Risk factor-based optimal endoscopic surveillance intervals after endoscopic submucosal dissection for gastric adenoma

Abstract To date, there exists no established endoscopic surveillance interval strategy after endoscopic submucosal dissection (ESD) for gastric adenoma. In this study, we suggest a risk factor-based statistical model for optimal surveillance intervals for gastric adenoma after ESD with curative res...

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Autores principales:	Choong-Kyun Noh, Eunyoung Lee, Gil Ho Lee, Sun Gyo Lim, Kee Myung Lee, Jin Roh, Young Bae Kim, Bumhee Park, Sung Jae Shin
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/fc917f50c1a1402bafeff661f688e6d4
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spelling	oai:doaj.org-article:fc917f50c1a1402bafeff661f688e6d42021-11-08T10:50:24ZRisk factor-based optimal endoscopic surveillance intervals after endoscopic submucosal dissection for gastric adenoma10.1038/s41598-021-00969-12045-2322https://doaj.org/article/fc917f50c1a1402bafeff661f688e6d42021-11-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-00969-1https://doaj.org/toc/2045-2322Abstract To date, there exists no established endoscopic surveillance interval strategy after endoscopic submucosal dissection (ESD) for gastric adenoma. In this study, we suggest a risk factor-based statistical model for optimal surveillance intervals for gastric adenoma after ESD with curative resection. A cox proportional hazard model was applied to identify risk factors for recurrence after ESD. Patients (n = 698) were categorized into groups based on the identified risk factors. The cumulative density of recurrence over time was computed using a cubic splined baseline hazard function, and the customized surveillance interval was modeled for each risk group. The overall cumulative incidence of recurrence was 7.3% (n = 51). Risk factors associated with recurrence were male (hazard ratio [HR], 2.60, P = 0.030), protruded scar (HR, 3.18, P < 0.001), and age ≥ 59 years (HR, 1.05, P < 0.001). The surveillance interval for each group was developed by using the recurrence limit for the generated risk groups. According to the developed schedule, high-risk patients would have a maximum of seven surveillance visits for 5 years, whereas low-risk patients would have biennial surveillance for cancer screening. We proposed a simple and promising strategy for determining a better endoscopic surveillance interval by parameterizing diverse and group-specific recurrence risk factors into a well-known survival model.Choong-Kyun NohEunyoung LeeGil Ho LeeSun Gyo LimKee Myung LeeJin RohYoung Bae KimBumhee ParkSung Jae ShinNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-10 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Choong-Kyun Noh Eunyoung Lee Gil Ho Lee Sun Gyo Lim Kee Myung Lee Jin Roh Young Bae Kim Bumhee Park Sung Jae Shin Risk factor-based optimal endoscopic surveillance intervals after endoscopic submucosal dissection for gastric adenoma
description	Abstract To date, there exists no established endoscopic surveillance interval strategy after endoscopic submucosal dissection (ESD) for gastric adenoma. In this study, we suggest a risk factor-based statistical model for optimal surveillance intervals for gastric adenoma after ESD with curative resection. A cox proportional hazard model was applied to identify risk factors for recurrence after ESD. Patients (n = 698) were categorized into groups based on the identified risk factors. The cumulative density of recurrence over time was computed using a cubic splined baseline hazard function, and the customized surveillance interval was modeled for each risk group. The overall cumulative incidence of recurrence was 7.3% (n = 51). Risk factors associated with recurrence were male (hazard ratio [HR], 2.60, P = 0.030), protruded scar (HR, 3.18, P < 0.001), and age ≥ 59 years (HR, 1.05, P < 0.001). The surveillance interval for each group was developed by using the recurrence limit for the generated risk groups. According to the developed schedule, high-risk patients would have a maximum of seven surveillance visits for 5 years, whereas low-risk patients would have biennial surveillance for cancer screening. We proposed a simple and promising strategy for determining a better endoscopic surveillance interval by parameterizing diverse and group-specific recurrence risk factors into a well-known survival model.
format	article
author	Choong-Kyun Noh Eunyoung Lee Gil Ho Lee Sun Gyo Lim Kee Myung Lee Jin Roh Young Bae Kim Bumhee Park Sung Jae Shin
author_facet	Choong-Kyun Noh Eunyoung Lee Gil Ho Lee Sun Gyo Lim Kee Myung Lee Jin Roh Young Bae Kim Bumhee Park Sung Jae Shin
author_sort	Choong-Kyun Noh
title	Risk factor-based optimal endoscopic surveillance intervals after endoscopic submucosal dissection for gastric adenoma
title_short	Risk factor-based optimal endoscopic surveillance intervals after endoscopic submucosal dissection for gastric adenoma
title_full	Risk factor-based optimal endoscopic surveillance intervals after endoscopic submucosal dissection for gastric adenoma
title_fullStr	Risk factor-based optimal endoscopic surveillance intervals after endoscopic submucosal dissection for gastric adenoma
title_full_unstemmed	Risk factor-based optimal endoscopic surveillance intervals after endoscopic submucosal dissection for gastric adenoma
title_sort	risk factor-based optimal endoscopic surveillance intervals after endoscopic submucosal dissection for gastric adenoma
publisher	Nature Portfolio
publishDate	2021
url	https://doaj.org/article/fc917f50c1a1402bafeff661f688e6d4
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Risk factor-based optimal endoscopic surveillance intervals after endoscopic submucosal dissection for gastric adenoma

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