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Prediction model for curative endoscopic submucosal dissection of undifferentiated-type early gastric cancer
- Title
- Prediction model for curative endoscopic submucosal dissection of undifferentiated-type early gastric cancer
- Authors
- Yang H.-J.; Joo M.K.; Park J.M.; Ahn J.Y.; Jang J.-Y.; Lim J.H.; Nam S.Y.; Kim J.-H.; Min B.-H.; Lee W.-S.; Lee B.E.; Shin W.G.; Lee H.L.; Gweon T.-G.; Park M.I.; Choi J.; Tae C.H.; Kim Y.-I.; Ryu K.W.; Choi I.J.
- Ewha Authors
- 태정현
- SCOPUS Author ID
- 태정현
- Issue Date
- 2022
- Journal Title
- Surgical Endoscopy
- ISSN
- 0930-2794
- Citation
- Surgical Endoscopy vol. 36, no. 2, pp. 1414 - 1423
- Keywords
- Curative resection; Early gastric cancer; Endoscopic submucosal dissection; Risk assessment; Undifferentiated-type histology
- Publisher
- Springer
- Indexed
- SCIE; SCOPUS
- Document Type
- Article
- 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. © 2021, The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.
- DOI
- 10.1007/s00464-021-08426-w
- Appears in Collections:
- 의과대학 > 의학과 > Journal papers
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