 /surgery 188ESD 67.2 (SD 9.9)/surgery 61.4 (SD 11.5)ESD 75.2%/surgery 67.0%ESD 4.4%/surgery 15.4%N/AN/AN/A
ChungKorea2014RetrospectiveFull textESD 76/surgery 149ESD (60.1 ± 13.2)/surgery (56.7 ± 12.8)ESD 75.2%/surgery 67.0%N/AESD ≤ 10 (18.4%), >10 ≤ 20 (57.9%), >20 ≤ 40 (19.7%), >4 (3.9%)/surgery ≤ 10 (27.5%), >10 ≤ 20 (72.5%), >2 ≤ 40 (0%), >4 (0%)ESD 41.7 ± 22.6 (SD)/surgery 42.8 ± 17.3 (SD)7
KimKorea2014RetrospectiveFull textESD 142/surgery 71ESD (62.0 ± 10.3)/surgery (56.7 ± 12.0)ESD 66.2%/surgery 81.7%ESD 4.9%/surgery 12.7%ESD ≤ 10 (16.9%), ≤20 (72.7%), ≤30 (21.1%), >30 (12.7%)/surgery ≤ 10 (15.5%), ≤20 (54.9%), ≤30 (14.1%), >30 (15.5%)ESD 76.7 ± 16.5 (SD)/surgery 65.5 ± 16.5 (SD)7
NajmehCanada2016RetrospectiveFull textESD 30/surgery 37ESD74 (40–86)/surgery 75 (34–86)ESD 77%/surgery 65%N/AESD 1.8 (0–5)/surgery 2.8 (0–9)ESD 74 (range 40–86)/surgery 75 (range 34–86)7
ParkKorea2014RetrospectiveFull textESD 132/surgery 132ESD (73.9 ± 3.5)/surgery (74.4 ± 3.7)ESD 73.5%/surgery 66.7%ESD 6.8%/surgery 6.8%ESD < 10 (39.4%), 10–20 (40.9%), 20–30 (13.6%), >30 (6.1%)/surgery < 10 (34.1%), 10–20 (43.2%), 20–30 (13.6%), >30 (9.1%)ESD 17.6 (range 9.9–25.7)/surgery 24.2 (range 12.5–36.7)7
RyuKorea2016RetrospectiveFull textESD 81/surgery 144ESD (63.65 ± 8.57)/surgery (61.37 ± 9.50)ESD 72.8%/surgery 81.9%N/AESD 19.32 ± 11.31/surgery 20.55 ± 10.68ESD 78.12 ± 9.72 (SD)/surgery 80.56 ± 8.92 (SD)7
ShinKorea2016RetrospectiveFull textESD 175/surgery 100ESD (61.7 ± 8.7)/surgery (60.5 ± 9.7)ESD 73.7%/surgery 73%ESD 1.7%/surgery 1.0%ESD major axis 12.4 ± 6.9 and minor axis 8.8 ± 4.9/surgery major axis 15.2 ± 8.7 and minor axis 12.0 ± 6.6ESD 56 (range 45–58)/surgery 53 (range 44–60)7
SohKorea2016RetrospectiveFull textESD 55/surgery 27ESD (52 (42–57))/surgery (53 (46–63))ESD 38.2%/surgery 55.6%N/AESD 15 (10–20)/surgery 27 (20–35)ESD 30 (range 15–49)/surgery 20 (range 9–37)7
SongChina2015RetrospectiveFull textESD 29/surgery 59ESD (65.3 ± 7.5)/surgery (45.8 ± 6.7)N/AESD 7.0%/surgery 0.3%ESD 27 ± 19/surgery 35 ± 16ESD 26.9 ± 8.5 (SD)/surgery 22.3 ± 9.4 (SD)7
KimKorea2015RetrospectiveFull textESD 82/surgery 112N/AN/AN/AN/A247
FukunagaJapan2016RetrospectiveFull textESD 74/surgery 74ESD (67.3 ± 8.8)/surgery (67.1 ± 7.5)ESD 23%/surgery 21.6%ESD 21.6%/surgery 18.9%ESD 23.1 ± 10.1/surgery 24.7 ± 11.4ESD 43.5 (IQR 26.3–76.0)/surgery 62.9 (IQR 36.5–91.7)7

ESD: endoscopic submucosal dissection; SM1: tumor infiltration into the submucosal layer/500 μm from the muscularis mucosae; SD: standard deviations; IQR: interquartile range; N/A: not available.