Endoscopic mucosal resection vs endoscopic submucosal dissection for superficial non-ampullary duodenal tumors

Table 1 Comparison of baseline clinicopathological characteristics between the endoscopic mucosal resection and endoscopic submucosal dissection groups

	All, n = 142	EMR group, n = 87	ESD group, n = 55	P value
Age, yr
Median (IQR)	63.5 (57-71.75)	62 (57-70)	66 (59-73.5)	0.15
Sex, n (%)
Male	79 (55.6)	56 (64.4)	23 (41.8)	0.01
Female	63 (44.4)	31 (35.6)	32 (58.2)
Tumor location, n (%)
Bulbs	32 (22.5)	17 (19.5)	15 (27.3)	0.31
Second portion or later	110 (77.5)	70 (80.5)	40 (72.7)
Morphology, n (%)
Flat or depressed	28 (19.7)	17 (19.5)	11 (20.0)	1
Protruded	114 (80.3)	70 (80.5)	44 (80.0)
Tumor size, mm
Median (IQR)	8 (5.25-15)	7 (5-10)	15 (10.5-20)	< 0.001
< 11 mm	85 (59.9)	71 (81.6)	14 (25.5)	< 0.001
≥ 11 mm	57 (40.1)	16 (18.4)	41 (74.5)
Tumor depth, n (%)
Mucosa	139 (97.9)	86 (98.9)	53 (96.4)	0.56
Submucosa	3 (2.1)	1 (1.1)	2 (3.6)
Histology, n (%)
Adenoma	103 (72.5)	72 (82.8)	31 (56.4)	0.001
Adenocarcinoma	39 (27.5)	15 (17.2)	24 (43.6)

P values were calculated using the Fisher exact test for categorical data and the Mann-Whitney U test for continuous data. EMR: Endoscopic mucosal resection; ESD: Endoscopic submucosal dissection; IQR: Interquartile range.

Table 2 Comparison of clinicopathological characteristics of the endoscopic mucosal resection and endoscopic submucosal dissection groups after propensity score matching

	EMR group, n = 28	ESD group, n = 28	P value	ASD
Variable matching between groups
Age, yr; ≥ 65/< 65	8/20	6/22	0.76	0.17
Sex; male/female	17/11	16/12	1	0.073
Tumor location; bulbs/others	8/20	6/22	0.67	0.17
Morphology; protruded/flat or depressed	22/6	23/5	1	0.090
Histology; adenocarcinoma/adenoma	8/20	7/21	1	0.081
Tumor depth; mucosa/submucosa	27/1	27/1	1	0
Tumor size; median (IQR)	11 (6.25-15)	10.5 (8-13)	0.90	0.026
Tumor size; ≥ 11 mm/< 11 mm	14/14	14/14	1	0

P values were calculated using the Fisher exact test for categorical data and the Mann-Whitney U test for continuous data. EMR: Endoscopic mucosal resection; ESD: Endoscopic submucosal dissection; ASD: Absolute standardized difference; IQR: Interquartile range.

Table 3 Comparison of treatment outcomes between the endoscopic mucosal resection and endoscopic submucosal dissection groups after propensity score matching

	EMR group, n = 28	ESD group, n = 28	P value
Procedure time, min
Median (IQR)	6 (3-10.75)	87.5 (68.5-136.5)	< 0.001
En bloc resection, n (%)	23 (82.1)	26 (92.9)	0.42
Complete resection, n (%)	20 (71.4)	25 (89.3)	0.18
Closure of mucosal defects, n (%)	24 (85.7)	27 (96.4)	0.35
Adverse events, n (%)	1 (3.6)	5 (17.9)	0.19
Intraoperative perforation, n (%)	0 (0)	3 (10.7)	0.24
Delayed perforation, n (%)	0 (0)	1 (3.6)	1
Delayed bleeding, n (%)	1 (3.6)	0 (0)	1
Emergency surgery, n (%)	0 (0)	1 (3.6)	1
Hospital stay, d
Median (IQR)	8 (6-10.75)	11 (8.25-14.75)	0.006
Follow-up duration, mo	23 (11-35.5)	24 (9.75-57.5)	0.831
Median (IQR)
One-year follow-up, n (%)	21 (75)	20 (71.4)	1
Local recurrence, n (%)	1 (3.6)	0 (0)	1
Metastatic recurrence, n (%)	0 (0)	0 (0)	-

P values were calculated using Fisher’s exact test for categorical data and Mann-Whitney U test for continuous data. EMR: Endoscopic mucosal resection; ESD: Endoscopic submucosal dissection; IQR: Interquartile range.