Predictors of difficult endoscopic resection of submucosal tumors originating from the muscularis propria layer at the esophagogastric junction

Table 3 Risk factors associated with piecemeal resection, long operative times (≥ 60 min) and bleeding during the procedure

Variable	En bloc resection and piecemeal resection		Operative times ≥ 60 min and < 60 min		Bleeding and no bleeding during the procedure
	Univariate analysis, OR (95%CI), P value	Multivariate analysis, OR (95%CI), P value	Univariate analysis, OR (95%CI), P value	Multivariate analysis, OR (95%CI), P value	Univariate analysis, OR (95%CI), P value	Multivariate analysis, OR (95%CI), P value
Age, (yr)
< 60	1 (reference)	1 (reference)	1 (reference)	1 (reference)	1 (reference)	1 (reference)
≥ 60	0.095 (0.012–0.763), 0.027	0.082 (0.007–0.929), 0.043	0.648 (0.260–1.614), 0.351	0.896 (0.172–4.677), 0.896	0.828 (0.276–2.485), 0.736	1.226 (0.234–6.419), 0.809
Sex, No.
Female	1 (reference)	1 (reference)	1 (reference)	1 (reference)	1 (reference)	1 (reference)
Male	1.171 (0.374–3.665), 0.786	1.807 (0.334–9.776), 0.492	1.111 (0.465–2.655), 0.813	1.089 (0.247–4.799), 0.911	0.760 (0.261–2.215), 0.615	1.101 (0.225–5.380), 0.906
Shape of lesion, No.
Regular shape	1 (reference)	1 (reference)	1 (reference)	1 (reference)	1 (reference)	1 (reference)
Irregular shape	19.933 (2.477–160.405), 0.005	18.004 (1.340–241.863), 0.029	9.491 (3.324–27.102), 0.000	6.863 (1.160–40.602), 0.034	12.054 (2.561–56.733), 0.002	19.020 (1.570–230.493), 0.021
Tumor diameter
< 30 mm	1 (reference)	1 (reference)	1 (reference)	1 (reference)	1 (reference)	1 (reference)
≥ 30 mm	14.7270 (3.043–71.279), 0.001	7.346 (1.191–45.323), 0.032	33.150 (9.855–111.510), 0.000	47.330 (8.411–266.322), 0.000	21.316 (4.456–101.977), 0.000	20.631 (3.066–138.803), 0.002
Surgical approach
STER	1 (reference)	1 (reference)	1 (reference)	1 (reference)	1 (reference)	1 (reference)
ESD	0.352 (0.088–1.401), 0.138	0.635 (0.088–4.572), 0.652	0.404 (0.144–1.134), 0.085	1.554 (0.217–11.120), 0.661	1.038 (0.321–3.354), 0.950	2.696 (0.372–19.537), 0.326
EFTR	0.262 (0.030–2.251), 0.222	1.596 (0.039–65.206), 0.805	1.083 (0.321–3.659), 0.897	7.233 (0.335–156.259), 0.207	1.227 (0.277–5.439), 0.787	37.935 (0.849–1694.936), 0.061
Location
Esophagocardia	1 (reference)	1 (reference)	1 (reference)	1 (reference)	1 (reference)	1 (reference)
Cardia	0.576 (0.141–2.349), 0.442	0.371 (0.059–2.342), 0.291	1.304 (0.422–4.027), 0.645	0.824 (0.132–5.134), 0.836	0.576 (0.141–2.349), 0.442	0.282 (0.045–1.772), 0.177
Gastrocardia	0.362 (0.091–1.443), 0.150	1.407 (0.115–17.261), 0.789	0.698 (0.239–2.044), 0.512	0.582 (0.051–6.572), 0.661	0.693 (0.203–2.368), 0.558	0.808 (0.055–11.832), 0.876
Growth pattern
Predominant intracavitary	1 (reference)	1 (reference)	1 (reference)	1 (reference)	1 (reference)	1 (reference)
Predominant extraluminal	0.288 (0.035–2.373), 0.248	0.272 (0.016–4.484), 0.362	1.932 (0.661–5.649), 0.229	5.522 (0.480–63.514), 0.170	0.516 (0.106–2.505), 0.411	0.086 (0.002–3.016), 0.176
Surface
Smooth	1 (reference)	1 (reference)	1 (reference)	1 (reference)	1 (reference)	1 (reference)
Reddish and erosive	1.800 (0.427–7.593), 0.424	0.707 (0.097–5.141), 0.732	1.783 (0.542–5.862), 0.341	1.315 (0.203–8.534), 0.774	2.188 (0.584–8.192), 0.245	2.059 (0.234–18.133), 0.515
Histopathology
Leiomyoma	1 (reference)	1 (reference)	1 (reference)	1 (reference)	1 (reference)	1 (reference)
GIST/Schwannoma	0.248 (0.030–2.027), 0.193	1.513 (0.072–31.658), 0.790	0.849 (0.288–2.508), 0.767	0.632 (0.055–7.297), 0.713	0.763 (0.195–2.988), 0.698	2.037 (0.122–34.081), 0.621

STER: Submucosal tunneling endoscopic resection; EFTR: Endoscopic full-thickness resection; ESD: Endoscopic submucosal dissection; GIST: Gastrointestinal stromal tumors.