Yang KZ, Chen L, Xu L, Xu BX, Li MY, Wang Z, Lu Q. Correlation between sarcopenia and esophageal stenosis following endoscopic submucosal dissection and construction of a postoperative stenosis risk model. World J Gastroenterol 2026; 32(5): 114752 [DOI: 10.3748/wjg.v32.i5.114752]
Corresponding Author of This Article
Qin Lu, MD, Associate Chief Physician, Research Fellow, Department of Gastroenterology, Zhongda Hospital Southeast University, No. 87 Dingjiaqiao, Gulou District, Nanjing 210009, Jiangsu Province, China. luqin81287@163.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Retrospective Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Feb 7, 2026 (publication date) through Jan 28, 2026
Times Cited of This Article
Times Cited (0)
Journal Information of This Article
Publication Name
World Journal of Gastroenterology
ISSN
1007-9327
Publisher of This Article
Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA
Share the Article
Yang KZ, Chen L, Xu L, Xu BX, Li MY, Wang Z, Lu Q. Correlation between sarcopenia and esophageal stenosis following endoscopic submucosal dissection and construction of a postoperative stenosis risk model. World J Gastroenterol 2026; 32(5): 114752 [DOI: 10.3748/wjg.v32.i5.114752]
World J Gastroenterol. Feb 7, 2026; 32(5): 114752 Published online Feb 7, 2026. doi: 10.3748/wjg.v32.i5.114752
Correlation between sarcopenia and esophageal stenosis following endoscopic submucosal dissection and construction of a postoperative stenosis risk model
Kai-Zhe Yang, Lu Chen, Li Xu, Bin-Xiang Xu, Ming-Yue Li, Zhi Wang, Qin Lu
Kai-Zhe Yang, Li Xu, Qin Lu, School of Medicine, Southeast University, Nanjing 210009, Jiangsu Province, China
Lu Chen, Ming-Yue Li, Zhi Wang, Qin Lu, Department of Gastroenterology, Zhongda Hospital Southeast University, Nanjing 210009, Jiangsu Province, China
Bin-Xiang Xu, Department of Gastroenterology, Baoying County Hospital of Traditional Chinese Medicine, Yangzhou 225800, Jiangsu Province, China
Author contributions: Yang KZ contributed to data curation; methodology; writing - original draft; Xu L contributed to software; Xu BX and Wang Z contributed to validation; Lu Q contributed to conceptualization; Yang KZ, Chen L, Xu L and Li MY contributed to formal analysis; Yang KZ and Lu Q contributed to writing - review & editing; Li MY and Lu Q contributed to funding acquisition; and all contributing authors read and approved the final manuscript.
Supported by the National Natural Science Foundation of China, No. 82300638; the General Program of Jiangsu Provincial Administration of Traditional Chinese Medicine, No. MS2024139; and Zhongda Hospital Affiliated to Southeast University, Jiangsu Province High-Level Hospital Construction Funds, No. YKK24268.
Institutional review board statement: This study was approved by the Ethics Committee of Southeast University, Zhongda Hospital Southeast University (approval No. 2025ZDSYLL373-P01). All study procedures adhered to the Declaration of Helsinki.
Informed consent statement: The ethics committee waived the requirement for obtaining informed consent from the patients owing to the retrospective nature of the study.
Conflict-of-interest statement: The authors declare that they have no conflicts of interest related to the manuscript.
Data sharing statement: The data used and analyzed during the study are available from the lead author and the corresponding authors upon reasonable request.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Qin Lu, MD, Associate Chief Physician, Research Fellow, Department of Gastroenterology, Zhongda Hospital Southeast University, No. 87 Dingjiaqiao, Gulou District, Nanjing 210009, Jiangsu Province, China. luqin81287@163.com
Received: September 28, 2025 Revised: November 20, 2025 Accepted: December 29, 2025 Published online: February 7, 2026 Processing time: 123 Days and 16.3 Hours
Abstract
BACKGROUND
Sarcopenia has been indicated to be related to the postoperative outcome of patients with various digestive tract diseases. However, no studies have investigated the association between sarcopenia and esophageal stenosis after endoscopic submucosal dissection (ESD).
AIM
To explore the correlation between sarcopenia and post-ESD esophageal stenosis, and subsequently develop a risk prediction model.
METHODS
Retrospective data from 499 patients who underwent esophageal ESD were collected. After stratification via the L3 skeletal muscle indices (L3-SMIs) into sarcopenia and non-sarcopenia groups, post-ESD stenosis rates were compared. Propensity score matching (PSM) was used for sensitivity analysis. The original cohort was randomly split at a ratio of 7:3 into training (n = 350) and validation (n = 149) groups to construct and validate a risk prediction model for post-ESD stenosis.
RESULTS
Sarcopenia was significantly associated with post-ESD esophageal stenosis (48.23% vs 22.35%, P < 0.001). Furthermore, multivariate analysis confirmed its independence as a predictor of this postoperative complication [odds ratio (OR): 3.86; 95% confidence interval: 1.76-8.45; P < 0.001]. This conclusion was consistent across the subgroup analyses and PSM analyses. The risk prediction model incorporating sarcopenia had area under the curve values of 0.848 (training set) and 0.794 (validation set). Calibration curves and Hosmer-Lemeshow tests indicated good calibration of the model. Moreover, decision curve analysis confirmed a positive net clinical benefit for the model.
CONCLUSION
Sarcopenia is an independent risk predictor of post-ESD esophageal stenosis. Our model integrating muscle mass assessment aids in early high-risk identification and intervention.
Core Tip: A novel finding of this study is that a body composition abnormality, quantified by an index associated with computed tomography-defined sarcopenia, is a clinically significant and independent predictor of the development of esophageal stenosis after endoscopic submucosal dissection (ESD). We successfully constructed a risk prediction model for post-ESD stenosis that includes sarcopenia, which achieved good internal validation. This investigation addresses a limitation of prior research, which focused solely on local lesion characteristics for predicting post-ESD esophageal stenosis. Moreover, the model helps in identifying high-risk groups at early time points and formulating individualized treatment strategies.
