Outcomes of Endoscopic Submucosal Dissection for Treatment of Superficial Pharyngeal Cancers: Systematic Review and Meta-Analysis
| Autor: | Muhammad Ali Khan, Zaid Imam, Douglas G. Adler, Ashu Acharya, Wade Lee-Smith, Faisal Kamal, Usman Zafar, Stephanie McDonough, Sachit Sharma, Ellen Petryna, Dawit Jowhar, Umer Farooq, Julia Esswein, Muhammad Aziz |
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| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
Funnel plot Asia Endoscopic Mucosal Resection Physiology business.industry Gastroenterology Pharyngeal Neoplasms Publication bias Hepatology Confidence interval Treatment Outcome Pharyngeal Neoplasm Internal medicine Meta-analysis medicine Humans Pharyngeal Squamous Cell Carcinoma Radiology Neoplasm Recurrence Local business Adverse effect Retrospective Studies |
| Zdroj: | Digestive Diseases and Sciences. 67:3518-3528 |
| ISSN: | 1573-2568 0163-2116 |
| Popis: | Studies evaluating the role of endoscopic submucosal dissection (ESD) in the management of superficial pharyngeal cancers have reported promising results. This meta-analysis evaluates the efficacy and safety of ESD in the management of superficial pharyngeal cancers. We reviewed several databases from inception to September 03, 2020, to identify studies evaluating the efficacy and safety of ESD in the management of superficial pharyngeal cancers. Our outcomes of interest were en bloc resection rate, complete resection rate, adverse events, and rates of local recurrence. Pooled rates with 95% confidence intervals (CI) for all outcomes were calculated using random-effect model. Heterogeneity was assessed by I2 statistic. We assessed publication bias by using funnel plots and Egger’s test. We conducted meta-regression analysis to explore heterogeneity in analyses. Ten studies were included in analyses. All studies were from Asia. Pooled rates (95% CI) for en bloc resection and complete resection were 94% (87%, 97%) and 72% (62%, 80%), respectively. The pooled rates (95% CI) for adverse events and local recurrence were 10% (5%, 17%) and 1.9% (0.9%, 4%), respectively. Most of the analyses were limited by substantial heterogeneity. On meta-regression analysis, the heterogeneity was explained by size of tumor and histology. Funnel plots and Egger’s test showed no evidence of publication bias. This meta-analysis including studies from Asian countries demonstrated that ESD is an efficacious and safe option in the management of superficial pharyngeal cancers. More studies and studies from Western countries are needed to further validate these findings. |
| Databáze: | OpenAIRE |
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