Efficacy and Safety of Endoscopic Resection Therapies for Rectal Carcinoid Tumors: A Meta-Analysis.
- Author:
Lei HE
1
;
Tao DENG
;
Hesheng LUO
Author Information
- Publication Type:Original Article ; Meta-Analysis
- Keywords: Endoscopic submucosal dissection; endoscopic mucosal resection; rectal carcinoid tumor; meta-analysis
- MeSH: Carcinoid Tumor/pathology/*surgery; Dissection/adverse effects; Endoscopy, Gastrointestinal/*adverse effects; Humans; Intestinal Mucosa/pathology/surgery; Intestinal Neoplasms/pathology/*surgery; Middle Aged; Neoplasm Recurrence, Local/pathology; Postoperative Complications/etiology; Publication Bias; Rectal Neoplasms/pathology/*surgery; Time Factors; Treatment Outcome; Tumor Burden
- From:Yonsei Medical Journal 2015;56(1):72-81
- CountryRepublic of Korea
- Language:English
- Abstract: PURPOSE: Several endoscopic resection therapies have been applied for the treatment of rectal carcinoid tumors. However, there is currently no consensus regarding the optimal strategy. We performed a meta-analysis to compare the efficacy and safety of endoscopic mucosal resection (EMR) or modified EMR (m-EMR) versus endoscopic submucosal dissection (ESD) for the treatment of rectal carcinoid tumors. MATERIALS AND METHODS: PubMed, Web of Science, Medline, Embase and CNKI were searched up to the end of January 2014 in order to identify all studies on the effects of EMR (or m-EMR) and ESD on rectal carcinoid tumors. RESULTS: A total of fourteen studies involving 782 patients were included. The pooled data suggested a significantly higher rate of pathological complete resection among patients treated with ESD or m-EMR than those treated with EMR [odds ratio (OR)=0.42, 95% confidence interval (CI): 0.25-0.71; OR=0.10, 95% CI: 0.03-0.33, respectively], while there was no significant difference between the m-EMR group and ESD group (OR=1.19, 95% CI: 0.49-2.86); The procedure time of ESD was longer than EMR or m-EMR groups [mean differences (MD)=-11.29, 95% CI: -14.19 - -8.38, MD= -10.90, 95% CI: -18.69 - -3.11, respectively], but it was insignificance between the EMR and m-EMR groups. No significant differences were detected among the treatment groups with regard to complications or recurrence. CONCLUSION: The results of this meta-analysis suggest that treatment of rectal carcinoid tumors with ESD or m-EMR is superior to EMR, and the efficacy of m-EMR is equivalence to ESD treatment. However, more well-designed studies are needed to confirm these findings.
