Surgical resection after endoscopic resection in patients with T1 colorectal cancer: a meta-analysis

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...

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Bibliographic Details
Published in:International journal of colorectal disease 2021-03, Vol.36 (3), p.457-466
Main Authors: Tian, Yuan, Rong, Long, Ma, Yongchen
Format: Article
Language:English
Subjects:
Analysis
Cancer patients
Care and treatment
Colorectal cancer
Colorectal carcinoma
Diseases
Endoscopy
Gastroenterology
Hepatology
Internal Medicine
Medicine
Medicine & Public Health
Meta-analysis
Metastases
Metastasis
Performance evaluation
Proctology
Relapse
Review
Sensitivity analysis
Surgery
Survival
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Summary: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.
ISSN:0179-1958
1432-1262
DOI:10.1007/s00384-020-03752-2