Evidence map›Paper›PMID 39589535›Full record

ArticleJournal of gastroenterology2025

Comprehensive pathological evaluation of risk factors for metastasis after endoscopic resection of superficial esophageal squamous cell carcinoma.

Ryu Ishihara, Hiroshi Kawachi, Kaoru Nakano, Tomohiro Kadota, Kenshi Matsuno, Ayumu Takizawa, Takashi Matsunaga, Akiyoshi Ishiyama, Tomonori Yano, Hiroaki Takahashi and 1 more

Abstract readMulticenter Study
PubMed Publisher
In one paragraph

Article in Journal of gastroenterology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

  1. Review
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Ryu IshiharaDepartment of Gastrointestinal Oncology, Osaka International Cancer Institute, 3-1-69 Otemae, Chuo-ku, Osaka, 541-8567, Japan. ryu1486@gmail.com.
Hiroshi KawachiDepartment of Pathology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan.
Kaoru NakanoDepartment of Pathology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan.
Tomohiro KadotaDepartment of Gastroenterology and Endoscopy, National Cancer Center Hospital East, Kashiwa, Japan.
Kenshi MatsunoDepartment of Gastroenterology and Hepatology, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan.
Ayumu TakizawaDepartment of Gastroenterology, Keiyukai Daini Hospital, Sapporo, Japan.
Takashi MatsunagaDepartment of Medical Informatics, Osaka International Cancer Institute, Osaka, Japan.
Akiyoshi IshiyamaDepartment of Gastroenterology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan.
Tomonori YanoDepartment of Gastroenterology and Endoscopy, National Cancer Center Hospital East, Kashiwa, Japan.
Hiroaki TakahashiDepartment of Gastroenterology, Keiyukai Daini Hospital, Sapporo, Japan.
Satoshi FujiiDepartment of Molecular Pathology, Yokohama City University Graduate School of Medicine, Yokohama, Japan.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundEsophageal cancer is a major cause of cancer mortality worldwide. Endoscopic resection (ER) is a curative treatment for esophageal squamous cell carcinoma (ESCC). Predicting risk of metastasis is crucial for post-ER management. In this study, we aimed to identify predictors of metastasis by examining endoscopically resected specimens.

methodsThe cohort of this retrospective multicenter study comprised 422 patients who had undergone ER for ESCC from 1994 to 2017. Inclusion required a histological diagnosis of pT1a-muscularis mucosa or pT1b-submucosa (SM) cancer. Central pathological review comprehensively evaluated depth of invasion, lymphovascular invasion (LVI), droplet infiltration (DI), infiltrative growth pattern, histological differentiation, intraductal and intraglandular involvement, solitary nest, resected margin, and other factors. Logistic regression was used to identify predictors of metastasis.

resultsMetastases were identified in 103 patients. Univariate analysis identified LVI, depth of invasion, and DI as significant predictive factors. Multivariate analysis identified LVI, depth of invasion pT1b-SM2 (odds ratio 2.72) and indeterminate (positive vertical margin) (odds ratio 3.63) compared with the reference category of pT1b-SM1 as independent predictors of metastasis. Conversely, there were no significant associations between metastasis and lesion size, differentiation, cytological atypia, or infiltration pattern. Subgroup analysis showed that both the number and layer of LVI were associated with metastasis risk. In addition, four or more foci of DI was an independent predictor of LVI.

conclusionsLVI and depth of invasion were significant predictors of metastasis in ESCC. Detailed pathological evaluation and standardized criteria are essential for accurately assessing risk of metastasis and guiding post-ER treatment strategies.

Indexed as

Esophageal NeoplasmsEsophageal Squamous Cell CarcinomaEsophagoscopyAdultAgedEsophagectomyFemaleHumansLymphatic MetastasisMaleMiddle AgedNeoplasm InvasivenessNeoplasm MetastasisRetrospective StudiesRisk FactorsEndoscopic resectionEsophageal cancerMetastasisRisk factorsSquamous cell

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.