Copyright: ©Author(s) 2026. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution-NonCommercial (CC BY-NC 4.0) license. No commercial re-use. See permissions. Published by Baishideng Publishing Group Inc.
World J Gastrointest Oncol. Jul 15, 2026; 18(7): 118867
Published online Jul 15, 2026. doi: 10.4251/wjgo.v18.i7.118867
Published online Jul 15, 2026. doi: 10.4251/wjgo.v18.i7.118867
Endoscopic ultrasonography lesion thickness predicts deep invasion in gastric cancer: Development and temporal validation of a preoperative model
Meng-Yu Cao, Yu-Fan Chen, Yun-Xiu Liao, Qing Yang, Shi-Yong Lin, Yin Li, Jun Weng, Xin-Xin Huang, Xiao-Yan Gao, Guo-Bao Wang, Hong-Bo Shan, Jian-Jun Li, Department of Endoscopy, Sun Yat-sen University Cancer Center, Guangzhou 510060, Guangdong Province, China
Co-first authors: Meng-Yu Cao and Yu-Fan Chen.
Co-corresponding authors: Hong-Bo Shan and Jian-Jun Li.
Author contributions: Cao MY and Chen YF contributed to the conception and design of the study, performed the statistical analysis and interpreted the data as co-first authors; Cao MY, Chen YF, Liao YX, and Yang Q participated in data acquisition and data curation; Cao MY drafted the manuscript; Liao YX and Yang Q accessed and verified the underlying study data; Shan HB supervised the study and provided methodological oversight; Shan HB and Li JJ contributed equally as co-corresponding authors. All authors critically reviewed the manuscript for important intellectual content, approved the final version, and accepted responsibility for the decision to submit the manuscript for publication.
Supported by Natural Science Foundation of Tibet Autonomous Region for Group Medical Assistance Project, No. XZ2019ZR-ZY60(Z); and Guangzhou Clinical Specialty Technology Construction Project, No. 2026P-TS016.
Institutional review board statement: The study was reviewed and approved by the Institutional Review Board of Sun Yat-sen University Cancer Center, No. SL-B2025-207-01.
Informed consent statement: The requirement for informed consent was waived by the Institutional Review Board because of the retrospective study design and the use of anonymised clinical data.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: The de-identified data and statistical code that support the findings of this study are available from the corresponding author upon reasonable request, subject to institutional and ethical requirements.
Corresponding author: Hong-Bo Shan, MD, PhD, Chief Physician, Senior Research Fellow, Department of Endoscopy, Sun Yat-sen University Cancer Center, No. 651 Dongfengdong Street, Yuexiu District, Guangzhou 510060, Guangdong Province, China.
Received: January 14, 2026
Revised: February 26, 2026
Accepted: March 31, 2026
Published online: July 15, 2026
Processing time: 173 Days and 21.8 Hours
Revised: February 26, 2026
Accepted: March 31, 2026
Published online: July 15, 2026
Processing time: 173 Days and 21.8 Hours
Core Tip
Core Tip: Preoperative identification of deep gastric wall invasion remains challenging. Endoscopic ultrasonography provides both a categorical T stage and a measurable lesion thickness. We developed and internally validated a logistic model that treats lesion thickness as a continuous predictor, together with routinely available clinical variables, to estimate individualised risk of pathological ≥ pT3 disease. The model showed good discrimination and decision-curve utility, and outperformed uT-based benchmarks. Temporal testing in a later same-institution cohort preserved discrimination but showed calibration drift, supporting future recalibration, external validation, and context-specific threshold selection.