Established nomogram based on clinicopathological characteristics, lifestyle, and comorbidities risk factors for metachronous recurrence in curative endoscopic submucosal dissection
Background: Metachronous gastric cancer (MGC) has gained increasing attention due to the preservation of the stomach during endoscopic resection for early gastric cancer (EGC). Objectives: This study aims to investigate the risk factors associated with MGC in the postoperative surveillance of endosc...
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| Format: | Article |
| Language: | English |
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SAGE Publishing
2025-04-01
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| Series: | Therapeutic Advances in Gastroenterology |
| Online Access: | https://doi.org/10.1177/17562848251330973 |
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| author | Ying Xiang Zhenyu Wang Yichun Ma Ying Yuan Wenying Li Yanmei Zhu Qiange Ye Yanan Wang Jinping Yang Qi Sun Xiwei Ding Faraz Longi Dehua Tang Fangmei An Guifang Xu |
| author_facet | Ying Xiang Zhenyu Wang Yichun Ma Ying Yuan Wenying Li Yanmei Zhu Qiange Ye Yanan Wang Jinping Yang Qi Sun Xiwei Ding Faraz Longi Dehua Tang Fangmei An Guifang Xu |
| author_sort | Ying Xiang |
| collection | DOAJ |
| description | Background: Metachronous gastric cancer (MGC) has gained increasing attention due to the preservation of the stomach during endoscopic resection for early gastric cancer (EGC). Objectives: This study aims to investigate the risk factors associated with MGC in the postoperative surveillance of endoscopic submucosal dissection (ESD). Design: A retrospective case-control study. Methods: The retrospective study was conducted between January 1, 2014, and June 30, 2020, at the Affiliated Drum Tower Hospital of Nanjing University Medical School. Results: Several independent risk factors for developing MGC were identified as smoking history (hazard ratio (HR) 2.39, 95% confidence interval (CI) 1.25–4.58), metabolic dysfunction-associated steatotic liver disease (MASLD; HR 2.44, 95% CI 1.23–4.87), cerebrovascular disease (CD; HR 2.55, 95% CI 1.09–5.99), multiple lesions (HR 2.06, 95% CI 1.17–3.63), Helicobacter pylori infection status (eradicated vs negative: HR 1.42, 95% CI 0.60–3.39; persistent vs negative: HR 5.47, 95% CI 2.13–14.03), and atrophic gastritis (AG; moderate vs mild: HR 4.44, 95% CI 1.36–14.53; severe vs mild: HR 7.30, 95% CI 2.11–25.22). The established nomogram based on these risk factors demonstrated high accuracy both in the training and test sets, with concordance indexes of 0.787, 0.762, and 0.845 for the training set, and 0.764, 0.824, and 0.788 for the test set at 2, 3, and 5 years, respectively. Conclusion: The risk factors for developing MGC after curative ESD for EGC were identified as smoking history, MASLD, CD, multiple lesions, H. pylori infection status, and AG. To reduce the risk of MGC, a healthy lifestyle, regular H. pylori testing, and annual endoscopic screening are recommended. |
| format | Article |
| id | doaj-art-aa86d08d0f234d59bb2cb04807b4a98e |
| institution | OA Journals |
| issn | 1756-2848 |
| language | English |
| publishDate | 2025-04-01 |
| publisher | SAGE Publishing |
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| series | Therapeutic Advances in Gastroenterology |
| spelling | doaj-art-aa86d08d0f234d59bb2cb04807b4a98e2025-08-20T02:19:50ZengSAGE PublishingTherapeutic Advances in Gastroenterology1756-28482025-04-011810.1177/17562848251330973Established nomogram based on clinicopathological characteristics, lifestyle, and comorbidities risk factors for metachronous recurrence in curative endoscopic submucosal dissectionYing XiangZhenyu WangYichun MaYing YuanWenying LiYanmei ZhuQiange YeYanan WangJinping YangQi SunXiwei DingFaraz LongiDehua TangFangmei AnGuifang XuBackground: Metachronous gastric cancer (MGC) has gained increasing attention due to the preservation of the stomach during endoscopic resection for early gastric cancer (EGC). Objectives: This study aims to investigate the risk factors associated with MGC in the postoperative surveillance of endoscopic submucosal dissection (ESD). Design: A retrospective case-control study. Methods: The retrospective study was conducted between January 1, 2014, and June 30, 2020, at the Affiliated Drum Tower Hospital of Nanjing University Medical School. Results: Several independent risk factors for developing MGC were identified as smoking history (hazard ratio (HR) 2.39, 95% confidence interval (CI) 1.25–4.58), metabolic dysfunction-associated steatotic liver disease (MASLD; HR 2.44, 95% CI 1.23–4.87), cerebrovascular disease (CD; HR 2.55, 95% CI 1.09–5.99), multiple lesions (HR 2.06, 95% CI 1.17–3.63), Helicobacter pylori infection status (eradicated vs negative: HR 1.42, 95% CI 0.60–3.39; persistent vs negative: HR 5.47, 95% CI 2.13–14.03), and atrophic gastritis (AG; moderate vs mild: HR 4.44, 95% CI 1.36–14.53; severe vs mild: HR 7.30, 95% CI 2.11–25.22). The established nomogram based on these risk factors demonstrated high accuracy both in the training and test sets, with concordance indexes of 0.787, 0.762, and 0.845 for the training set, and 0.764, 0.824, and 0.788 for the test set at 2, 3, and 5 years, respectively. Conclusion: The risk factors for developing MGC after curative ESD for EGC were identified as smoking history, MASLD, CD, multiple lesions, H. pylori infection status, and AG. To reduce the risk of MGC, a healthy lifestyle, regular H. pylori testing, and annual endoscopic screening are recommended.https://doi.org/10.1177/17562848251330973 |
| spellingShingle | Ying Xiang Zhenyu Wang Yichun Ma Ying Yuan Wenying Li Yanmei Zhu Qiange Ye Yanan Wang Jinping Yang Qi Sun Xiwei Ding Faraz Longi Dehua Tang Fangmei An Guifang Xu Established nomogram based on clinicopathological characteristics, lifestyle, and comorbidities risk factors for metachronous recurrence in curative endoscopic submucosal dissection Therapeutic Advances in Gastroenterology |
| title | Established nomogram based on clinicopathological characteristics, lifestyle, and comorbidities risk factors for metachronous recurrence in curative endoscopic submucosal dissection |
| title_full | Established nomogram based on clinicopathological characteristics, lifestyle, and comorbidities risk factors for metachronous recurrence in curative endoscopic submucosal dissection |
| title_fullStr | Established nomogram based on clinicopathological characteristics, lifestyle, and comorbidities risk factors for metachronous recurrence in curative endoscopic submucosal dissection |
| title_full_unstemmed | Established nomogram based on clinicopathological characteristics, lifestyle, and comorbidities risk factors for metachronous recurrence in curative endoscopic submucosal dissection |
| title_short | Established nomogram based on clinicopathological characteristics, lifestyle, and comorbidities risk factors for metachronous recurrence in curative endoscopic submucosal dissection |
| title_sort | established nomogram based on clinicopathological characteristics lifestyle and comorbidities risk factors for metachronous recurrence in curative endoscopic submucosal dissection |
| url | https://doi.org/10.1177/17562848251330973 |
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