Qian Meng, Sheng Yuan, Wu Min, Wang Song, Zhang Kaiguang
Department of Gastroenterology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei 230001, China.
Graduate School, Bengbu Medical College, Bengbu 233000, China.
Cancers (Basel). 2022 Jul 24;14(15):3603. doi: 10.3390/cancers14153603.
: Endoscopic submucosal dissection (ESD) has become a preferred treatment option for early gastric cancer (EGC). This study aimed to compare the clinical outcomes of ESD and surgical resection for EGC. : This was a retrospective case-control study. Patients with a diagnosis of EGC who underwent ESD or surgery in our hospital from 2011 to 2020 were enrolled. We compared the clinical characteristics and treatment outcomes of these two groups according to propensity score-matching. The primary outcome comparison was overall survival (OS). Secondary outcomes were disease-specific survival (DSS), recurrence-free survival (RFS), and treatment-related events. : In the matched cohort, the ESD group showed comparable OS, RFS, and DSS with the surgery group. Statistical differences were shown in blood loss and adverse events. Furthermore, the ESD group showed lower hospital cost, as well as a shorter operative time and hospital duration than the surgery group. The R0 resection and recurrence rates were similar between the two groups. In Cox regression analysis, age, tumor size, poor differentiation, and lymphovascular invasion were regarded as independent factors of OS. : With sufficient safety and advantages, ESD can be a first-line treatment of EGC. Preoperative evaluation is vital to the appropriate treatment and prognosis.
内镜黏膜下剥离术（ESD）已成为早期胃癌（EGC）的首选治疗方案。本研究旨在比较ESD与手术切除治疗EGC的临床疗效。 ：这是一项回顾性病例对照研究。纳入2011年至2020年在我院接受ESD或手术治疗的EGC患者。我们根据倾向得分匹配比较了两组的临床特征和治疗结果。主要结局比较为总生存期（OS）。次要结局为疾病特异性生存期（DSS）、无复发生存期（RFS）和治疗相关事件。 ：在匹配队列中，ESD组的OS、RFS和DSS与手术组相当。两组在失血量和不良事件方面存在统计学差异。此外，ESD组的住院费用较低，手术时间和住院时间也比手术组短。两组的R0切除率和复发率相似。在Cox回归分析中，年龄、肿瘤大小、低分化和脉管侵犯被视为OS的独立因素。 ：ESD具有足够的安全性和优势，可作为EGC的一线治疗方法。术前评估对恰当的治疗和预后至关重要。
