title: Endoscopic submucosal dissection for early gastric cancer with undifferentiated-type histology: A meta-analysis.
abstract: OBJECTIVE
  To evaluate the efficacy and safety of endoscopic submucosal dissection (ESD) for early gastric cancer (EGC) with undifferentiated-type histology.
  
  
  METHODS
  A systematic literature review was conducted using the core databases. Complete resection, curative resection, en bloc resection, recurrence and adverse event rate were extracted and analyzed. A random effect model was applied. The methodological quality of the enrolled studies was assessed using the Newcastle-Ottawa Scale. Publication bias was evaluated using a funnel plot, the trim and fill method, Egger's test, and a rank correlation test.
  
  
  RESULTS
  Fourteen retrospective studies between 2009 and 2014 were identified (972 EGC lesions with undifferentiated-type histology). The total en bloc and complete resection rates were estimated as 92.1% (95%CI: 87.4%-95.2%) and 77.5% (95%CI: 69.3%-84%), respectively. The total curative resection rate was 61.4% (95%CI: 44.5%-75.9%). The overall recurrence rate was 7.6% (95%CI: 3.4%-16%). Limited to histologically diagnosed expanded-criteria lesions, the en bloc and complete resection rates were 91.2% and 85.6%, respectively. The curative resection rate was 79.8%.
  
  
  CONCLUSIONS
  In this analysis, ESD is a technically feasible treatment modality for EGC with undifferentiated-type histology. Long-term studies are needed to confirm these therapeutic outcomes.
authors.affiliation: Chang Seok Bang, Gwang Ho Baik, Jing Bong Kim, Ki Tae Suk, Jai Hoon Yoon, Yeon Soo Kim, Dong Joon Kim, Woon Geon Shin, Kyung Ho Kim, Hak Yang Kim, Hyun Lim, Ho Seok Kang, Jong Hyeok Kim, Jin Bae Kim, Sung Won Jung, Sea Hyub Kae, Hyun Joo Jang, Min Ho Choi, Department of Internal Medicine, Hallym University College of Medicine, Chuncheon 200-704, South Korea.
authors.forename: Chang Seok
authors.initials: CS
authors.lastname: Bang
authors.affiliation: Chang Seok Bang, Gwang Ho Baik, Jing Bong Kim, Ki Tae Suk, Jai Hoon Yoon, Yeon Soo Kim, Dong Joon Kim, Woon Geon Shin, Kyung Ho Kim, Hak Yang Kim, Hyun Lim, Ho Seok Kang, Jong Hyeok Kim, Jin Bae Kim, Sung Won Jung, Sea Hyub Kae, Hyun Joo Jang, Min Ho Choi, Department of Internal Medicine, Hallym University College of Medicine, Chuncheon 200-704, South Korea.
authors.forename: Gwang Ho
authors.initials: GH
authors.lastname: Baik
authors.affiliation: Chang Seok Bang, Gwang Ho Baik, Jing Bong Kim, Ki Tae Suk, Jai Hoon Yoon, Yeon Soo Kim, Dong Joon Kim, Woon Geon Shin, Kyung Ho Kim, Hak Yang Kim, Hyun Lim, Ho Seok Kang, Jong Hyeok Kim, Jin Bae Kim, Sung Won Jung, Sea Hyub Kae, Hyun Joo Jang, Min Ho Choi, Department of Internal Medicine, Hallym University College of Medicine, Chuncheon 200-704, South Korea.
authors.forename: In Soo
authors.initials: IS
authors.lastname: Shin
authors.affiliation: Chang Seok Bang, Gwang Ho Baik, Jing Bong Kim, Ki Tae Suk, Jai Hoon Yoon, Yeon Soo Kim, Dong Joon Kim, Woon Geon Shin, Kyung Ho Kim, Hak Yang Kim, Hyun Lim, Ho Seok Kang, Jong Hyeok Kim, Jin Bae Kim, Sung Won Jung, Sea Hyub Kae, Hyun Joo Jang, Min Ho Choi, Department of Internal Medicine, Hallym University College of Medicine, Chuncheon 200-704, South Korea.
authors.forename: Jing Bong
authors.initials: JB
authors.lastname: Kim
authors.affiliation: Chang Seok Bang, Gwang Ho Baik, Jing Bong Kim, Ki Tae Suk, Jai Hoon Yoon, Yeon Soo Kim, Dong Joon Kim, Woon Geon Shin, Kyung Ho Kim, Hak Yang Kim, Hyun Lim, Ho Seok Kang, Jong Hyeok Kim, Jin Bae Kim, Sung Won Jung, Sea Hyub Kae, Hyun Joo Jang, Min Ho Choi, Department of Internal Medicine, Hallym University College of Medicine, Chuncheon 200-704, South Korea.
authors.forename: Ki Tae
authors.initials: KT
authors.lastname: Suk
authors.affiliation: Chang Seok Bang, Gwang Ho Baik, Jing Bong Kim, Ki Tae Suk, Jai Hoon Yoon, Yeon Soo Kim, Dong Joon Kim, Woon Geon Shin, Kyung Ho Kim, Hak Yang Kim, Hyun Lim, Ho Seok Kang, Jong Hyeok Kim, Jin Bae Kim, Sung Won Jung, Sea Hyub Kae, Hyun Joo Jang, Min Ho Choi, Department of Internal Medicine, Hallym University College of Medicine, Chuncheon 200-704, South Korea.
authors.forename: Jai Hoon
authors.initials: JH
authors.lastname: Yoon
authors.affiliation: Chang Seok Bang, Gwang Ho Baik, Jing Bong Kim, Ki Tae Suk, Jai Hoon Yoon, Yeon Soo Kim, Dong Joon Kim, Woon Geon Shin, Kyung Ho Kim, Hak Yang Kim, Hyun Lim, Ho Seok Kang, Jong Hyeok Kim, Jin Bae Kim, Sung Won Jung, Sea Hyub Kae, Hyun Joo Jang, Min Ho Choi, Department of Internal Medicine, Hallym University College of Medicine, Chuncheon 200-704, South Korea.
authors.forename: Yeon Soo
authors.initials: YS
authors.lastname: Kim
authors.affiliation: Chang Seok Bang, Gwang Ho Baik, Jing Bong Kim, Ki Tae Suk, Jai Hoon Yoon, Yeon Soo Kim, Dong Joon Kim, Woon Geon Shin, Kyung Ho Kim, Hak Yang Kim, Hyun Lim, Ho Seok Kang, Jong Hyeok Kim, Jin Bae Kim, Sung Won Jung, Sea Hyub Kae, Hyun Joo Jang, Min Ho Choi, Department of Internal Medicine, Hallym University College of Medicine, Chuncheon 200-704, South Korea.
authors.forename: Dong Joon
authors.initials: DJ
authors.lastname: Kim
authors.affiliation: Chang Seok Bang, Gwang Ho Baik, Jing Bong Kim, Ki Tae Suk, Jai Hoon Yoon, Yeon Soo Kim, Dong Joon Kim, Woon Geon Shin, Kyung Ho Kim, Hak Yang Kim, Hyun Lim, Ho Seok Kang, Jong Hyeok Kim, Jin Bae Kim, Sung Won Jung, Sea Hyub Kae, Hyun Joo Jang, Min Ho Choi, Department of Internal Medicine, Hallym University College of Medicine, Chuncheon 200-704, South Korea.
authors.forename: Woon Geon
authors.initials: WG
authors.lastname: Shin
authors.affiliation: Chang Seok Bang, Gwang Ho Baik, Jing Bong Kim, Ki Tae Suk, Jai Hoon Yoon, Yeon Soo Kim, Dong Joon Kim, Woon Geon Shin, Kyung Ho Kim, Hak Yang Kim, Hyun Lim, Ho Seok Kang, Jong Hyeok Kim, Jin Bae Kim, Sung Won Jung, Sea Hyub Kae, Hyun Joo Jang, Min Ho Choi, Department of Internal Medicine, Hallym University College of Medicine, Chuncheon 200-704, South Korea.
authors.forename: Kyung Ho
authors.initials: KH
authors.lastname: Kim
authors.affiliation: Chang Seok Bang, Gwang Ho Baik, Jing Bong Kim, Ki Tae Suk, Jai Hoon Yoon, Yeon Soo Kim, Dong Joon Kim, Woon Geon Shin, Kyung Ho Kim, Hak Yang Kim, Hyun Lim, Ho Seok Kang, Jong Hyeok Kim, Jin Bae Kim, Sung Won Jung, Sea Hyub Kae, Hyun Joo Jang, Min Ho Choi, Department of Internal Medicine, Hallym University College of Medicine, Chuncheon 200-704, South Korea.
authors.forename: Hak Yang
authors.initials: HY
authors.lastname: Kim
authors.affiliation: Chang Seok Bang, Gwang Ho Baik, Jing Bong Kim, Ki Tae Suk, Jai Hoon Yoon, Yeon Soo Kim, Dong Joon Kim, Woon Geon Shin, Kyung Ho Kim, Hak Yang Kim, Hyun Lim, Ho Seok Kang, Jong Hyeok Kim, Jin Bae Kim, Sung Won Jung, Sea Hyub Kae, Hyun Joo Jang, Min Ho Choi, Department of Internal Medicine, Hallym University College of Medicine, Chuncheon 200-704, South Korea.
authors.forename: Hyun
authors.initials: H
authors.lastname: Lim
authors.affiliation: Chang Seok Bang, Gwang Ho Baik, Jing Bong Kim, Ki Tae Suk, Jai Hoon Yoon, Yeon Soo Kim, Dong Joon Kim, Woon Geon Shin, Kyung Ho Kim, Hak Yang Kim, Hyun Lim, Ho Seok Kang, Jong Hyeok Kim, Jin Bae Kim, Sung Won Jung, Sea Hyub Kae, Hyun Joo Jang, Min Ho Choi, Department of Internal Medicine, Hallym University College of Medicine, Chuncheon 200-704, South Korea.
authors.forename: Ho Seok
authors.initials: HS
authors.lastname: Kang
authors.affiliation: Chang Seok Bang, Gwang Ho Baik, Jing Bong Kim, Ki Tae Suk, Jai Hoon Yoon, Yeon Soo Kim, Dong Joon Kim, Woon Geon Shin, Kyung Ho Kim, Hak Yang Kim, Hyun Lim, Ho Seok Kang, Jong Hyeok Kim, Jin Bae Kim, Sung Won Jung, Sea Hyub Kae, Hyun Joo Jang, Min Ho Choi, Department of Internal Medicine, Hallym University College of Medicine, Chuncheon 200-704, South Korea.
authors.forename: Jong Hyeok
authors.initials: JH
authors.lastname: Kim
authors.affiliation: Chang Seok Bang, Gwang Ho Baik, Jing Bong Kim, Ki Tae Suk, Jai Hoon Yoon, Yeon Soo Kim, Dong Joon Kim, Woon Geon Shin, Kyung Ho Kim, Hak Yang Kim, Hyun Lim, Ho Seok Kang, Jong Hyeok Kim, Jin Bae Kim, Sung Won Jung, Sea Hyub Kae, Hyun Joo Jang, Min Ho Choi, Department of Internal Medicine, Hallym University College of Medicine, Chuncheon 200-704, South Korea.
authors.forename: Jin Bae
authors.initials: JB
authors.lastname: Kim
authors.affiliation: Chang Seok Bang, Gwang Ho Baik, Jing Bong Kim, Ki Tae Suk, Jai Hoon Yoon, Yeon Soo Kim, Dong Joon Kim, Woon Geon Shin, Kyung Ho Kim, Hak Yang Kim, Hyun Lim, Ho Seok Kang, Jong Hyeok Kim, Jin Bae Kim, Sung Won Jung, Sea Hyub Kae, Hyun Joo Jang, Min Ho Choi, Department of Internal Medicine, Hallym University College of Medicine, Chuncheon 200-704, South Korea.
authors.forename: Sung Won
authors.initials: SW
authors.lastname: Jung
authors.affiliation: Chang Seok Bang, Gwang Ho Baik, Jing Bong Kim, Ki Tae Suk, Jai Hoon Yoon, Yeon Soo Kim, Dong Joon Kim, Woon Geon Shin, Kyung Ho Kim, Hak Yang Kim, Hyun Lim, Ho Seok Kang, Jong Hyeok Kim, Jin Bae Kim, Sung Won Jung, Sea Hyub Kae, Hyun Joo Jang, Min Ho Choi, Department of Internal Medicine, Hallym University College of Medicine, Chuncheon 200-704, South Korea.
authors.forename: Sea Hyub
authors.initials: SH
authors.lastname: Kae
authors.affiliation: Chang Seok Bang, Gwang Ho Baik, Jing Bong Kim, Ki Tae Suk, Jai Hoon Yoon, Yeon Soo Kim, Dong Joon Kim, Woon Geon Shin, Kyung Ho Kim, Hak Yang Kim, Hyun Lim, Ho Seok Kang, Jong Hyeok Kim, Jin Bae Kim, Sung Won Jung, Sea Hyub Kae, Hyun Joo Jang, Min Ho Choi, Department of Internal Medicine, Hallym University College of Medicine, Chuncheon 200-704, South Korea.
authors.forename: Hyun Joo
authors.initials: HJ
authors.lastname: Jang
authors.affiliation: Chang Seok Bang, Gwang Ho Baik, Jing Bong Kim, Ki Tae Suk, Jai Hoon Yoon, Yeon Soo Kim, Dong Joon Kim, Woon Geon Shin, Kyung Ho Kim, Hak Yang Kim, Hyun Lim, Ho Seok Kang, Jong Hyeok Kim, Jin Bae Kim, Sung Won Jung, Sea Hyub Kae, Hyun Joo Jang, Min Ho Choi, Department of Internal Medicine, Hallym University College of Medicine, Chuncheon 200-704, South Korea.
authors.forename: Min Ho
authors.initials: MH
authors.lastname: Choi
mesh_terms: D002454:Cell Differentiation; D016009:Chi-Square Distribution; D004210:Dissection / Q000009:adverse effects / Q000379:methods*; D005743:Gastrectomy / Q000009:adverse effects / Q000379:methods*; D005753:Gastric Mucosa / Q000473:pathology / Q000601:surgery*; D005773:Gastroscopy / Q000009:adverse effects / Q000379:methods*; D006801:Humans; D009367:Neoplasm Staging; D016017:Odds Ratio; D018570:Risk Assessment; D012307:Risk Factors; D013274:Stomach Neoplasms / Q000473:pathology / Q000601:surgery*; D016896:Treatment Outcome
keywords: Carcinoma; Endoscopic submucosal dissection; Endoscopy; Gastric cancer; Meta-analysis