{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,11]],"date-time":"2026-06-11T13:21:58Z","timestamp":1781184118282,"version":"3.54.1"},"reference-count":34,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2026,1,5]],"date-time":"2026-01-05T00:00:00Z","timestamp":1767571200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Life"],"abstract":"<jats:p>Background\/Objectives: The prevalence of gastric subepithelial lesions (SELs) is rising. Endoscopic resection (ER) technique provides a minimally invasive alternative to manage gastric SELs. This study aims to evaluate the effectiveness and safety of ER for gastric myogenic tumors, and examine predictors for gastrointestinal stromal tumors (GISTs). Methods: The retrospective study was conducted between 2012 and 2024 at nine tertiary centers in Taiwan. We enrolled patients with endoscopic ultrasound (EUS)-documented gastric myogenic tumors managed by endoscopic muscular dissection (EMD), endoscopic subserosal dissection (ESSD), submucosal tunneling endoscopic resection (STER), and endoscopic full-thickness resection (EFTR). Clinical manifestation, endoscopic features, and outcomes were analyzed. Results: We enrolled 325 patients with 332 lesions [mean EUS size 14.5 mm, 153 (46.1%) leiomyoma, 152 (45.8%) GISTs, 27 (8.1%) other histology]. ER techniques were 193 (58.1%) EMD, 46 (13.9%) ESSD, 28 (8.4%) STER, and 65 (19.6%) EFTR. Technical success, en bloc, and R0 resection rates were 97.0%, 94.3%, and 88.9%, respectively. Twenty-four (9.0%) procedures were shifted to unintentional EFTR, and 21 (6.3%) patients had complications. No recurrence occurred during mean follow-up period of 921.4 days. Two (0.6%) patients died of non-procedure related reasons. Old age, fundus location, heterogeneous echotexture, and exophytic growth pattern were independent risk factors for GIST (all with p &lt; 0.05). Using the above factors, we built a prediction model with sensitivity of 77.0%, specificity of 85.6%, and AUC of 0.8771. Conclusions: ER is an efficient and safe management for gastric myogenic tumors. The histological type could be predicted by demographic characteristics and EUS features.<\/jats:p>","DOI":"10.3390\/life16010082","type":"journal-article","created":{"date-parts":[[2026,1,5]],"date-time":"2026-01-05T16:07:07Z","timestamp":1767629227000},"page":"82","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Nationwide Multicenter Study of Advanced Endoscopic Resection and Malignant Risk Model for Gastric Myogenic Tumors (GASTRO Trial)"],"prefix":"10.3390","volume":"16","author":[{"given":"Chih-Tsung","family":"Fan","sequence":"first","affiliation":[{"name":"Division of Gastroenterology and Hepatology, Department of Internal Medicine, Far Eastern Memorial Hospital, New Taipei City 220, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5920-8055","authenticated-orcid":false,"given":"Tze-Yu","family":"Shieh","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Department of Internal Medicine, Mackay Memorial Hospital, Taipei City 104, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wen-Hung","family":"Hsu","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Kaohsiung Medical University Chung-Ho Memorial Hospital, Kaohsiung City 807, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5101-5358","authenticated-orcid":false,"given":"Hsi-Yuan","family":"Chien","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, Chung Shan Hospital, Taipei City 106, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ching-Tai","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Endoscopy, E-Da Hospital and I-Shou University, Kaohsiung City 824, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ming-Yao","family":"Chen","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, Department of Internal Medicine, Shuang Ho Hospital, Taipei Medical University, New Taipei City 235, Taiwan"},{"name":"Division of Gastroenterology and Hepatology, Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei City 110, Taiwan"},{"name":"Taipei Medical University Research Center for Digestive Medicine, Taipei Medical University, Taipei City 110, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chung-Ying","family":"Lee","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, Department of Internal Medicine, Shuang Ho Hospital, Taipei Medical University, New Taipei City 235, Taiwan"},{"name":"Division of Gastroenterology and Hepatology, Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei City 110, Taiwan"},{"name":"Taipei Medical University Research Center for Digestive Medicine, Taipei Medical University, Taipei City 110, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei-Chen","family":"Tai","sequence":"additional","affiliation":[{"name":"Division of Hepatogastroenterology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung City 833, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4385-5095","authenticated-orcid":false,"given":"Sz-Iuan","family":"Shiu","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung City 407, Taiwan"},{"name":"Department of Critical Care Medicine, Taichung Veterans General Hospital, Taichung City 407, Taiwan"},{"name":"Department of Internal Medicine, Yang Ming Chiao Tung University, Taipei City 112, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"I-Ching","family":"Cheng","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Department of Medicine, Taiwan Adventist Hospital, Taipei City 105, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9224-4958","authenticated-orcid":false,"given":"Chen-Shuan","family":"Chung","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, Department of Internal Medicine, Far Eastern Memorial Hospital, New Taipei City 220, Taiwan"},{"name":"Program A, Department of Electrical Engineering, Yuan Ze University, Taoyuan City 320, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,1,5]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"418","DOI":"10.4253\/wjge.v8.i11.418","article-title":"Management of gastric subepithelial tumors: The role of endoscopy","volume":"8","author":"Kim","year":"2016","journal-title":"World J. 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