A scoring system to support surgical decision-making for cardial submucosal tumors

Abstract: Background and study aims Submucosal tunneling endoscopic resection (STER) and non-tunneling techniques are two alternative options for the treatment of cardial submucosal tumors (SMTs). We aimed to establish a regression model and develop a simple scoring system (Zhongshan Tunnel Score) to help clinicians make surgical decisions for cardial submucosal tumors. Patients and methods A total of 246 patients who suffered cardial SMTs and received endoscopic resection were included in this study. All of them were randomized into either the training cohort (n = 147) or the internal validation cohort (n = 99). Then, the scoring system was proposed based on multivariate logistic regression analysis in the training cohort and assessed in the validation cohort. Results Of 246 patients, 97 were treated with STER and the others with non-tunneling endoscopic resection. In the training stage, four factors were weighted with points based on the β coefficient from the regression model, including irregular morphology (–2 points), ulcer (2 points), the direction of the gastroscope (–2 points for forward direction and 1 point for reverse direction), and originating from the muscularis propria (–2 points). The patients were categorized into low-score ( –3) groups, and those with low scores were more likely to be treated with STER. Our score model performed satisfying discriminatory power in internal validation (Area under the receiver-operator characteristic curve, 0.829; 95 % confidence interval, 0.694–0.964) and goodness-of-fit in the Hosmer-Lemeshow test (P = .4721). Conclusions This scoring system could provide clinicians the references for making decisions about the treatment of cardial submucosal tumors.

Standort
Deutsche Nationalbibliothek Frankfurt am Main
Umfang
Online-Ressource
Sprache
Englisch

Erschienen in
A scoring system to support surgical decision-making for cardial submucosal tumors ; volume:10 ; number:04 ; year:2022 ; pages:E468-E478
Endoscopy International Open ; 10, Heft 04 (2022), E468-E478

Beteiligte Personen und Organisationen
Geng, Zi-Han
Zhu, Yan
Chen, Wei-Feng
Chen, Shi-Yao
Zhong, Yun-Shi
Zhang, Yi-Qun
Ma, Li-Li
Qin, Wen-Zheng
Hu, Jian-Wei
Cai, Ming-Yan
Yao, Li-Qing
Li, Quan-Lin
Zhou, Ping-Hong

DOI
10.1055/a-1775-7976
URN
urn:nbn:de:101:1-2022071411122991381956
Rechteinformation
Open Access; Der Zugriff auf das Objekt ist unbeschränkt möglich.
Letzte Aktualisierung
15.08.2025, 07:24 MESZ

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Beteiligte

  • Geng, Zi-Han
  • Zhu, Yan
  • Chen, Wei-Feng
  • Chen, Shi-Yao
  • Zhong, Yun-Shi
  • Zhang, Yi-Qun
  • Ma, Li-Li
  • Qin, Wen-Zheng
  • Hu, Jian-Wei
  • Cai, Ming-Yan
  • Yao, Li-Qing
  • Li, Quan-Lin
  • Zhou, Ping-Hong

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