Background: The use of endoscopic submucosal dissection (ESD) for treating early signet ring cell carcinoma (SRC) is controversial due to the risk of lymph node metastasis.
Aim: To carry out a meta-analysis to evaluate ESD for therapeutic efficacy and safety in early signet ring cell gastric cancer.
Methods: The PubMed, Web of Science, Cochrane Library, and EMBASE databases were used to search for relevant studies evaluating the therapeutic efficacy and safety of ESD in SRC. The rates of recurrence, complete resection, incomplete resection, curative resection, resection, and adverse events were extracted and analyzed. The methodological quality of the enrolled studies was assessed using the Newcastle-Ottawa Scale. Publication bias was evaluated by the Egger's test. Institutional review board approval and written consent were not needed for this report.
Results: This meta-analysis enrolled seven studies with 653 participants undergoing ESD treatment for early SRC. The overall recurrence rate was 0.010 [95% confidence interval (CI): 0.000-0.040, = 1.422, = 0.155]. The total lymphovascular invasion rate was 0.038 (95%CI: 0.007-0.088, = 3.026, = 0.002). The total resection rate was estimated at 0.984 (95%CI: 0.925-1.000, = 19.463, = 0.000). The total complete and incomplete resection rates were estimated at 0.785 (95%CI: 0.596-0.928, = 9.789, = 0.000) and 0.188 (95%CI: 0.016-0.468, = 2.531, = 0.011), respectively. The total procedure-associated gastric hemorrhage and perforation rates were estimated at 0.026 (95%CI: 0.005-0.061, = 3.006 = 0.003) and 0.004 (95%CI: 0.000-0.028, = 0.938, = 0.348), respectively. The curative resection, vertical margin invasion, and lateral margin invasion rates were 72.1% (145/341), 2.3% (8/348), and 34.45% (41/119), respectively.
Conclusion: ESD constitutes a promising therapeutic approach for early undifferentiated SRC gastric cancer. However, further improvements are required for increasing its treatment efficacy and reducing adverse outcomes.
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| http://dx.doi.org/10.12998/wjcc.v10.i20.6915 | DOI Listing |
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Article Synopsis
- Cutaneous metastases from gastric carcinoma, specifically signet-ring cell (SRC) type, are rare but can indicate advanced disease or recurrence and may present as asymptomatic skin nodules that are easily misdiagnosed.
- Diagnosis relies on histopathological examination and specific staining techniques to confirm SRC tumors, which tend to spread aggressively and are resistant to chemotherapy.
- The presence of skin metastases is associated with a poor prognosis and necessitates a collaborative approach among healthcare providers for early detection and better patient outcomes.
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