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Survival benefits of additional surgery after non-curative endoscopic resection in patients with early gastric cancer: a meta-analysis.

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.

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