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.
Keywords: EUS-guided gastroenterostomy; gastric cancer; gastric outlet obstruction; pancreatic cancer; self-expandable metal stent.