Endoscopic submucosal dissection for superficial ultra-low rectal tumors: outcomes and predictive factors for procedure difficulty

作者：Yinxin Wu · 发表于：American Journal of Cancer Research · 年份：2024 · DOI：10.62347/pvvd6843 · 被引用次数：1 · 研究领域：Gastric Cancer Management and Outcomes、Gastrointestinal Tumor Research and Treatment、Esophageal Cancer Research and Treatment

Background: Ultra-low rectal endoscopic submucosal dissection (ESD) presents technical challenges due to anatomical features.The objective of this research was to determine the risk factors linked to unsuccessful curative resections and to create a nomogram predictive model to assess the likelihood of encountering technical challenges.Methods: Patients with ultra-low rectal tumors received ESD form June 2017 to December 2022 were retrospectively enrolled.An ESD procedure exceeding 30 min was deemed difficult.A logistic regression analysis was performed to pinpoint important factors and predictors.The effectiveness of the nomogram, which incorporated the identified predictors, was evaluated by employing receiver operating characteristic (ROC) curves, calibration plots, and decision curve analysis (DCA).Results: A total of 300 patients with ultra-low rectal tumors were enrolled, with a curative resection rate of 82.0%.Multivariate logistic regression revealed that poor lifting sign (OR = 3.282, P = 0.026), non-granular type laterally spreading tumors (LST-NG, OR = 2.230, P = 0.042) and procedure time 60 min (OR = 6.976,P = 0.010) contributed to non-curative resection.Predictors for ESD difficulty included tumor diameter 30 mm (compared with < 30 mm, 30-50 mm, OR = 2.450, P = 0.044; 50 mm, OR = 5.047, P = 0.009), 1/2 circumference involvement (OR = 3.183, P = 0.038); dentate line invasion (OR = 3.881, P = 0.026) and less colorectal ESD experience (OR = 3.415, P = 0.032).The nomo...