title: Endoscopic resection versus surgery for early gastric cancer and precancerous lesions: a meta-analysis.
abstract: OBJECTIVE
  To compare the efficacy and safety of endoscopic resection (ER) and surgery for the treatment of early gastric cancer and precancerous lesions.
  
  
  METHODS
  Databases, such as PubMed, EMBASE, Cochrane Library, and Science Citation Index, from 2000 to 2016, were searched for eligible articles. In this meta-analysis, the main outcome measurements were local recurrence, complications, metachronous lesions, hospital stay, and 5-year overall survival.
  
  
  RESULTS
  Nine trials were identified and a total of 2748 patients were included. The rate of complication was higher in the surgery group compared with the ER group (OR 0.41; 95 % CI 0.30-0.55). The rates of local recurrence and metachronous lesions were lower in the surgery group (OR 0.03; 95 % CI 0.00-0.06; OR 8.76; 95 % CI 4.17-18.41). The hospital stay was shorter in the ER group (mean difference -6.96; 95 % CI -7.94 to -5.99). The 5-year overall survival rate did not significantly differ between the two groups (OR 1.23; 95 % CI 1.03-1.47).
  
  
  CONCLUSIONS
  We provided evidence that, ER was comparable to surgery in terms of the 5-year overall survival. In addition, ER had a lower rate of complications and shorter hospital stay, but a higher rate of local recurrence and metachronous lesions for the treatment of early gastric cancer and precancerous lesions.
authors.affiliation: Department of Gastroenterology, Shandong Provincial Hospital Affiliated to Shandong University, 324 Jingwu Weiqi Rd, Jinan, 250021 China.
authors.forename: Shulei
authors.initials: S
authors.lastname: Zhao
authors.affiliation: Department of Gastroenterology, Shandong Provincial Hospital Affiliated to Shandong University, 324 Jingwu Weiqi Rd, Jinan, 250021 China.
authors.forename: Xiaohua
authors.initials: X
authors.lastname: Zhang
authors.affiliation: Department of Gastroenterology, Shandong Provincial Hospital Affiliated to Shandong University, 324 Jingwu Weiqi Rd, Jinan, 250021 China.|Department of Hepatology, Shandong Provincial Hospital Affiliated to Shandong University, 324 Jingwu Weiqi Rd, Jinan, 250021 China.
authors.forename: Jing
authors.initials: J
authors.lastname: Wang
authors.affiliation: Department of Gastroenterology, Shandong Provincial Hospital Affiliated to Shandong University, 324 Jingwu Weiqi Rd, Jinan, 250021 China.
authors.forename: Jian
authors.initials: J
authors.lastname: Ge
authors.affiliation: Department of Gastroenterology, Shandong Provincial Hospital Affiliated to Shandong University, 324 Jingwu Weiqi Rd, Jinan, 250021 China.
authors.forename: Jin
authors.initials: J
authors.lastname: Liu
keywords: Early gastric cancer; Endoscopic resection; Precancerous lesions; Surgery