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.
Declaration of interests
The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.
Reviewer disclosures
Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.
Author contributions
Study concept and design: MC Conti Bellocchi, A Facciorusso and SF Crinò designed the study, worked on the acquisition of data, conducted the statistical analysis, and drafted the manuscript. M Fioravante, EM Gabrieletto, L Bernardoni and S di Stefano collected data. P Gkolfakis, A Ofosu and A Gabbrielli critically revised the final manuscript. All the authors approved the final version of the manuscript and agreed to be accountable for all aspects of the work.