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Development and validation of the SDLD score: a simplified tool to predict successful endoscopic papillectomy in ampullary lesions :focused communication

Background and Aims - Endoscopic papillectomy (EP) is the standard treatment for noninvasive ampullary lesions (ALs), whereas advanced cases require surgery. Managing ALs is challenging and may lead to over- or undertreatment. We developed a score to identify the best candidates for endoscopic or su...

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Hauptverfasser: Vu Trung, Kien (VerfasserIn) , Abou-Ali, Einas (VerfasserIn) , Gulla, Aiste (VerfasserIn) , Soares, Kevin (VerfasserIn) , Caillol, Fabrice (VerfasserIn) , Paik, Woo H. (VerfasserIn) , Napoleon, Bertrand (VerfasserIn) , Halimi, Asif (VerfasserIn) , Masaryk, Viliam (VerfasserIn) , Bruno, Marco J. (VerfasserIn) , Pérez-Cuadrado-Robles, Enrique (VerfasserIn) , Bolm, Louisa (VerfasserIn) , Seyfried, Steffen (VerfasserIn) , Petrone, Maria C. (VerfasserIn) , Heise, Christian (VerfasserIn) , Auriemma, Francesco (VerfasserIn) , Rosendahl, Jonas (VerfasserIn)
Dokumenttyp: Article (Journal)
Sprache:Englisch
Veröffentlicht: October 2025
In: Gastrointestinal endoscopy
Year: 2025, Jahrgang: 102, Heft: 4, Pages: 602-606
ISSN:1097-6779
DOI:10.1016/j.gie.2025.03.1333
Online-Zugang:Verlag, lizenzpflichtig, Volltext: https://doi.org/10.1016/j.gie.2025.03.1333
Verlag, lizenzpflichtig, Volltext: https://www.sciencedirect.com/science/article/pii/S0016510725015111
Volltext
Verfasserangaben:Kien Vu Trung, MD, Einas Abou-Ali, MD, Aiste Gulla, Prof, Kevin Soares, MD, Fabrice Caillol, Prof, Woo H. Paik, Prof, Bertrand Napoleon, MD, Asif Halimi, MD, PhD, Viliam Masaryk, MD, Marco J. Bruno, Prof, Enrique Pérez-Cuadrado-Robles, Prof, Louisa Bolm, MD, Steffen Seyfried, MD, PhD, Maria C. Petrone, Prof, Bengisu Yilmaz, MD, Charles Vollmer, MD, Arthur Berger, MD, PhD, Laura Maggino, MD, Peter Schemmer, Prof, Dörte Wichmann, MD, PhD, Elias Karam, MD, Ana Dugic, MD, Lumir Kunovsky, Prof, Sara Regner, Prof, Sebastien Gaujoux, Prof, Marcus Hollenbach, MD, PhD, for the ESAP Study Group
Beschreibung
Zusammenfassung:Background and Aims - Endoscopic papillectomy (EP) is the standard treatment for noninvasive ampullary lesions (ALs), whereas advanced cases require surgery. Managing ALs is challenging and may lead to over- or undertreatment. We developed a score to identify the best candidates for endoscopic or surgical treatment. - Methods - We analyzed 447 patients who underwent EP. The cohort was randomly split into a training set (n = 325) and validation set (n = 122). Logistic regression identified predictors for incomplete resection (R1), which were incorporated into a 4-item score. Performance was assessed using the area under the receiver-operating characteristic curve (AUROC). - Results - Independent predictors for R1 included size ≥30 mm (S), high-grade dysplasia and/or invasive cancer (D), laterally spreading-lesion (L), and bile or pancreatic duct dilation (D), which we named the SDLD score. ALs with 0 to 1 points had the highest complete resection rates (training, 86.0%; validation, 88.5%), whereas ≥2 points significantly increased R1 rates (training, 52.0%; validation, 57.7%; P < .001). The AUROC was 0.792 (training) and 0.708 (validation). - Conclusions - The SDLD score predicts R1 in EP and aids in treatment decisions.
Beschreibung:Online verfügbar: 29. Mai 2025, Artikelversion: 22. September 2025
Gesehen am 18.12.2025
Mitglieder der ESAP Group: Christian Heise, MD, Francesco Auriemma, MD, Galen Leung, MD, Mark A. Schattner, MD, William R. Jarnagin, MD, Tiegong Wang, MD, Marc Giovannini, MD, Jean Philippe Ratone, MD, Alessandro Zerbi, MD, Gennaro Nappo, MD, Urban Arnelo, MD, Erik Haraldsson, MD, Alexander Waldthaler, MD, Uwe Will, MD, Rita Saadeh, MD, Sophia E. van der Wiel, [und viele weitere...]
Beschreibung:Online Resource
ISSN:1097-6779
DOI:10.1016/j.gie.2025.03.1333

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