Article révisé par les pairs
Résumé : Objective To 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. Design Retrospective 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. Results A 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. Conclusion The 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.

Documents en relation

DI-fusion

  • Deep submucosal invasion as a risk factor for recurrence after endoscopic submucosal dissection for T1 colorectal cancer
    par Santos-Antunes, João , Berr, Frieder , Pioche, Mathieu , Ramos-Zabala, Felipe , Cecinato, Paolo , Gallego, Francisco , Barreiro, Pedro , Félix, Catarina , Sferrazza, Sandro , Wagner, Andrej , Lemmers, Arnaud , Figueiredo, Mariana , Albeniz, Eduardo , Küttner-Magalhães, Ricardo , Fernandes, Carlos , Morais, Rui , Gupta, Sunil , Martinho-Dias, Daniel , Rios, Elisabete , Faria-Ramos, Isabel , Marques, Margarida , Bourke, Michael John , Macedo, Guilherme
    Publication 2023-09-01
  • Risk of Residual Neoplasia after a Local-Risk Resection of Colorectal Lesions by Endoscopic Submucosal Dissection: A Multinational Study
    par Santos-Antunes, João , Pioche, Mathieu , Ramos-Zabala, Felipe , Cecinato, Paolo , Gallego, Francisco , Barreiro, Pedro , Mascarenhas, André , Sferrazza, Sandro , Berr, Frieder , Wagner, Andrej , Lemmers, Arnaud , Ferreira, Mariana Figueiredo , Albéniz, Eduardo , Uchima, Hugo , Küttner-Magalhães, Ricardo , Fernandes, Carlos , Morais, Rui , Gupta, Sunil , Martinho-Dias, Daniel , Faria-Ramos, Isabel , Marques, Margarida , Bourke, Michael John , Macedo, Guilherme
    Publication 2023-08
  • Risk of residual neoplasia after a noncurative colorectal endoscopic submucosal dissection for malignant lesions: a multinational study
    par Santos-Antunes, João , Pioche, Mathieu , Ramos-Zabala, Felipe , Cecinato, Paolo , Gallego Rojo, Francisco Javier , Barreiro, Pedro , Félix, Catarina , Sferrazza, Sandro , Berr, Frieder , Wagner, Andrej , Lemmers, Arnaud , Figueiredo Ferreira, Mariana , Albéniz, Eduardo , Uchima, Hugo , Küttner-Magalhães, Ricardo , Fernandes, Carlos , Morais, Rui , Gupta, Sunil , Martinho-Dias, Daniel , Rios, Elisabete , Faria-Ramos, Isabel , Marques, Margarida , Bourke, Michael John , Macedo, Guilherme
    Publication 2023-02-01
  • Risk of residual neoplasia after a non-curative colorectal ESD for malignant lesions; A multinational study
    par Santos-Antunes, João , Pioche, Mathieu , Ramos-Zabala, Felipe , Cecinato, Paolo , Gallego Rojo, Francisco Javier , Barreiro, Pedro , Félix, Catarina , Sferrazza, Sandro , Berr, Frieder , Wagner, Andrej , Lemmers, Arnaud , Figueiredo Ferreira, Mariana , Albéniz, Eduardo , Uchima-Koeklin, Hugo , Küttner-Magalhães, Ricardo , Fernandes, Carlos , Morais, Rui , Gupta, Sunil , Martinho-Dias, Daniel , Rios, Elisabete , Faria-Ramos, Isabel , Marques, Margarida , Bourke, Michael John , Macedo, Guilherme
    Publication 2022-10-01
  • Endoscopic submucosal dissection for rectal neuroendocrine tumours: A multicentric retrospective study
    par Rimondi, Alessandro , Despott, Edward , Chacchi, Rocio , Lazaridis, Nikolaos , Costa, Deborah , Bucalau, Ana-Maria , Mandair, Dalvinder , Pioche, Mathieu , Rivory, Jérôme , Santos-Antunes, João , Marques, Margarida , Ramos-Zabala, Felipe , Barbaro, Federico , Pimentel-Nunes, Pedro , Dinis-Ribeiro, Mário Jorge M. , Albeniz, Eduardo , Tantau, Marcel , Spada, Cristiano , Lemmers, Arnaud , Caplin, Martyn Evan , Toumpanakis, Christos , Murino, Alberto
    Publication 2024-10-01