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©The Author(s) 2026. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Oncol. Feb 15, 2026; 18(2): 114782
Published online Feb 15, 2026. doi: 10.4251/wjgo.v18.i2.114782
Published online Feb 15, 2026. doi: 10.4251/wjgo.v18.i2.114782
Predicting the magnitude of risk for non-curative endoscopic submucosal dissection in superficial esophageal cancer using explainable artificial intelligence
Zi-Chen Luo, Hai-Yang Guo, Xin-Rui Chen, Cheng-Yu Zhang, Yu-Tong Cui, Ji Zuo, Hao-Rui Li, Xue-Mei Hou, Hao Chen, Shao-Bi Song, Xian-Fei Wang, Department of Gastroenterology, Affiliated Hospital of North Sichuan Medical College, Nanchong 637000, Sichuan Province, China
Xiao Tang, Department of Gastroenterology, Langzhong People’s Hospital, Langzhong 637400, Sichuan Province, China
Xian-Fei Wang, Department of Gastroenterology, Sichuan Branch of National Clinical Research Center for Digestive Diseases, Nanchong 637000, Sichuan Province, China
Co-first authors: Zi-Chen Luo and Hai-Yang Guo.
Author contributions: Luo ZC and Guo HY contributed equally to this work as co-first authors; Wang XF, Luo ZC, and Guo HY designed the study, analyzed the data, drafted the article, and critically revised the article; Luo ZC, Zhang CY, Guo HY, Chen XR, Cui YT, Zuo J, Li HR, Hou XM, Chen H, Song SB, and Tang X collected the data. All authors have read and approved the final manuscript.
Institutional review board statement: The study was reviewed and approved by the Ethics Committee of The Affiliated Hospital of North Sichuan Medical College, No. 2024ER140-1.
Informed consent statement: The requirement for informed consent was waived by the Ethics Committee due to the retrospective nature of the study.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: The original datasets presented in the study are included in the article, further inquiries can be directed to the corresponding author.
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: Xian-Fei Wang, Chief Physician, Full Professor, Department of Gastroenterology, Affiliated Hospital of North Sichuan Medical College, No. 1 Maoyuan South Road, Shunqing District, Nanchong 637000, Sichuan Province, China.
Received: September 29, 2025
Revised: October 31, 2025
Accepted: December 19, 2025
Published online: February 15, 2026
Processing time: 127 Days and 21.7 Hours
Revised: October 31, 2025
Accepted: December 19, 2025
Published online: February 15, 2026
Processing time: 127 Days and 21.7 Hours
Core Tip
Core Tip: This multicenter study produced an online, interpretable prediction tool that quantifies the preoperative risk of non-curative endoscopic submucosal dissection for superficial esophageal cancer. With a clear cutoff (SHapley Additive exPlanations value ≥ 0.185), it provides immediate, transparent guidance: High-risk patients are directed to radical surgery, while low-risk ones are confirmed as endoscopic submucosal dissection candidates, ensuring the first treatment choice is optimal.