Prediction model for curative endoscopic submucosal dissection of undifferentiated-type early gastric cancer

Hyo Joon Yang, Moon Kyung Joo, Jae Myung Park, Ji Yong Ahn, Jae Young Jang, Joo Hyun Lim, Su Youn Nam, Jie Hyun Kim, Byung Hoon Min, Wan Sik Lee, Bong Eun Lee, Woon Geon Shin, Hang Lak Lee, Tae Geun Gweon, Moo In Park, Jeongmin Choi, Chung Hyun Tae, Young Il Kim, Keun Won Ryu, Il Ju Choi

Research output: Contribution to journalArticlepeer-review

3 Scopus citations


Background: Endoscopic submucosal dissection (ESD) is an effective treatment for early gastric cancer (EGC); however, its curative resection rate is low for undifferentiated-type EGC. We developed and externally validated a prediction model for curative ESD of undifferentiated-type EGC. Methods: In this cross-sectional study, we included 448 patients who underwent ESD for undifferentiated-type EGC at 18 hospitals in Korea between 2005 and 2015 in the development cohort and 1342 patients who underwent surgery at two hospitals in the validation cohort. A prediction model was developed using the logistic regression model. Results: Endoscopic tumor size 1–2 cm (odds ratio [OR], 2.40; 95% confidence interval [CI] 1.54–3.73), tumor size > 2 cm (OR, 14.00; 95% CI 6.81–28.77), and proximal tumor location from the lower to upper third of the stomach (OR, 1.45; 95% CI 1.03–2.04) were independent predictors of non-curative ESD. A six-score prediction model was developed by assigning points to endoscopic tumor size > 2 cm (five points), tumor size 1–2 cm (two points), upper third location (two points), and middle third location (one point). The rate of curative ESD ranged from 70.6% (score 0) to 11.6% (score 5) with an area under the receiver operating characteristic curve (AUC) of 0.720 (95% CI 0.673–0.766). The model also showed good performance in the validation cohort (AUC, 0.775; 95% CI 0.748–0.803). Conclusions: This six-score prediction model may help in predicting curative ESD and making informed decisions about the treatment selection between ESD and surgery for undifferentiated-type EGC.

Original languageEnglish
Pages (from-to)1414-1423
Number of pages10
JournalSurgical Endoscopy
Issue number2
StatePublished - Feb 2022

Bibliographical note

Publisher Copyright:
© 2021, The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.


  • Curative resection
  • Early gastric cancer
  • Endoscopic submucosal dissection
  • Risk assessment
  • Undifferentiated-type histology


Dive into the research topics of 'Prediction model for curative endoscopic submucosal dissection of undifferentiated-type early gastric cancer'. Together they form a unique fingerprint.

Cite this