Evidence map›Paper›PMID 40467993›Full record

ArticleEsophagus : official journal of the Japan Esophageal Society2025

Individual risk stratification to predict metastasis for ESD of superficial esophageal squamous cell carcinoma.

Dongxian Jiang, Weijie Chen, Xue Zhang, Qi Song, Haixing Wang, Jie Huang, Jieakesu Su, Licheng Shen, Chen Xu, Yingyong Hou

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Article in Esophagus : official journal of the Japan Esophageal Society, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

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4 · The record

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5 · Who and what money

Authors and funding

10 authors.

Dongxian Jiang *Department of Pathology, Zhongshan Hospital, Fudan University, Shanghai, 200032, People's Republic of China.
Weijie Chen *Department of Pathology, Zhongshan Hospital, Fudan University, Shanghai, 200032, People's Republic of China.
Xue ZhangDepartment of Pathology, Zhongshan Hospital, Fudan University, Shanghai, 200032, People's Republic of China.
Qi SongDepartment of Pathology, Zhongshan Hospital, Fudan University, Shanghai, 200032, People's Republic of China.
Haixing WangDepartment of Pathology, Zhongshan Hospital, Fudan University, Shanghai, 200032, People's Republic of China.
Jie HuangDepartment of Pathology, Zhongshan Hospital, Fudan University, Shanghai, 200032, People's Republic of China.
Jieakesu SuDepartment of Pathology, Zhongshan Hospital, Fudan University, Shanghai, 200032, People's Republic of China.
Licheng ShenDepartment of Pathology, Zhongshan Hospital, Fudan University, Shanghai, 200032, People's Republic of China.
Chen XuDepartment of Pathology, Zhongshan Hospital, Fudan University, Shanghai, 200032, People's Republic of China. xu.chen@zs-hospital.sh.cn.
Yingyong HouDepartment of Pathology, Zhongshan Hospital, Fudan University, Shanghai, 200032, People's Republic of China. houyingyong@aliyun.com.ORCID 0000-0001-9156-2305

Funding

National Clinical Key Specialty-Pathology Department YWP2023-001National Natural Science Foundation of China 81702372Shanghai Municipal Health Commission 20214Y0275Shanghai Municipal Key Clinical Specialty shslczdzk01302
6 · The paper itself

Abstract

purposeThis study was aimed at identifying histopathological risk factors for metastasis and developing a reliable risk stratification system for superficial esophageal squamous cell carcinoma (sESCC) after endoscopic submucosal dissection (ESD).

methodsThree hundred and thirty-one patients who underwent ESD from January 2009 to December 2019 and were pathologically confirmed as mucosal or submucosal cancer were included. Their clinicopathological characteristics were reviewed.

resultsThe median follow-up period was 51 months (range 12-132 months). We found 42 patients had recurrence, 16 metastasized (1 distant metastasis, 13 lymph node metastasis, 2 both distant and lymph node metastasis), and 24 patients died. This univariate analysis revealed five morphological features were significantly associated with metastasis and overall survival. They were invasive depth, tumor budding, differentiation, infiltrative growth pattern, and vessel invasion (P < 0.05). Vessel invasion (HR 3.635, 95% CI 1.063-12.435) was confirmed with multivariate analysis as independent risk factor for metastasis. The five factors were included in the risk stratification system and assigned scores (0-5). According to the 5-year non-metastasis rate, all cases were re-classed into a group of 293 low-risk tumors, and a group of 38 high-risk tumors. Our data revealed the metastasis rates of patients in high-risk group were significantly higher than those in low-risk group (P < 0.001).

conclusionsBased on histopathological characteristics of ESD specimens, we developed a risk stratification system, which significantly divided sESCC into low-risk and high-risk group for metastasis. This may be used to assist in the decision-making process of sESCC to determine who need additional therapy after ESD.

Indexed as

Endoscopic Mucosal ResectionEsophageal NeoplasmsEsophageal Squamous Cell CarcinomaAgedAged, 80 and overFemaleFollow-Up StudiesHumansLymphatic MetastasisMaleMiddle AgedNeoplasm InvasivenessNeoplasm Recurrence, LocalRetrospective StudiesRisk AssessmentRisk FactorsEndoscopic submucosal dissection (ESD)Histopathological characteristicsMetastasisRisk stratification systemSuperficial esophageal squamous cell carcinoma (sESCC)

Identifiers

PMID40467993

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