Meta-Analysis
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Jul 16, 2022; 10(20): 6915-6926
Published online Jul 16, 2022. doi: 10.12998/wjcc.v10.i20.6915
Endoscopic submucosal dissection for early signet ring cell gastric cancer: A systematic review and meta-analysis
Chun-Yan Weng, Shao-Peng Sun, Chang Cai, Jing-Li Xu, Bin Lv
Chun-Yan Weng, Shao-Peng Sun, Chang Cai, Department of Gastroenterology, The First Clinical Medical College of Zhejiang Chinese Medical University, Hangzhou 310000, Zhejiang Province, China
Jing-Li Xu, Department of Gastrointestinal Surgery, The First Clinical Medical University of Zhejiang Chinese Medical University, Hangzhou 310000, Zhejiang Province, China
Bin Lv, Department of Gastroenterology, The First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou 310006, Zhejiang Province, China
Author contributions: Weng CY, Cai C, and Sun SP collected the data; Weng CY, Xu JL, and Lv B wrote the draft of the article; all authors contributed to offered critical revisions, and have read and approved the manuscript.
Supported by National Natural Science Foundation of China, No. 8177030774.
Conflict-of-interest statement: The authors have no conflicts of interest or financial ties to disclose.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Bin Lv, MD, Chief Doctor, Professor, Department of Gastroenterology, The First Affiliated Hospital of Zhejiang Chinese Medical University, No. 54 Youdian Road, Hangzhou 310006, Zhejiang Province, China. lvbin@medmail.com.cn
Received: September 6, 2021
Peer-review started: September 6, 2021
First decision: November 7, 2021
Revised: November 11, 2021
Accepted: April 21, 2022
Article in press: April 21, 2022
Published online: July 16, 2022
Processing time: 301 Days and 18.8 Hours
ARTICLE HIGHLIGHTS
Research background

Endoscopic submucosal dissection (ESD) for the treatment of early signet ring cell carcinoma (SRC) is controversial.

Research motivation

SRC may represent an indication for ESD. Nevertheless, ESD for SRC early gastric cancer (EGC) remains debatable. Therefore, a meta-analysis was carried out for assessing the clinical outcomes of ESD for undifferentiated (UD) SRC EGC cases.

Research objectives

This work aimed to meta-analyzed reports evaluating the therapeutic efficacy and safety of ESD in early SRC gastric cancer.

Research methods

The PubMed, Web of Science, Cochrane Library, and EMBASE databases were searched for relevant reports evaluating the efficacy and safety of ESD for treating SRC.

Research results

The total lymphovascular invasion and en bloc resection rates were 3.8% and 98.4%, respectively. The total complete and incomplete resection rates were estimated at 78.5% and 18.8%, respectively. The total procedure-associated gastric hemorrhage and perforation rates were 2.6% and 0.4%, respectively. The curative resection, vertical margin invasion, and lateral margin invasion rates were 72.1%, 2.3%, and 34.45%, respectively.

Research conclusions

ESD represents a promising therapeutic approach for UD SRC EGC. Further improvements are required to increase treatment efficacy and reduce adverse outcomes.

Research perspectives

ESD as a treatment tool constitutes a critical step in improving daily clinical practice associated with SRC EGC. Future trials with a larger sample size and longer follow-up duration are warranted to evaluate the long-term efficacy and safety of ESD treatment for SRC EGC.