Evidence map›Paper›PMID 42301470›Full record

ArticleSurgical endoscopy2026

Long-term outcomes after non-curative endoscopic submucosal dissection for undifferentiated early gastric cancer: a multicenter retrospective study.

Zhi-Yu Xiang, Yun Wang, Hunter Wang, Guo-Liang Ye, Wen-Kai Ni, Rui-Ying Jing, Hai-Han Xu, Wei Su, Rong-Dan Lu, Sai-Yan Bian and 5 more

Abstract readMulticenter Study
PubMed Publisher
In one paragraph

Article in Surgical endoscopy, 2026. 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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0citing papers in PubMed
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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

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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

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

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5 · Who and what money

Authors and funding

15 authors.

Zhi-Yu Xiang *Endoscopy Center and Endoscopy Research Institute, Zhongshan Hospital, Fudan University, Shanghai, China.
Yun Wang *Endoscopy Center and Endoscopy Research Institute, Zhongshan Hospital, Fudan University, Shanghai, China.
Hunter Wang *Department of Gastroenterology, Concord Repatriation General Hospital, 1A Hospital Road, Concord, NSW, 2139, Australia.
Guo-Liang Ye *The First Affiliated Hospital of Ningbo University, Ningbo, China.
Wen-Kai NiResearch Center of Clinical Medicine, Affiliated Hospital of Nantong University, Medical School of Nantong University, Nantong, China.
Rui-Ying JingDepartment of Gastroenterology, Jiangsu Province Hospital and Nanjing Medical University First Affiliated Hospital, Nanjing, China.
Hai-Han XuEndoscopy Center and Endoscopy Research Institute, Zhongshan Hospital, Fudan University, Shanghai, China.
Wei SuEndoscopy Center and Endoscopy Research Institute, Zhongshan Hospital, Fudan University, Shanghai, China.
Rong-Dan LuThe First Affiliated Hospital of Ningbo University, Ningbo, China.
Sai-Yan BianResearch Center of Clinical Medicine, Affiliated Hospital of Nantong University, Medical School of Nantong University, Nantong, China.
Wen-Jie ZhengResearch Center of Clinical Medicine, Affiliated Hospital of Nantong University, Medical School of Nantong University, Nantong, China.
Michael BourkeDepartment of Gastroenterology, Concord Repatriation General Hospital, 1A Hospital Road, Concord, NSW, 2139, Australia.
Ping-Hong ZhouEndoscopy Center and Endoscopy Research Institute, Zhongshan Hospital, Fudan University, Shanghai, China. poemzhou@163.com.
Yao-Yao GongDepartment of Gastroenterology, Jiangsu Province Hospital and Nanjing Medical University First Affiliated Hospital, Nanjing, China. ygong@njmu.edu.cn.
Sheng-Li LinEndoscopy Center and Endoscopy Research Institute, Zhongshan Hospital, Fudan University, Shanghai, China. lin.shengli@zs-hospital.sh.cn.ORCID http://orcid.org/0000-0002-5785-8695

Funding

General Program of the National Natural Science Foundation of China 82570788Major Project of Shanghai Municipal Science and Technology Committee 23ZR1445500
6 · The paper itself

Abstract

backgroundThe prognosis of non-curative endoscopic submucosal dissection (ESD) for undifferentiated-type early gastric cancer (UD-EGC) remains unclear. This study aimed to identify risk factors for residual tumor, lymph node metastasis (LNM), and recurrence after non-curative ESD, and to define a potential low-risk subgroup suitable for active surveillance rather than additional surgery.

methodsThis retrospective multicenter study included patients with non-curative ESD for UD-EGC from five institutions between 2017 and 2021. Patients were categorized into an additional surgery group or an observation group according to subsequent management. Clinicopathologic characteristics and survival outcomes were compared.

resultsNinety-nine patients were analyzed, including 44 in the observation group and 55 in the additional surgery group. The median follow-up duration was 64 months. Six patients undergoing surveillance experienced recurrence within 12.0 to 37.3 months after ESD. Fourteen patients in the additional surgery group showed residual tumor or LNM. Vertical margin involvement independently predicted recurrence in the observation group, while ulceration and vertical margin involvement were independent predictors of residual tumor or LNM in surgical specimens or recurrence. Overall and disease-free survival were worse in the observation group. Disease-free survival in the observation group was associated with depth of invasion, lymphatic invasion, venous invasion, and resection margin status. Lesions with negative resection margins and no lymphovascular invasion meeting either (1) pT1a, UL0, > 2 cm, or (2) pT1a, UL1, ≤ 3 cm demonstrated excellent long-term outcomes without recurrence.

conclusionsAdditional surgery remains standard after non-curative ESD for UD-EGC. However, a carefully selected low-risk subgroup may be appropriate candidates for close surveillance instead of further surgical intervention.

Indexed as

Endoscopic Mucosal ResectionStomach NeoplasmsAgedDisease-Free SurvivalFemaleHumansLymphatic MetastasisMaleMiddle AgedNeoplasm Recurrence, LocalNeoplasm, ResidualRetrospective StudiesRisk FactorsTreatment OutcomeEndoscopic submucosal dissectionNon-curative resectionStomach neoplasmsUndifferentiated-type histology

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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.