Analysis of clinicopathological characteristics of early gastric cancers with different endoscopic curability categories after endoscopic submucosal dissection - read online free

Q: What is the study purpose regarding early gastric cancer after ESD?

To analyze clinicopathological characteristics of early gastric cancer after endoscopic submucosal dissection, stratified by endoscopic curability categories, and to identify risk factors for non-curative resection. It also develops a pre-ESD prediction model.

Q: Which factors were identified as predictors of non-curative resection?

Univariate analysis identified smoking, H. pylori infection, upper/middle gastric location, certain Paris types, mucosal damage, tumor size > 30 mm, undifferentiated-dominated histology, and submucosal invasion. Multivariate analysis further confirmed independent predictors including prior-ESD smoking, H. pylori infection, proximal location, and EUS-confirmed submucosal invasion.

Sep 22, 2026

Upload by Maya Linwood

Single-center retrospective study analyzes clinicopathological features of early gastric cancer treated by endoscopic submucosal dissection, stratified by endoscopic curability categories. The work identifies risk factors for non-curative resection and constructs a pre-ESD prediction model. Patients with early gastric cancer undergoing ESD at Peking University Third Hospital from 2010 to 2024 were analyzed using chi-squared and logistic approaches. Model performance was assessed via ROC curves with AUC values. Results highlight smoking, H. pylori infection, location, invasion depth, and tumor-related factors.

LanguageEnglish

CategoryResearch & Report

FormatPDF

Pages10

Reading Time25 min

AccessFree to download

Abstract

Background and Aims

Method

Results

Conclusion

Methods

Patients

Ethical Approval

Assessment

eCura Categories

Surgical Endoscopy (2026) 40:3022–3031 [https://doi.org/10.1007/s00464-025-12563-x](https://doi.org/10.1007/s00464-025-12563-x) and Other Interventional Techniques Analysis of clinicopathological characteristics of early gastric cancers with different endoscopic curability categories after endoscopic submucosal dissection and related risk factors of non‑curative resection Wei Wu1 · Moyige Jize1 · Hejun Zhang2 · Keyan Chen1 · Zhijun Guo1 · Shigang Ding1 · Jing Zhang1 Received: 24 June 2025 / Accepted: 14 September 2025 / Published online: 20 January 2026 © The Author(s) 2026 Abstract Background and Aims This single-center retrospective study aims to analyze the clinicopathological characteristics of early gastric cancer (EGC) treated with endoscopic submucosal dissection (ESD), stratified by endoscopic curability (eCura) categories. Additionally, we aim to identify the risk factors associated with non-curative resection (NCR) and the prediction model before ESD. Method We included patients with EGC undergoing ESD at Peking University Third Hospital from 2010 to 2024. Statistical analyses included chi-squared test and logistic analysis. Multiple logistic regression analysis was used to investigate independent risk factors to predict NCR. Model performance was evaluated through receiver operating characteristic (ROC) curve analysis, with area under the curve (AUC) values quantifying predictive accuracy. Results A total of 540 individuals with 659 lesions were included. Univariate analysis identified smoking, H.pylori infection, upper/middle gastric location, 0-I/0-IIb-type, mucosal damage, tumor size > 30 mm, undifferentiated dominated histology, and submucosal (SM) invasion as significant predictors of NCR (all p < 0.05) . Multivariate analysis revealed prior-ESD independent predictors (smoking, H.pylori infection, proximal location, EUS-confirmed SM invasion). The prior-ESD model demonstrated an AUC of 0.783 (95%CI: 0.708–0.858) with 80.0% sensitivity. Conclusion This study developed a prior-ESD prediction model for assessing NCR risk, which includes comprehensive clinicopathological data. The model might potentially improve curative resection rates and guide clinical decision-making for EGC. Keywords Early gastric cancer · Endoscopic submucosal dissection · Endoscopic curability · Non-curative resection Early gastric cancer (EGC) is defined as gastric cancer that is confined to the mucosal or submucosal layer, regardless of whether there is lymph node metastasis. According to the data from 2022, gastric cancer ranks fifth in terms of incidence and mortality worldwide, with the highest incidence in East Asia [1]. Endoscopic submucosal dissection (ESD) is now considered as a standard minimally invasive treatment for EGC. In patients meeting absolute or expanded indications for endoscopic resection, the procedure demonstrates * Jing Zhang [sihuizhang@sina.com](sihuizhang@sina.com) 1 Department of Gastroenterology; Peking University Third Hospital, Beijing 100191, China 2 Department of Gastroenterology Pathology; Peking University Third Hospital, Beijing 100191, China excellent long-term outcomes with 5-year survival rates exceeding 90%[2] . However, the evaluation of curability is crucial for EGC patients, which affects the clinical decision choice and patients’ prognosis. The 6th edition of JGCA (gastric cancer treatment guidelines) (2021) introduced the endoscopic curability (eCura) categories to evaluate curability after ESD for EGCs, which guide subsequent follow-up and treatment decisions [3] . Thus, we aimed to investigate the symbol features of different eCura categories and find the discrepancy. In addition, based on more comprehensive clinicopathological data, we tried to demonstrate a prior-ESD prediction model to predict the risk of NCR. At present, no studies have analyzed the features of different eCura categories per current JGCA guidelines, and existing NCR prediction models lack i

FAQs

What is the study purpose regarding early gastric cancer after ESD?

To analyze clinicopathological characteristics of early gastric cancer after endoscopic submucosal dissection, stratified by endoscopic curability categories, and to identify risk factors for non-curative resection. It also develops a pre-ESD prediction model.

How were patients selected and how long was the study period?

Patients with early gastric cancer undergoing ESD at Peking University Third Hospital from 2010 to 2024 were included, with exclusions for lesions mainly treated by EMR with indeterminate eCura and for postoperative non-neoplastic gastric lesions.

Which factors were identified as predictors of non-curative resection?

Univariate analysis identified smoking, H. pylori infection, upper/middle gastric location, certain Paris types, mucosal damage, tumor size > 30 mm, undifferentiated-dominated histology, and submucosal invasion. Multivariate analysis further confirmed independent predictors including prior-ESD smoking, H. pylori infection, proximal location, and EUS-confirmed submucosal invasion.

Sep 22, 2026

Upload by Maya Linwood