Work

Updated evaluation of additional surgery versus non-gastrectomy treatment for early gastric cancer after noncurative endoscopic resection: a meta-analysis

Year: 2026

Type: review

Study designs: Systematic Review, Meta-Analysis

Abstract: BACKGROUND: Debate regarding whether additional surgery should be the preferred treatment option for patients with early gastric cancer who have undergone noncurative endoscopic resection is ongoing. OBJECTIVES: This meta-analysis aims to provide clarity for clinicians and patients to facilitate better informed treatment decisions. METHODS: Our meta-analysis involved searches of PubMed, Embase, and Web of Science databases. We analyzed the following prognosis-related indicators in groups receiving additional surgical or nonsurgical treatment: 5-year overall survival (OS), 8-year overall survival (OS), 5-year disease-specific survival (DSS), 5-year disease-free survival (DFS), 5-year recurrence-free survival (RFS), 5-year cancer-specific survival (CSS), and clinicopathological data. RESULTS: After applying strict inclusion and exclusion criteria, 26 studies published in English through May 2024 were included, comprising data from 9177 patients with early-stage gastric tumors following noncurative endoscopic resection. These patients were categorized into additional surgery (n = 4903) and nonsurgical (n = 4274) groups. The following outcomes were significantly better in the additional surgery group: 5-year OS (odds ratio [OR] = 3.37, 95% confidence interval [CI] = 2.91-3.91, p < 0.00001; hazard ratio [HR] = 0.51, 95% CI = 0.41-0.64, p < 0.00001), 8-year OS (OR = 1.96, 95% CI = 1.22-3.16, p = 0.005), 5-year DSS (OR = 3.08, 95% CI = 2.08-4.55, p < 0.00001), 5-year DFS (OR = 4.17, 95% CI = 1.53-11.4, p = 0.005), 5-year RFS (OR = 9.14, 95% CI = 3.63-23.01, p < 0.00001), and 5-year CSS (OR = 2.54, 95% CI = 1.32-4.9, p = 0.005). Additionally, subgroup analysis revealed that patients over 70 years old benefitted more from surgery (OR = 3.09, 95% CI = 2.37-4.02, p < 0.00001). The results of the analysis were significant, with minimal heterogeneity. CONCLUSIONS: Our review revealed that the prognostic indicators of patients in the additional surgery group were greater and cannot be ignored.

Source: Surgical Endoscopy

DOI: 10.1007/s00464-026-12606-x

Authors: Baifang Wang, Jia Zhu, Na Gao, Ying Zhao, Guoqing Xiang, Ping Zhu

Institutions: Liaoning Cancer Hospital & Institute, China Medical University

Language: English

Topic: Gastric Cancer Management and Outcomes

Subfield: Pulmonary and Respiratory Medicine

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: hybrid

Estimated APC paid: $4,390