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Prediction model for curative endoscopic submucosal dissection of undifferentiated-type early gastric cancer

Authors
Yang, Hyo-JoonJoo, Moon KyungPark, Jae MyungAhn, Ji YongJang, Jae-YoungLim, Joo HyunNam, Su YounKim, Jie-HyunMin, Byung-HoonLee, Wan-SikLee, Bong EunShin, Woon GeonLee, Hang LakGweon, Tae-GeunPark, Moo InChoi, JeongminTae, Chung HyunKim, Young-IlRyu, Keun WonChoi, Il Ju
Issue Date
Feb-2022
Publisher
SPRINGER
Keywords
Early gastric cancer; Undifferentiated-type histology; Endoscopic submucosal dissection; Curative resection; Risk assessment
Citation
SURGICAL ENDOSCOPY AND OTHER INTERVENTIONAL TECHNIQUES, v.36, no.2, pp.1414 - 1423
Indexed
SCIE
SCOPUS
Journal Title
SURGICAL ENDOSCOPY AND OTHER INTERVENTIONAL TECHNIQUES
Volume
36
Number
2
Start Page
1414
End Page
1423
URI
https://scholarworks.korea.ac.kr/kumedicine/handle/2020.sw.kumedicine/52647
DOI
10.1007/s00464-021-08426-w
ISSN
0930-2794
Abstract
Background Endoscopic submucosal dissection (ESD) is an effective treatment for early gastric cancer (EGC); however, its curative resection rate is low for undifferentiated-type EGC. We developed and externally validated a prediction model for curative ESD of undifferentiated-type EGC. Methods In this cross-sectional study, we included 448 patients who underwent ESD for undifferentiated-type EGC at 18 hospitals in Korea between 2005 and 2015 in the development cohort and 1342 patients who underwent surgery at two hospitals in the validation cohort. A prediction model was developed using the logistic regression model. Results Endoscopic tumor size 1-2 cm (odds ratio [OR], 2.40; 95% confidence interval [CI] 1.54-3.73), tumor size > 2 cm (OR, 14.00; 95% CI 6.81-28.77), and proximal tumor location from the lower to upper third of the stomach (OR, 1.45; 95% CI 1.03-2.04) were independent predictors of non-curative ESD. A six-score prediction model was developed by assigning points to endoscopic tumor size > 2 cm (five points), tumor size 1-2 cm (two points), upper third location (two points), and middle third location (one point). The rate of curative ESD ranged from 70.6% (score 0) to 11.6% (score 5) with an area under the receiver operating characteristic curve (AUC) of 0.720 (95% CI 0.673-0.766). The model also showed good performance in the validation cohort (AUC, 0.775; 95% CI 0.748-0.803). Conclusions This six-score prediction model may help in predicting curative ESD and making informed decisions about the treatment selection between ESD and surgery for undifferentiated-type EGC.
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Joo, Moon Kyung
Guro Hospital (Department of Gastroenterology and Hepatology, Guro Hospital)
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