Predicting residual neoplasia after a non-curative gastric ESD: validation and modification of the eCura system in the Western setting: the W-eCura score

• Tipo: Artigo em Revista Científica Internacional
• Data: 2024

Autores

Morais, R (Autor) Outra; Libanio, D (Autor) Outra; Mario Dinis Ribeiro (Autor) FMUP; Ferreira, A (Autor) Outra; Barreiro, P (Autor) Outra; Bourke, MJ (Autor) Outra; Gupta, S (Autor) Outra; Amaro, P (Autor) Outra; Magalhaes, RK (Autor) Outra; Cecinato, P (Autor) Outra; Carvalho, PB (Autor) Outra; Pinho, R (Autor) Outra; de Santiago, ER (Autor) Outra; Sferrazza, S (Autor) Outra; Lemmers, A (Autor) Outra; Figueiredo, M (Autor) Outra; Pioche, M (Autor) Outra; Gallego, F (Autor) Outra; Albéniz, E (Autor) Outra; Zabala, FR (Autor) Outra; Uchima, H (Autor) Outra; Berr, F (Autor) Outra; Wagner, A (Autor) Outra; Marques, M (Autor) Outra; Pimentel Nunes, P (Autor) Outra; Gonçalves, M (Autor) Outra; Mascarenhas, A (Autor) Outra; Soares, EG (Autor) Outra; Xavier, S (Autor) Outra; Faria Ramos, I (Autor) Outra; Sousa Pinto, B (Autor) FMUP; Gullo, I (Autor) Outra; Carneiro F (Autor) FMUP; Macedo G (Autor) FMUP; João Santos-Antunes (Autor) FMUP

Revista

Título: Gut

Vol. 73

Páginas: 105-117

ISSN: 0017-5749

Editora: BMJ PUBLISHING GROUP

Indexação

ISI Web of Knowledge - 18 Citações

Scopus - 17 Citações

Outras Informações

ID Authenticus: P-00Z-0SZ

DOI: 10.1136/gutjnl-2023-330804

Abstract (EN): 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.

Idioma: Inglês

Tipo (Avaliação Docente): Científica

Nº de páginas: 13