1.Stratifying Risk of Lymph Node Metastasis After Non-Curative Endoscopic Submucosal Dissection of Early Gastric Cancer: Comparison of the eCura System and Elderly Criteria
Tae-woo KIM ; Hyo-Joon YANG ; Giho LEE ; Soo-Kyung PARK ; Yoon Suk JUNG ; Jung Ho PARK ; Dong Il PARK ; Chong Il SOHN
Journal of Gastric Cancer 2025;25(2):370-381
Purpose:
The novel curability criteria for elderly (EL) patients have been proposed to stratify their risk of lymph node metastasis (LNM), following non-curative endoscopic submucosal dissection (ESD) for early gastric cancer (EGC). Hence, this study aimed to evaluate the effectiveness of the EL criteria and compare them with those of the well-known eCura system.
Materials and Methods:
A retrospective analysis was performed on 143 patients who did not meet the curative ESD criteria at a tertiary hospital in Korea between 2011 and 2022. Of these, 102 underwent additional surgery, while 41 were followed up without further treatment. The LNM rates based on the EL and eCura systems were stratified and compared.
Results:
In the surgery group, 29.4% (30/102) patients were classified as EL-low (EL-L) and 70.2% (72/102) as EL-high (EL-H). The LNM rates (95% confidence interval) were 0.0% (0.0–11.6) and 9.7% (4.0–19.0) for EL-L and EL-H, respectively (P=0.102). EL-L was closely aligned with the eCura low-risk category, with a similar patient proportion (32.4%) and an LNM rate of 0.0% (0.0–10.6). The eCura system classified 94.1% (48/51) of the EL-L patients as lowrisk, with an 86% concordance rate (123/143). Discordant cases included patients with positive vertical margins, but without other risk factors, who were classified as EL-H without LNM.
Conclusions
Patients with EL-L showed no LNM, and the EL criteria demonstrated high concordance with the eCura system. The EL criteria may be as effective as the eCura system in identifying low-risk patients after non-curative ESD for EGC.
2.Stratifying Risk of Lymph Node Metastasis After Non-Curative Endoscopic Submucosal Dissection of Early Gastric Cancer: Comparison of the eCura System and Elderly Criteria
Tae-woo KIM ; Hyo-Joon YANG ; Giho LEE ; Soo-Kyung PARK ; Yoon Suk JUNG ; Jung Ho PARK ; Dong Il PARK ; Chong Il SOHN
Journal of Gastric Cancer 2025;25(2):370-381
Purpose:
The novel curability criteria for elderly (EL) patients have been proposed to stratify their risk of lymph node metastasis (LNM), following non-curative endoscopic submucosal dissection (ESD) for early gastric cancer (EGC). Hence, this study aimed to evaluate the effectiveness of the EL criteria and compare them with those of the well-known eCura system.
Materials and Methods:
A retrospective analysis was performed on 143 patients who did not meet the curative ESD criteria at a tertiary hospital in Korea between 2011 and 2022. Of these, 102 underwent additional surgery, while 41 were followed up without further treatment. The LNM rates based on the EL and eCura systems were stratified and compared.
Results:
In the surgery group, 29.4% (30/102) patients were classified as EL-low (EL-L) and 70.2% (72/102) as EL-high (EL-H). The LNM rates (95% confidence interval) were 0.0% (0.0–11.6) and 9.7% (4.0–19.0) for EL-L and EL-H, respectively (P=0.102). EL-L was closely aligned with the eCura low-risk category, with a similar patient proportion (32.4%) and an LNM rate of 0.0% (0.0–10.6). The eCura system classified 94.1% (48/51) of the EL-L patients as lowrisk, with an 86% concordance rate (123/143). Discordant cases included patients with positive vertical margins, but without other risk factors, who were classified as EL-H without LNM.
Conclusions
Patients with EL-L showed no LNM, and the EL criteria demonstrated high concordance with the eCura system. The EL criteria may be as effective as the eCura system in identifying low-risk patients after non-curative ESD for EGC.
3.Stratifying Risk of Lymph Node Metastasis After Non-Curative Endoscopic Submucosal Dissection of Early Gastric Cancer: Comparison of the eCura System and Elderly Criteria
Tae-woo KIM ; Hyo-Joon YANG ; Giho LEE ; Soo-Kyung PARK ; Yoon Suk JUNG ; Jung Ho PARK ; Dong Il PARK ; Chong Il SOHN
Journal of Gastric Cancer 2025;25(2):370-381
Purpose:
The novel curability criteria for elderly (EL) patients have been proposed to stratify their risk of lymph node metastasis (LNM), following non-curative endoscopic submucosal dissection (ESD) for early gastric cancer (EGC). Hence, this study aimed to evaluate the effectiveness of the EL criteria and compare them with those of the well-known eCura system.
Materials and Methods:
A retrospective analysis was performed on 143 patients who did not meet the curative ESD criteria at a tertiary hospital in Korea between 2011 and 2022. Of these, 102 underwent additional surgery, while 41 were followed up without further treatment. The LNM rates based on the EL and eCura systems were stratified and compared.
Results:
In the surgery group, 29.4% (30/102) patients were classified as EL-low (EL-L) and 70.2% (72/102) as EL-high (EL-H). The LNM rates (95% confidence interval) were 0.0% (0.0–11.6) and 9.7% (4.0–19.0) for EL-L and EL-H, respectively (P=0.102). EL-L was closely aligned with the eCura low-risk category, with a similar patient proportion (32.4%) and an LNM rate of 0.0% (0.0–10.6). The eCura system classified 94.1% (48/51) of the EL-L patients as lowrisk, with an 86% concordance rate (123/143). Discordant cases included patients with positive vertical margins, but without other risk factors, who were classified as EL-H without LNM.
Conclusions
Patients with EL-L showed no LNM, and the EL criteria demonstrated high concordance with the eCura system. The EL criteria may be as effective as the eCura system in identifying low-risk patients after non-curative ESD for EGC.
4.Necrotizing Fasciitis Following Peripheral Intravenous Cannulation in Laos
Yoonseob KIM ; Chansin LEE ; Giho MOON ; Kyungwon LEE
Journal of Acute Care Surgery 2024;14(3):134-137
A year on from the end of coronavirus disease pandemic, there has been a resurgence in interest in international travel from South Korea. In the event of unexpected illness whilst abroad, there is a lack of information regarding the provision of medical services, repatriation, and treatment outcomes, both abroad and upon return to South Korea. A 39-year-old male experienced swelling, redness, and severe pain in his right upper arm, axilla, and anterior chest wall after undergoing intravenous cannulation in Laos. He received treatment in South Korea, 5 days after symptom onset, delayed by his travel back to South Korea. Upon diagnosis of necrotizing fasciitis emergency surgery was conducted promptly. Subsequently, he underwent multiple surgeries. The patient`s wound was closed 13 days postadmission. He was discharged on the 33rd day without complications, although continued rehabilitation was required.
5.Necrotizing Fasciitis Following Peripheral Intravenous Cannulation in Laos
Yoonseob KIM ; Chansin LEE ; Giho MOON ; Kyungwon LEE
Journal of Acute Care Surgery 2024;14(3):134-137
A year on from the end of coronavirus disease pandemic, there has been a resurgence in interest in international travel from South Korea. In the event of unexpected illness whilst abroad, there is a lack of information regarding the provision of medical services, repatriation, and treatment outcomes, both abroad and upon return to South Korea. A 39-year-old male experienced swelling, redness, and severe pain in his right upper arm, axilla, and anterior chest wall after undergoing intravenous cannulation in Laos. He received treatment in South Korea, 5 days after symptom onset, delayed by his travel back to South Korea. Upon diagnosis of necrotizing fasciitis emergency surgery was conducted promptly. Subsequently, he underwent multiple surgeries. The patient`s wound was closed 13 days postadmission. He was discharged on the 33rd day without complications, although continued rehabilitation was required.
6.Necrotizing Fasciitis Following Peripheral Intravenous Cannulation in Laos
Yoonseob KIM ; Chansin LEE ; Giho MOON ; Kyungwon LEE
Journal of Acute Care Surgery 2024;14(3):134-137
A year on from the end of coronavirus disease pandemic, there has been a resurgence in interest in international travel from South Korea. In the event of unexpected illness whilst abroad, there is a lack of information regarding the provision of medical services, repatriation, and treatment outcomes, both abroad and upon return to South Korea. A 39-year-old male experienced swelling, redness, and severe pain in his right upper arm, axilla, and anterior chest wall after undergoing intravenous cannulation in Laos. He received treatment in South Korea, 5 days after symptom onset, delayed by his travel back to South Korea. Upon diagnosis of necrotizing fasciitis emergency surgery was conducted promptly. Subsequently, he underwent multiple surgeries. The patient`s wound was closed 13 days postadmission. He was discharged on the 33rd day without complications, although continued rehabilitation was required.

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