Outcomes of Endoscopic Submucosal Dissection for Treatment of Superficial Pharyngeal Cancers: Systematic Review and Meta-Analysis
Document Type
Article
Publication Date
9-9-2021
Publication Title
Digestive diseases and sciences
E-ISSN
1573-2568
Department(s)
Department of Medicine
Keywords
Endoscopic dissection, Endoscopic resection, Endoscopic submucosal resection, Pharyngeal carcinoma, Pharyngeal neoplasm, Pharyngeal squamous cell carcinoma
Abstract
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 I 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.
DOI
10.1007/s10620-021-07225-6
PubMed ID
34505257
Recommended Citation
Kamal, F., Khan, M. A., Lee-Smith, W., Sharma, S., Imam, Z., Jowhar, D., Petryna, E., Esswein, J., Acharya, A., Aziz, M., Farooq, U., Zafar, M., Mcdonough, S., & Adler, D. G. (2021). Outcomes of Endoscopic Submucosal Dissection for Treatment of Superficial Pharyngeal Cancers: Systematic Review and Meta-Analysis. LVHN Scholarly Works. Retrieved from https://scholarlyworks.lvhn.org/research-historical-works/39
DOI: 10.1007/s10620-021-07225-6