Endoscopic mucosal resection for early gastric cancer

Area of Science:

• Gastroenterology
• Surgical Oncology
• Endoscopic Procedures

Background:

• Endoscopic mucosal resection (EMR) has been used for early gastric cancer (EGC) for two decades.
• The effectiveness and safety of EMR for EGC remain debated.
• Systematic assessment of bias in EMR trials is lacking.

Purpose of the Study:

• To compare the effectiveness and safety of EMR versus gastrectomy for EGC treatment.
• To systematically review existing evidence on EMR for EGC.

Main Methods:

• Comprehensive literature search of multiple databases (CENTRAL, MEDLINE, EMBASE, CINAHL, CBM) up to March 2005, with updates in 2006 and 2009.
• Handsearching of reference lists and conference abstracts.
• Contacting experts for additional trial information.
• Inclusion criteria: Randomized controlled trials comparing EMR and gastrectomy for EGC.

Main Results:

• No randomized controlled trials (RCTs) were identified for systematic review.
• The review could not provide definitive conclusions based on RCT evidence.
• Evidence from non-randomized controlled trials is discussed in the full text.

Conclusions:

• A significant lack of high-quality RCTs comparing EMR and gastrectomy for EGC exists.
• Well-designed RCTs are crucial to establish the comparative efficacy and safety of EMR versus gastrectomy.
• Further research is needed to guide clinical practice for EGC treatment.