Background: The survival benefit of additional surgery after non-curative endoscopic resection of early gastric cancer is a matter of debate. This meta-analysis is intended to draw a convincing conclusion on this issue based on data currently available.
Methods: A systematic review of PubMed/Medline database was performed from 2010 to 2018 for studies comparing survival outcomes of additional surgery versus simple follow-up after non-curative endoscopic resection for early gastric cancer. Differences between groups were calculated using either the fixed effects model or random effects model.
Results: Ten retrospective studies with 4225 patients met the inclusion criteria. Additional surgery significantly provided better 5 years overall survival [odds ratios (OR) 3.50, 95% confidence interval (95% CI) 2.89-4.24] and disease-specific survival (OR 3.99, 95% CI 2.50-6.36).
Conclusions: Additional surgery offers survival benefits to patients undergoing non-curative endoscopic resection of early gastric cancer.
Keywords: Additional surgery; Early gastric cancer; Endoscopic sub-mucosal dissection; Long-term outcomes; Non-curative resection.