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

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Abstract

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.

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Data availability

The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.

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  1. Department of Endoscopy Center, Peking University First Hospital, No. 8 Xishiku street, Xicheng District, Beijing, 100034, China

    Yuan Tian, Long Rong & Yongchen Ma

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Sensitivity analysis for overall survival. (PNG 449 kb)

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Tian, Y., Rong, L. & Ma, Y. Surgical resection after endoscopic resection in patients with T1 colorectal cancer: a meta-analysis. Int J Colorectal Dis 36, 457–466 (2021). https://doi.org/10.1007/s00384-020-03752-2

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