JoVE - Journal of Visualized Experiments
JoVE Visualize
Contact Us

Stratifying Risk of Lymph Node Metastasis After Non-Curative Endoscopic Submucosal Dissection of Early Gastric Cancer: Comparison of the eCura System and Elderly Criteria

  • 0Division of Gastroenterology, Department of Internal Medicine and Gastrointestinal Cancer Center, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea.
Journal of Gastric Cancer +

|

April 9, 2025

|

April 9, 2025

View abstract on PubMed

Summary

This summary is machine-generated.

The novel elderly (EL) criteria effectively identify low-risk patients for lymph node metastasis (LNM) after non-curative endoscopic submucosal dissection (ESD) for early gastric cancer (EGC). These criteria show high concordance with the established eCura system, suggesting similar efficacy in risk stratification.

Area Of Science

  • Gastroenterology
  • Oncology
  • Surgical Pathology

Background

  • Endoscopic submucosal dissection (ESD) is a standard treatment for early gastric cancer (EGC).
  • Non-curative resections necessitate risk stratification for lymph node metastasis (LNM).
  • Novel criteria for elderly (EL) patients aim to improve LNM risk assessment post-ESD.

Purpose Of The Study

  • To evaluate the effectiveness of the proposed EL criteria for stratifying LNM risk in elderly patients with EGC after non-curative ESD.
  • To compare the performance of the EL criteria against the established eCura system.

Main Methods

  • Retrospective analysis of 143 patients with non-curative ESD for EGC (2011-2022).
  • Patients were stratified using both EL and eCura criteria.
  • LNM rates were compared between risk groups, including those undergoing surgery versus follow-up.

Main Results

  • EL criteria classified patients into EL-low (EL-L) and EL-high (EL-H) groups.
  • EL-L patients showed a 0.0% LNM rate, while EL-H patients had a 9.7% LNM rate (P=0.102).
  • EL-L demonstrated high concordance with the eCura low-risk category, with an 86% overall agreement between systems.

Conclusions

  • The EL criteria effectively identified elderly patients with EGC after non-curative ESD who were at low risk for LNM.
  • No LNM was observed in the EL-L group.
  • The EL criteria appear to be a viable alternative to the eCura system for risk stratification in this patient population.

Keywords: