Endoscopic Submucosal Dissection versus Surgical Treatment for Early Esophagogastric Junction Adenocarcinoma:Propensity Score Matching Analysis
10.3969/j.issn.1672-2159.2024.04.007
- VernacularTitle:内镜黏膜下剥离术与外科手术治疗早期食管胃连接部腺癌的倾向性评分匹配分析
- Author:
Xue-Tong ZHANG
1
;
Ying-Ling LIU
;
Chao XU
;
Si-Qing SHANG
;
Kai-Guang ZHANG
Author Information
1. 233000 蚌埠医科大学研究生院
- Keywords:
Early esophagogastric junction adenocarcinoma;
Endoscopic submucosal dissection;
Surgery
- From:
Modern Interventional Diagnosis and Treatment in Gastroenterology
2024;29(4):422-428
- CountryChina
- Language:Chinese
-
Abstract:
Objective To compare the clinical efficacy and prognosis of endoscopic submucosal dissection(ESD)and surgical methods in the treatment of early esophagogastric junction adenocarcinoma(AEG),and to analyze factors influencing prognosis.Methods Hospitalized patients with early AEG who underwent ESD or surgical treatment at Anhui Provincial Hospital from January 2010 to December 2022 were collected.Among them,186 patients underwent ESD and 364 patients underwent surgical treatment.Propensity score matching was used with a ratio of 1∶1,with 164 patients in each group.Clinical outcomes,survival outcomes,and postoperative complications were compared before and after matching.Factors influencing mortality and recurrence in EGJ patients were analyzed.Results 1.Before and after matching,the ESD group had lower surgical time,hospital stay,hospital costs,intraoperative bleeding volume,and adverse events compared to the surgical group(P＜0.001).2.The matched ESD group had 1-,3-,and 5-year overall survival rates of 99.5％,94.5％,and 90.2％,respectively,while the surgical group had rates of 100％,99.4％,and 97.5％for the same periods.The 1-,3-,and 5-year recurrence-free survival rates in the matched ESD group were 99.5％,96.3％,and 93.4％,respectively,compared to 100％,98.6％,and 92.5％in the surgical group.Kaplan-Meier survival analysis before and after matching showed no significant difference in overall survival and recurrence-free survival between the two groups(P＞0.05).3.Age,poor differentiation,and vascular invasion were independent risk factors for OS;age and tumor size were independent risk factors for RFS.Conclusion Patients with early AEG undergoing ESD or surgical treatment have consistent clinical outcomes.ESD can be considered an effective and safe treatment for early AEG.
