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

Author(s):  
Hyo-Joon Yang ◽  
Moon Kyung Joo ◽  
Jae Myung Park ◽  
Ji Yong Ahn ◽  
Jae-Young Jang ◽  
...  
2013 ◽  
Vol 61 (4) ◽  
pp. 196 ◽  
Author(s):  
Moon Han Choi ◽  
Su Jin Hong ◽  
Jae Pil Han ◽  
Jeong-Yeop Song ◽  
Dae Yong Kim ◽  
...  

Gut ◽  
2020 ◽  
pp. gutjnl-2019-319926 ◽  
Author(s):  
Waku Hatta ◽  
Yosuke Tsuji ◽  
Toshiyuki Yoshio ◽  
Naomi Kakushima ◽  
Shu Hoteya ◽  
...  

ObjectiveBleeding after endoscopic submucosal dissection (ESD) for early gastric cancer (EGC) is a frequent adverse event after ESD. We aimed to develop and externally validate a clinically useful prediction model (BEST-J score: Bleeding after ESD Trend from Japan) for bleeding after ESD for EGC.DesignThis retrospective study enrolled patients who underwent ESD for EGC. Patients in the derivation cohort (n=8291) were recruited from 25 institutions, and patients in the external validation cohort (n=2029) were recruited from eight institutions in other areas. In the derivation cohort, weighted points were assigned to predictors of bleeding determined in the multivariate logistic regression analysis and a prediction model was established. External validation of the model was conducted to analyse discrimination and calibration.ResultsA prediction model comprised 10 variables (warfarin, direct oral anticoagulant, chronic kidney disease with haemodialysis, P2Y12 receptor antagonist, aspirin, cilostazol, tumour size >30 mm, lower-third in tumour location, presence of multiple tumours and interruption of each kind of antithrombotic agents). The rates of bleeding after ESD at low-risk (0 to 1 points), intermediate-risk (2 points), high-risk (3 to 4 points) and very high-risk (≥5 points) were 2.8%, 6.1%, 11.4% and 29.7%, respectively. In the external validation cohort, the model showed moderately good discrimination, with a c-statistic of 0.70 (95% CI, 0.64 to 0.76), and good calibration (calibration-in-the-large, 0.05; calibration slope, 1.01).ConclusionsIn this nationwide multicentre study, we derived and externally validated a prediction model for bleeding after ESD. This model may be a good clinical decision-making support tool for ESD in patients with EGC.


2015 ◽  
Vol 8 (5) ◽  
pp. 255-262 ◽  
Author(s):  
Yasuhiro Inokuchi ◽  
Maki Kobayashi ◽  
Kana Kudo ◽  
Hiroaki Yamada ◽  
Shuntaro Inoue ◽  
...  

2019 ◽  
Vol 23 (2) ◽  
pp. 285-292 ◽  
Author(s):  
Yusuke Horiuchi ◽  
Satoshi Ida ◽  
Noriko Yamamoto ◽  
Souya Nunobe ◽  
Naoki Ishizuka ◽  
...  

2019 ◽  
Vol 07 (02) ◽  
pp. E274-E281
Author(s):  
Shoichi Yoshimizu ◽  
Yorimasa Yamamoto ◽  
Yusuke Horiuchi ◽  
Toshiyuki Yoshio ◽  
Akiyoshi Ishiyama ◽  
...  

Abstract Background and study aims Delineating undifferentiated-type early gastric cancer (UD-type EGC) from noncancerous areas is difficult. Therefore, the lateral margin negative (LM−) resection rate of endoscopic submucosal dissection (ESD) is lower for UD-type EGC than for differentiated-type EGC. This study aimed to retrospectively evaluate the effectiveness of the marking methods with circumferential biopsies in ESD for UD-type EGC. Patients and methods We analyzed the clinical outcomes of ESD in 127 patients with UD-type EGC between April 2013 and 2017. We performed diagnostic delineation of cancerous areas using magnifying endoscopy with narrow-band imaging, and four or more circumferential biopsies approximately 5 mm apart from the estimated lesion border were obtained to confirm noncancerous areas. The markings were placed on the circumferential biopsy scars, and a mucosal incision line was made outside the markings. Results Median size of the tumors and ESD specimens was 12 and 35 mm, respectively. En-bloc resection rate was 100 % (127/127), and LM− and curative resection rates were 97.6 % (124/127) and 80.3 % (102/127), respectively. Circumferential biopsy in preoperative esophagogastroduodenoscopy has successfully identified the misdiagnosis of cancerous areas of four patients (3.2 %), with three (2.4%) achieving LM− resection. LM + resection was pathologically identified in three patients (2.4 %), with all undergoing non-curative resection due to > 20-mm tumor. The proportion of patients with the shortest distance ≥ 5 mm from the lesion edge to the specimen edge was 88.2 % (112/127). Conclusion Our marking methods with circumferential biopsies may reduce LM + resections in ESD for UD-type EGC.


2012 ◽  
Vol 75 (4) ◽  
pp. AB156
Author(s):  
Seiichiro Abe ◽  
Ichiro ODA ◽  
Haruhisa Suzuki ◽  
Satoru Nonaka ◽  
Shigetaka Yoshinaga ◽  
...  

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