Metachronous lesions after gastric endoscopic submucosal dissection: first assessment of the FAMISH prediction score.


Journal

Endoscopy
ISSN: 1438-8812
Titre abrégé: Endoscopy
Pays: Germany
ID NLM: 0215166

Informations de publication

Date de publication:
10 2023
Historique:
medline: 29 9 2023
pubmed: 10 5 2023
entrez: 9 5 2023
Statut: ppublish

Résumé

Surveillance after gastric endoscopic submucosal dissection (ESD) is recommended for all patients owing to the persistent risk of metachronous gastric lesions (MGLs). We developed and validated a prediction score to estimate MGL risk after ESD for early neoplastic gastric lesions, to define an individualized and cost-saving approach. Clinical predictors and a risk score were derived from meta-analysis data. A retrospective, single-center, cohort study including patients with ≥ 3 years of standardized surveillance after ESD was conducted for score validation. Predictive accuracy of the score by the area under the receiver operating characteristic curve (AUC) was assessed and cumulative probabilities of MGL were estimated. The risk score (0-9 points) included six clinical predictors (scored 0-3): positive family history of gastric cancer, older age, male sex, corpus intestinal metaplasia, synchronous gastric lesions, and persistent The FAMISH score might be a useful tool to accurately identify patients with low-to-intermediate risk for MGL at 3 years of follow-up who could have surveillance intervals extended to reduce the burden of care.

Sections du résumé

BACKGROUND
Surveillance after gastric endoscopic submucosal dissection (ESD) is recommended for all patients owing to the persistent risk of metachronous gastric lesions (MGLs). We developed and validated a prediction score to estimate MGL risk after ESD for early neoplastic gastric lesions, to define an individualized and cost-saving approach.
METHODS
Clinical predictors and a risk score were derived from meta-analysis data. A retrospective, single-center, cohort study including patients with ≥ 3 years of standardized surveillance after ESD was conducted for score validation. Predictive accuracy of the score by the area under the receiver operating characteristic curve (AUC) was assessed and cumulative probabilities of MGL were estimated.
RESULTS
The risk score (0-9 points) included six clinical predictors (scored 0-3): positive family history of gastric cancer, older age, male sex, corpus intestinal metaplasia, synchronous gastric lesions, and persistent
CONCLUSION
The FAMISH score might be a useful tool to accurately identify patients with low-to-intermediate risk for MGL at 3 years of follow-up who could have surveillance intervals extended to reduce the burden of care.

Identifiants

pubmed: 37160262
doi: 10.1055/a-2089-6849
doi:

Types de publication

Journal Article Comment

Langues

eng

Sous-ensembles de citation

IM

Pagination

909-917

Commentaires et corrections

Type : CommentOn

Informations de copyright

Thieme. All rights reserved.

Déclaration de conflit d'intérêts

M. Dinis-Ribeiro has been a consultant for Roche (2022) and Medtronic (2021). A. Rei, R. Ortigão, M. Pais, L.P. Afonso, P. Pimentel-Nunes, and D. Libânio, declare that they have no conflict of interest.

Auteurs

Andreia Rei (A)

Gastroenterology Department, Centro Hospitalar Universitário de Santo António, Porto, Portugal.

Raquel Ortigão (R)

Gastroenterology Department, RISE@CI-IPOP (Health Research Network), Portuguese Oncology Institute of Porto (IPO Porto) and Porto Comprehensive Cancer Centre (Porto.CCC), Porto, Portugal.

Mariana Pais (M)

MEDCIDS, Faculty of Medicine, University of Porto, Porto, Portugal.

Luís P Afonso (LP)

Pathology Department, Portuguese Oncology Institute of Porto, Porto, Portugal.

Pedro Pimentel-Nunes (P)

Gastroenterology Department, RISE@CI-IPOP (Health Research Network), Portuguese Oncology Institute of Porto (IPO Porto) and Porto Comprehensive Cancer Centre (Porto.CCC), Porto, Portugal.

Mário Dinis-Ribeiro (M)

Gastroenterology Department, RISE@CI-IPOP (Health Research Network), Portuguese Oncology Institute of Porto (IPO Porto) and Porto Comprehensive Cancer Centre (Porto.CCC), Porto, Portugal.
MEDCIDS, Faculty of Medicine, University of Porto, Porto, Portugal.

Diogo Libânio (D)

Gastroenterology Department, RISE@CI-IPOP (Health Research Network), Portuguese Oncology Institute of Porto (IPO Porto) and Porto Comprehensive Cancer Centre (Porto.CCC), Porto, Portugal.
MEDCIDS, Faculty of Medicine, University of Porto, Porto, Portugal.

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