Development and validation of a risk score for prediction of clinical success after duodenal stenting for malignant gastric outlet obstruction. (3rd April 2022)

• Record Type: Journal Article
• Authors: Conti Bellocchi, Maria Cristina; Crinò, Stefano Francesco; Fioravante, Marzia; Gabrieletto, Enrico Maria; Di Stefano, Serena; Bernardoni, Laura; Gkolfakis, Paraskevas; Ofosu, Andrew; Facciorusso, Antonio; Gabbrielli, Armando
• Is Part Of: Expert review of gastroenterology & hepatology. Volume 16:Number 4(2022)
• Page Start: 393
• Page End: 399
• Publication Date: 2022-04-03
• Subjects: EUS-guided gastroenterostomy -- gastric cancer -- gastric outlet obstruction -- pancreatic cancer -- self-expandable metal stent; Gastroenterology -- Periodicals; Liver -- Diseases -- Periodicals; 616.3
• DOI: 10.1080/17474124.2022.2056445
• Languages: English
• ISSNs: 1747-4124

Abstract

ABSTRACT: Background: 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: 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: 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: Our score could be useful at identifying, among poor surgical candidates, patients more likely to benefit from SEMS.