Daoud DC, Suter N, Durand M, Bouin M, Faulques B, von Renteln D. Comparing outcomes for endoscopic submucosal dissection between Eastern and Western countries: A systematic review and meta-analysis. World J Gastroenterol 2018; 24(23): 2518-2536 [PMID: 29930473 DOI: 10.3748/wjg.v24.i23.2518]
Corresponding Author of This Article
Madeleine Durand, FRCP(C), MD, MSc, Assistant Professor, Doctor, Department of Medicine, Division of Internal Medicine, Centre hospitalier de l’Université de Montréal (CHUM) and Centre de Recherche du Centre hospitalier de l’Université de Montréal (CRCHUM), 850 Rue Saint-Denis, Montréal, Québec H2X 0A9, Canada. madeleine.durand@gmail.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Meta-Analysis
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (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: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastroenterol. Jun 21, 2018; 24(23): 2518-2536 Published online Jun 21, 2018. doi: 10.3748/wjg.v24.i23.2518
Comparing outcomes for endoscopic submucosal dissection between Eastern and Western countries: A systematic review and meta-analysis
Dane Christina Daoud, Nicolas Suter, Madeleine Durand, Mickael Bouin, Bernard Faulques, Daniel von Renteln
Dane Christina Daoud, Mickael Bouin, Bernard Faulques, Daniel von Renteln, Department of Medicine, Division of Gastroenterology, Centre Hospitalier de l’Université de Montréal (CHUM) and Centre de Recherche du Centre hospitalier de l’Université de Montréal (CRCHUM), Montreal, Quebec H2X 0A9, Canada
Nicolas Suter, Madeleine Durand, Department of Medicine, Division of Internal Medicine, Centre Hospitalier de l’Université de Montréal (CHUM) and Centre de Recherche du Centre hospitalier de l’Université de Montréal (CRCHUM), Montreal, Quebec H2X 0A9, Canada
Author contributions: Daoud DC designed the study, collected and analyzed the data and wrote the manuscript; Suter N collected and analyzed the data; Durand M performed the statistical analysis and analyzed the data; von Renteln D designed the study, analyzed the data and wrote the manuscript; Bouin M and Faulques B revised the manuscript critically for intellectual content; and all the authors provided intellectual input for the study and approved the final version of the manuscript.
Conflict-of-interest statement: None of the authors have any potential personal conflict of interest with regard to the study to declare.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (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: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Madeleine Durand, FRCP(C), MD, MSc, Assistant Professor, Doctor, Department of Medicine, Division of Internal Medicine, Centre hospitalier de l’Université de Montréal (CHUM) and Centre de Recherche du Centre hospitalier de l’Université de Montréal (CRCHUM), 850 Rue Saint-Denis, Montréal, Québec H2X 0A9, Canada. madeleine.durand@gmail.com
Telephone: +1-514-8908444
Received: March 10, 2018 Peer-review started: March 11, 2018 First decision: March 29, 2018 Revised: May 5, 2018 Accepted: June 2, 2018 Article in press: June 2, 2018 Published online: June 21, 2018
ARTICLE HIGHLIGHTS
Research background
Endoscopic submucosal dissection (ESD) has become the preferred approach to remove advanced gastrointestinal lesions in Asian countries while widespread adoption in the Western world remains limited.
Research motivation
Many previous meta-analyses suggest that ESD is a superior technique for treatment of precancerous gastrointestinal lesions or early cancers. However, there might be regional differences in outcomes since the majority of ESD publications come from the Eastern world. Studies evaluating differences for ESD outcomes between Eastern and Western countries are lacking.
Research objectives
To provide a global comparison of ESD outcomes between Eastern and Western countries.
Research methods
A systematic review and meta-analysis were conducted on studies reporting ESD outcomes. Were excluded studies with less than 50 patients, using hybrid ESD technique or targeting subepithelial lesions. Primary and secondary outcomes were efficacy of ESD (curative, en bloc and R0 resection), complications (bleeding, perforation) and other related factors as local recurrence and procedural time.
Research results
Our meta-analysis showed that Eastern countries have better ESD outcomes compared to Western countries for curative, en bloc and R0 resection. ESD performed in Western countries were associated with a higher proportion of perforation requiring surgery. Subgroups analysis by organ showed similar outcomes for gastric lesions while Eastern countries had better curative, en bloc and R0 resection rates for colorectal lesions.
Research conclusions
This meta-analysis provided evidence that there are regional differences for ESD outcomes. Eastern countries show better ESD outcomes compared to Western countries.
Research perpective
Clinical decision-making for or against ESD should consider such outcomes and locally available expertise. Standardized reporting of outcomes should be used for future ESD studies.
