External Validation of the eCura System for Undifferentiated-Type Early Gastric Cancer with Noncurative Endoscopic Resection

Background/Aims: The eCura system, a scoring model for stratifying the lymph node metastasis risk after noncurative endoscopic resection for early gastric cancer (EGC), has been internally validated, primarily for differentiated-type EGC. We aimed to externally validate this model for undifferentiat...

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Published in:Gut and liver 2023-07, Vol.17 (4), p.537
Main Authors: Hyo-joon Yang, Young-il Kim, Ji Yong Ahn, Kee Don Choi, Sang Gyun Kim, Seong Woo Jeon, Jie-hyun Kim, Sung Kwan Shin, Hyuk Lee, Wan Sik Lee, Gwang Ha Kim, Jae Myung Park, Woon Geon Shin, Il Ju Choi
Format: Article
Language:Korean
Subjects:
Endoscopic mucosal resection
Lymphatic metastasis
Stomach neoplasms
Undifferentiated-type histology
Validation study
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Summary:Background/Aims: The eCura system, a scoring model for stratifying the lymph node metastasis risk after noncurative endoscopic resection for early gastric cancer (EGC), has been internally validated, primarily for differentiated-type EGC. We aimed to externally validate this model for undifferentiated-type EGC. Methods: This multicenter, retrospective cohort study included 634 patients who underwent additional surgery (radical surgery group, n=270) or were followed up without additional treatment (no additional treatment group, n=364) after noncurative endoscopic resection for undifferentiated-type EGC between 2005 and 2015. The lymph node metastasis and survival rates were compared according to the risk categories. Results: For the radical surgery group, the lymph node metastasis rates were 2.6%, 10.9%, and 14.8% for the low-, intermediate-, and high-risk eCura categories, respectively (p for trend=0.003). For the low-, intermediate-, and high-risk categories in the no additional treatment group, the overall survival (92.7%, 68.9%, and 80.0% at 5 years, respectively, p
ISSN:1976-2283