Portal de investigação
Predicting residual neoplasia after a non-curative gastric ESD: validation and modification of the eCura system in the Western setting: the W-eCura score
Autores da FMUP
Participantes de fora da FMUP
- Morais, R
- Ferreira, A
- Barreiro, P
- Bourke, MJ
- Gupta, S
- Amaro, P
- Magalhaes, RK
- Cecinato, P
- Carvalho, PB
- Pinho, R
- de Santiago, ER
- Sferrazza, S
- Lemmers, A
- Figueiredo, M
- Pioche, M
- Gallego, F
- Albeniz, E
- Zabala, FR
- Uchima, H
- Berr, F
- Wagner, A
- Marques, M
- Gonçalves, M
- Mascarenhas, A
- Soares, EG
- Xavier, S
- Faria-Ramos, I
- Santos-Antunes, J
Unidades de investigação
Abstract
ObjectiveTo evaluate the risk factors for lymph node metastasis (LNM) after a non-curative (NC) gastric endoscopic submucosal dissection (ESD) and to validate and eventually refine the eCura scoring system in the Western setting. Also, to assess the rate and risk factors for parietal residual disease.DesignRetrospective multicentre multinational study of prospectively collected registries from 19 Western centres. Patients who had been submitted to surgery or had at least one follow-up endoscopy were included. The eCura system was applied to assess its accuracy in the Western setting, and a modified version was created according to the results (W-eCura score). The discriminative capacities of the eCura and W-eCura scores to predict LNM were assessed and compared.ResultsA total of 314 NC gastric ESDs were analysed (72% high-risk resection (HRR); 28% local-risk resection). Among HRR patients submitted to surgery, 25% had parietal disease and 15% had LNM in the surgical specimen. The risk of LNM was significantly different across the eCura groups (areas under the receiver operating characteristic curve (AUC-ROC) of 0.900 (95% CI 0.852 to 0.949)). The AUC-ROC of the W-eCura for LNM (0.916, 95% CI 0.870 to 0.961; p=0.012) was significantly higher compared with the original eCura. Positive vertical margin, lymphatic invasion and younger age were associated with a higher risk of parietal residual lesion in the surgical specimen.ConclusionThe eCura scoring system may be applied in Western countries to stratify the risk of LNM after a gastric HRR. A new score is proposed that may further decrease the number of unnecessary surgeries.
© Author(s) (or their employer(s)) 2024. No commercial re-use. See rights and permissions. Published by BMJ.
Dados da publicação
- ISSN/ISSNe:
- 1468-3288, 0017-5749
- Tipo:
- Article
- Páginas:
- 105-117
- Link para outro recurso:
- www.scopus.com
Gut BMJ Publishing Group
Citações Recebidas na Scopus: 12
Documentos
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Filiações
Keywords
- gastric adenocarcinoma; endoscopic procedures; therapeutic endoscopy; gastrointestinal endoscopy
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Citar a publicação
Morais R,Libanio D,Ribeiro MD,Ferreira A,Barreiro P,Bourke MJ,Gupta S,Amaro P,Magalhaes RK,Cecinato P,Carvalho PB,Pinho R,de Santiago ER,Sferrazza S,Lemmers A,Figueiredo M,Pioche M,Gallego F,Albeniz E,Zabala FR,Uchima H,Berr F,Wagner A,Marques M,Pimentel P,Gonçalves M,Mascarenhas A,Soares EG,Xavier S,Faria I,Sousa B,Gullo I,Carneiro F,Macedo G,Santos J. Predicting residual neoplasia after a non-curative gastric ESD: validation and modification of the eCura system in the Western setting: the W-eCura score. Gut. 2023. 73. (1):p. 105-117. IF:24,500. (1).
