TY - JOUR
T1 - Outcomes of Endoscopic Submucosal Dissection for Treatment of Superficial Pharyngeal Cancers
T2 - Systematic Review and Meta-Analysis
AU - Kamal, Faisal
AU - Khan, Muhammad Ali
AU - Lee-Smith, Wade
AU - Sharma, Sachit
AU - Imam, Zaid
AU - Jowhar, Dawit
AU - Petryna, Ellen
AU - Esswein, Julia
AU - Acharya, Ashu
AU - Aziz, Muhammad
AU - Farooq, Umer
AU - Zafar, Usman
AU - Mcdonough, Stephanie
AU - Adler, Douglas G.
N1 - Publisher Copyright:
© 2021, The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.
PY - 2022/8
Y1 - 2022/8
N2 - Background and Aims: Studies evaluating the role of endoscopic submucosal dissection (ESD) in the management of superficial pharyngeal cancers have reported promising results. This meta-analysis evaluates the efficacy and safety of ESD in the management of superficial pharyngeal cancers. Methods: We reviewed several databases from inception to September 03, 2020, to identify studies evaluating the efficacy and safety of ESD in the management of superficial pharyngeal cancers. Our outcomes of interest were en bloc resection rate, complete resection rate, adverse events, and rates of local recurrence. Pooled rates with 95% confidence intervals (CI) for all outcomes were calculated using random-effect model. Heterogeneity was assessed by I2 statistic. We assessed publication bias by using funnel plots and Egger’s test. We conducted meta-regression analysis to explore heterogeneity in analyses. Results: Ten studies were included in analyses. All studies were from Asia. Pooled rates (95% CI) for en bloc resection and complete resection were 94% (87%, 97%) and 72% (62%, 80%), respectively. The pooled rates (95% CI) for adverse events and local recurrence were 10% (5%, 17%) and 1.9% (0.9%, 4%), respectively. Most of the analyses were limited by substantial heterogeneity. On meta-regression analysis, the heterogeneity was explained by size of tumor and histology. Funnel plots and Egger’s test showed no evidence of publication bias. Conclusions: This meta-analysis including studies from Asian countries demonstrated that ESD is an efficacious and safe option in the management of superficial pharyngeal cancers. More studies and studies from Western countries are needed to further validate these findings.
AB - Background and Aims: Studies evaluating the role of endoscopic submucosal dissection (ESD) in the management of superficial pharyngeal cancers have reported promising results. This meta-analysis evaluates the efficacy and safety of ESD in the management of superficial pharyngeal cancers. Methods: We reviewed several databases from inception to September 03, 2020, to identify studies evaluating the efficacy and safety of ESD in the management of superficial pharyngeal cancers. Our outcomes of interest were en bloc resection rate, complete resection rate, adverse events, and rates of local recurrence. Pooled rates with 95% confidence intervals (CI) for all outcomes were calculated using random-effect model. Heterogeneity was assessed by I2 statistic. We assessed publication bias by using funnel plots and Egger’s test. We conducted meta-regression analysis to explore heterogeneity in analyses. Results: Ten studies were included in analyses. All studies were from Asia. Pooled rates (95% CI) for en bloc resection and complete resection were 94% (87%, 97%) and 72% (62%, 80%), respectively. The pooled rates (95% CI) for adverse events and local recurrence were 10% (5%, 17%) and 1.9% (0.9%, 4%), respectively. Most of the analyses were limited by substantial heterogeneity. On meta-regression analysis, the heterogeneity was explained by size of tumor and histology. Funnel plots and Egger’s test showed no evidence of publication bias. Conclusions: This meta-analysis including studies from Asian countries demonstrated that ESD is an efficacious and safe option in the management of superficial pharyngeal cancers. More studies and studies from Western countries are needed to further validate these findings.
KW - Endoscopic dissection
KW - Endoscopic resection
KW - Endoscopic submucosal resection
KW - Pharyngeal carcinoma
KW - Pharyngeal neoplasm
KW - Pharyngeal squamous cell carcinoma
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U2 - 10.1007/s10620-021-07225-6
DO - 10.1007/s10620-021-07225-6
M3 - Review article
C2 - 34505257
AN - SCOPUS:85114629151
SN - 0163-2116
VL - 67
SP - 3518
EP - 3528
JO - Digestive diseases and sciences
JF - Digestive diseases and sciences
IS - 8
ER -