Evidence map›Paper›PMID 40350513›Full record

ArticleJournal of gastroenterology2025

External validation of the eCura system and comparison with the W-eCura score for predicting lymph node metastasis after non-curative endoscopic submucosal dissection for early gastric cancer: a multicenter retrospective cohort study.

Yohei Yabuuchi, Yuichi Masui, Ken Kumagai, Hiroyoshi Iwagami, Katsuyuki Murai, Takeshi Setoyama, Tomomasa Tochio, Takahiro Utsumi, Takaaki Yoshikawa, Osamu Araki and 13 more

Abstract readMulticenter StudyComparative StudyValidation 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 9 papers.

0numbers the graph read from it
0cells of the map it votes in
9citing 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

9 citing papers in PubMed.

  1. Review
  2. External validation and comparison of five prediction models for lymph node metastasis after noncurative endoscopic submucosal dissection for early gastric cancer.Gastric cancer : official journal of the International Gastric Cancer Association and the Japanese Gastric Cancer Association · 2026
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

23 authors.

Yohei YabuuchiDepartment of Gastroenterology, Kobe City Medical Center General Hospital, 2-1-1 Minatojima Minamimachi, Chuo-ku, Kobe, Hyogo, 650-0047, Japan. yohei_yabuuchi@kcho.jp.ORCID 0000-0003-0491-2579
Yuichi MasuiDepartment of Gastroenterology, Shizuoka General Hospital, Shizuoka, Japan.
Ken KumagaiDepartment of Gastroenterology and Hepatology, Kobe City Nishi-Kobe Medical Center, Hyogo, Japan.
Hiroyoshi IwagamiDepartment of Gastroenterology and Hepatology, Japanese Red Cross Wakayama Medical Center, Wakayama, Japan.
Katsuyuki MuraiDepartment of Gastroenterology, Kyoto Medical Center, Kyoto, Japan.
Takeshi SetoyamaDepartment of Gastroenterology and Hepatology, Osaka Red Cross Hospital, Osaka, Japan.
Tomomasa TochioDepartment of Gastroenterology, Tenri Hospital, Nara, Japan.
Takahiro UtsumiDepartment of Gastroenterology and Hepatology, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
Takaaki YoshikawaDepartment of Gastroenterology and Hepatology, Kitano Hospital, Tazuke Kofukai Medical Research Institute, Osaka, Japan.
Osamu ArakiDepartment of Gastroenterology and Hepatology, Kyoto Katsura Hospital, Kyoto, Japan.
Shintaro MurakamiDepartment of Gastroenterology, Himeji Medical Center, Hyogo, Japan.
Motoya KitamiDepartment of Gastroenterology, Otsu Red Cross Hospital, Shiga, Japan.
Kenshi MatsuuraDepartment of Gastroenterology and Hepatology, Takamatsu Red Cross Hospital, Kagawa, Japan.
Naoki KandaDepartment of Gastroenterology and Hepatology, Takatsuki Red Cross Hospital, Osaka, Japan.
Eriko HishitaniDepartment of Gastroenterology, Hyogo Prefectural Amagasaki General Medical Center, Hyogo, Japan.
Junya TanakaDepartment of Gastroenterology and Hepatology, Mitsubishi Kyoto Hospital, Kyoto, Japan.
Saiko MaruiDepartment of Gastroenterology and Hepatology, Shiga General Hospital, Shiga, Japan.
Kozo IkutaDivision of Gastroenterology, Shinko Hospital, Hyogo, Japan.
Hiroyuki YoshidaDepartment of Gastroenterology and Hepatology, Kansai Electric Power Hospital, Osaka, Japan.
Yoshitaka NishikawaDepartment of Health Informatics, Kyoto University School of Public Health, Kyoto, Japan.
Yuki NakanishiDepartment of Gastroenterology and Hepatology, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
Hiroshi SenoDepartment of Gastroenterology and Hepatology, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
KONOE Project

Funding

Japan Society for the Promotion of Science JP24K20216
6 · The paper itself

Abstract

backgroundThe eCura system is a widely used risk-scoring model for predicting lymph node metastasis (LNM) after non-curative endoscopic submucosal dissection (ESD) for early gastric cancer (EGC), but its external validation is limited. Recently, the W-eCura score, a modified version, was proposed. We aimed to validate the eCura system and compare its discriminatory performance with the W-eCura score.

methodsA multicenter retrospective study was conducted using data from 19 Japanese institutions. The patients who underwent ESD for EGC followed by gastrectomy with lymph node dissection were included. The predictive performance of the eCura system, including calibration and discrimination, was evaluated and its discrimination was compared with the W-eCura score.

resultsAmong 901 eligible patients, 65 cases (7.2%) showed LNM. The eCura system demonstrated good calibration, with a calibration-in-the-large of -0.008 (95% confidence interval [CI] -0.024-0.010), an observed-to-expected ratio of 0.905 (95% CI 0.707-1.121), and a calibration slope of 0.975 (95% CI 0.692-1.257). Discrimination was also good, with a C-statistic of 0.741 (95% CI 0.676-0.806). In patients evaluable for both systems, the C-statistics for the eCura system and W-eCura score were 0.745 (95% CI 0.675-0.816) and 0.750 (95% CI 0.684-0.817), respectively, showing no significant difference (P = 0.547).

conclusionsThe eCura system was validated as a reliable tool for predicting LNM following ESD in real-world clinical settings.

Indexed as

Endoscopic Mucosal ResectionLymphatic MetastasisStomach NeoplasmsAgedFemaleGastrectomyHumansJapanLymph Node ExcisionMaleMiddle AgedPredictive Value of TestsRetrospective StudiesRisk AssessmentEarly gastric cancereCura systemEndoscopic submucosal dissectionLymph node metastasisValidation study

Identifiers

PMID40350513

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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.