Comparison of effectiveness and safety between endoscopic and surgical resection for 2-5cm gastric stromal tumors.

Abstract

As endoscopic resection remains controversial, this study aims to compare the effectiveness and safety between endoscopic and surgical resection for 2-5cm gastric stromal tumors (GSTs). Patients with 2-5cm GST resected at West China Hospital from March 2008 to April 2019 were enrolled. Propensity score matching (PSM) (1:1) was performed to achieve baseline data consistency. 112 patients were matched between the endoscopic resection group (ER) and the open surgery group. There were no significant differences in the complete resection rate (94.6% vs. 100%), the incidence of complications (25.0% vs. 14.3%), the recurrence rate (0% vs. 1.8%) and the 5-year relapse-free survival (100% vs. 97.9%) (P > 0.05). The ER had a shorter fasting time (3.5days vs. 5days), a shorter postoperative hospital stay (7days vs. 8days) and a lower hospitalization cost (3,589.16 USD vs. 5,931.24 USD) (P < 0.05). 54 cases were matched between the ER and the laparoscopic surgery group (LS). There were no significant differences in the complete resection rate (92.6% vs. 96.3%), the incidence of complications (22.2% vs. 11.1%), the fasting time (4days vs. 3days), the recurrence rate (0% vs. 3.7%) and the 5-year relapse-free survival (100% vs. 96.3%) (P > 0.05). The hospitalization cost (3,589.25 USD vs. 4,715.16 USD) was lower in the ER, and the postoperative hospital stay was shorter in the LS (6days vs. 7days) (P < 0.05). Although slightly higher incidences of incomplete resection and perforation were shown in the endoscopic resection group, there was insignificant difference between groups (P > 0.05). Endoscopic resection might be an alternative surgical method for 2-5cm GSTs.