A modified cap-assisted endoscopic mucosal resection (mEMR-C) technique to treat intraluminal gastric gastrointestinal stromal tumor (GIST) measuring 20 mm or less leads to shorter operation times and lower costs compared to endoscopic submucosal dissection.
This is according to a new study published in the journal Clinical and Translational Gastroenterology.
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To compare the outcomes of mEMR-C, a novel variation of the standard endoscopic submucosal dissection introduced in this study, and endoscopic submucosal dissection itself for the treatment of small intraluminal gastric GIST, a team of researchers from China conducted a retrospective study in 199 patients with GIST. Of these 199 patients, 156 had standard endoscopic submucosal dissection, while 43 underwent mEMR-C.
The researchers reported that the block resection rate for all patients was 100%, and the complete resection rate was comparable between the 2 groups.
Around 9.5% of patients had a positive margin regardless of the technique used.
There were also no differences between the 2 groups of patients in terms of adverse events.
The mEMR-C was associated with shorter operation times and lower costs compared to standard endoscopic submucosal dissection.
The disease recurred in 2 patients at 1 and 5 years following endoscopic submucosal dissection. The median follow-up was 62 months.
There were no metastasis or disease-related death in either group of patients.
The researchers also conducted a propensity score matching analysis and obtained similar results.
The study authors concluded that the mEMRC should be the preferable technique for small intraluminal gastric GIST.
“In conclusion, the current evidence suggests that the efficacy and safety of mEMR-C and[endoscopic submucosal dissection] is comparable for treating intraluminal gGISTs smaller than 20 mm,” they wrote. “However, further high-quality studies are needed to assess [the] implementation of this technique.”
Meng R, Ni M, Ren W, et al. Comparison of modified cap-assisted endoscopic mucosal resection and endoscopic submucosal dissection in treating intraluminal gastric gastrointestinal stromal tumor (≤20 mm). Clin Transl Gastroenterol. Published online April 5, 2023. doi:10.14309/ctg.0000000000000589