Development and validation of a risk score for prediction of clinical success after duodenal stenting for malignant gastric outlet obstruction.

EUS-guided gastroenterostomy gastric cancer gastric outlet obstruction pancreatic cancer self-expandable metal stent

Journal

Expert review of gastroenterology & hepatology
ISSN: 1747-4132
Titre abrégé: Expert Rev Gastroenterol Hepatol
Pays: England
ID NLM: 101278199

Informations de publication

Date de publication:
Apr 2022
Historique:
pubmed: 22 3 2022
medline: 28 4 2022
entrez: 21 3 2022
Statut: ppublish

Résumé

To develop and validate a risk score for predicting clinical success after duodenal stenting using self-expanding metallic stents (SEMS) for malignant gastric outlet obstruction (GOO). Consecutive patients who underwent duodenal stenting for malignant GOO were evaluated. Potential predictors of clinical success were determined by uni/multivariate logistic regression analysis.Multiplication of the regression coefficients of the logistic regression model by a factor of two and rounding to obtain easy-to-use point numbers enabling the calculation of the score. Using 10-fold cross-validation, the model was internally validated. One hundred twelve patients were included. Clinical success was achieved in 93 (83.0%) patients. On multivariate logistic regression, selected age ≤65 years (p = 0.05, 1.5 points), stenosis type I (p = 0.04, 3 points), and pancreatic cancer (p = 0.01, 3.5 points) were significant predictors of clinical success. On the Receiver Operating Characteristic (ROC) analysis, a score of 5 had higher specificity and sensitivity. Our score could be useful at identifying, among poor surgical candidates, patients more likely to benefit from SEMS.

Sections du résumé

BACKGROUND UNASSIGNED
To develop and validate a risk score for predicting clinical success after duodenal stenting using self-expanding metallic stents (SEMS) for malignant gastric outlet obstruction (GOO).
RESEARCH DESIGN AND METHODS UNASSIGNED
Consecutive patients who underwent duodenal stenting for malignant GOO were evaluated. Potential predictors of clinical success were determined by uni/multivariate logistic regression analysis.Multiplication of the regression coefficients of the logistic regression model by a factor of two and rounding to obtain easy-to-use point numbers enabling the calculation of the score. Using 10-fold cross-validation, the model was internally validated.
RESULTS UNASSIGNED
One hundred twelve patients were included. Clinical success was achieved in 93 (83.0%) patients. On multivariate logistic regression, selected age ≤65 years (p = 0.05, 1.5 points), stenosis type I (p = 0.04, 3 points), and pancreatic cancer (p = 0.01, 3.5 points) were significant predictors of clinical success. On the Receiver Operating Characteristic (ROC) analysis, a score of 5 had higher specificity and sensitivity.
CONCLUSION UNASSIGNED
Our score could be useful at identifying, among poor surgical candidates, patients more likely to benefit from SEMS.

Identifiants

pubmed: 35306934
doi: 10.1080/17474124.2022.2056445
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

393-399

Auteurs

Maria Cristina Conti Bellocchi (MC)

Department of Medicine, Gastroenterology and Digestive Endoscopy Unit, The Pancreas Institute, G.B. Rossi University Hospital, Verona, Italy.

Stefano Francesco Crinò (SF)

Department of Medicine, Gastroenterology and Digestive Endoscopy Unit, The Pancreas Institute, G.B. Rossi University Hospital, Verona, Italy.

Marzia Fioravante (M)

Department of Medicine, Gastroenterology and Digestive Endoscopy Unit, The Pancreas Institute, G.B. Rossi University Hospital, Verona, Italy.

Enrico Maria Gabrieletto (EM)

Department of Medicine, Gastroenterology and Digestive Endoscopy Unit, The Pancreas Institute, G.B. Rossi University Hospital, Verona, Italy.

Serena Di Stefano (S)

Department of Medicine, Gastroenterology and Digestive Endoscopy Unit, The Pancreas Institute, G.B. Rossi University Hospital, Verona, Italy.

Laura Bernardoni (L)

Department of Medicine, Gastroenterology and Digestive Endoscopy Unit, The Pancreas Institute, G.B. Rossi University Hospital, Verona, Italy.

Paraskevas Gkolfakis (P)

Department of Gastroenterology, Hepatopancreatology, and Digestive Oncology, CUB Erasme Hospital, Université Libre de Bruxelles (ULB), Brussels, Belgium.

Andrew Ofosu (A)

University of Cincinnati Medical Center, Division of Digestive Diseases and Hepatology, Cincinnati, Ohio, USA.

Antonio Facciorusso (A)

Department of Medicine, Gastroenterology and Digestive Endoscopy Unit, The Pancreas Institute, G.B. Rossi University Hospital, Verona, Italy.
Digestive Endoscopy Unit, Department of Medical Sciences, University of Foggia, Foggia, Italy.

Armando Gabbrielli (A)

Department of Medicine, Gastroenterology and Digestive Endoscopy Unit, The Pancreas Institute, G.B. Rossi University Hospital, Verona, Italy.

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