Risk factors and a nomogram for predicting local recurrence in adult patients with early gastric cancer after endoscopic submucosal dissection

Shaoya Li; Ainun Nahar; Qian Zhang; Jie Xing; Peng Li; Shutian Zhang; Xiujing Sun

doi:10.1016/j.dld.2024.04.004

Risk factors and a nomogram for predicting local recurrence in adult patients with early gastric cancer after endoscopic submucosal dissection

Dig Liver Dis. 2024 Apr 26:S1590-8658(24)00347-5. doi: 10.1016/j.dld.2024.04.004. Online ahead of print.

Authors

Shaoya Li¹, Ainun Nahar¹, Qian Zhang¹, Jie Xing¹, Peng Li¹, Shutian Zhang¹, Xiujing Sun²

Affiliations

¹ Department of Gastroenterology, Beijing Friendship Hospital, Capital Medical University, National Clinical Research Center for Digestive Diseases, Beijing Digestive Disease Center, Faculty of Gastroenterology of Capital Medical University, Beijing Key Laboratory for Precancerous Lesion of Digestive Diseases, Beijing, 100050 China.
² Department of Gastroenterology, Beijing Friendship Hospital, Capital Medical University, National Clinical Research Center for Digestive Diseases, Beijing Digestive Disease Center, Faculty of Gastroenterology of Capital Medical University, Beijing Key Laboratory for Precancerous Lesion of Digestive Diseases, Beijing, 100050 China. Electronic address: sunxiujing@ccmu.edu.cn.

PMID: 38677974
DOI: 10.1016/j.dld.2024.04.004

Abstract

Background and aims: Endoscopic submucosal dissection (ESD) is an effective treatment method for early gastric cancers. The aim of this study was to evaluate the risk factors of recurrence for patients with early gastric cancer after ESD and construct a nomogram for predicting recurrence.

Methods: A retrospective observational study was conducted on patients with early gastric cancer who underwent ESD at Beijing Friendship Hospital between 2013 and 2018. The risk factors of gastric cancer recurrence after ESD were analyzed by univariate and multivariate Cox regression.

Results: A total of 238 patients with a median follow-up period of 70.5-month were enrolled in the study. Risk factors for recurrence included diabetes (HR = 3.68), alcohol consumption history (HR = 5.73), complications (HR = 5.22), lymphatic invasion (HR = 13.09) and multiple lesions (HR = 4.34). The analysis of the receiver operating characteristic curve, calibration curve, and model consistency index demonstrates that the graphical representation exhibits a good predictive capability.

Conclusions: Based on identified risk factors, this study developed the first nomogram with high accuracy to predict the recurrence of early gastric cancer after ESD. This model offers valuable guidance to clinicians for identifying high-risk patient groups and planning more intensive follow-up strategies.

Keywords: Early gastric cancer; Endoscopic submucosal dissection; Nomogram; Predictive model; Recurrence; Risk factors.