Validation of a novel BCM model for recurrence risk prediction after mucosectomy of colorectal lateral spreading tumors in a European cohort - 17/07/24
, Ana Catarina Garcia, Gonçalo Alexandrino, Ana Maria Oliveira, David Horta, Luís Carvalho Lourenço, Mariana Nuno CostaHighlights |
• | The compromise between complete resection and the absence of complications represents a challenge during ER of large colorectal LST. |
• | BCM model showed to be an independent predictor for both ER and LR in a European cohort. |
• | SERT score presented a good performance in predicting mainly ER with different cut-off from those used in the original study. |
• | Ablation margin therapy, snare tip soft coagulation or argon plasma coagulation, may minimize the recurrence risk following ER of large LST. |
Abstract |
Background and aim |
Piecemeal endoscopic mucosal resection (pEMR) is the best approach to resect large lateral spreading tumors (LST, > 20 mm width). However, it is associated with early recurrence (ER) and late recurrence (LR). This study aims to assess the risk factors associated with ER and LR and to validate different predictive scores (SMSA, SERT, and BCM) in identifying the risk of ER and LR after LST resected by pEMR in a European cohort.
Methods |
Retrospective observational cohort study, based on a prospectively collected database, of large LST submitted to pEMR.
Results |
A total of 108 patients were included in the study and the incidence rates of ER and LR were 22 % and 8 %, respectively. The lesion's size, SERT, and BCM scores were independent predictor factors of ER (p-value < 0.05), while the lesion's site and BCM score were independent predictor factors of LR (p-value < 0.05). For the prediction of ER, the SERT score (cut-off > 1) presented the highest AUROC (0.758 vs 0.697 from BCM and 0.647 from SMSA). Regarding LR, the BCM model (cut-off > 2) presented the highest AUROC (0.817 vs 0.708 from SERT and 0.691 from SMSA).
Conclusions |
We present the first external validation of the three scores mentioned in an European cohort. SERT and BCM scores had an acceptable performance in predicting ER and LR. However, the BCM model was the only score that proved to be an independent predictor of both ER and LR, proving to be valuable for both applications.
Le texte complet de cet article est disponible en PDF.Keywords : Large lateral spreading tumors, Piecemeal endoscopic mucosal resection, Early recurrence, Late recurrence, BCM model, SERT score, SMSA score
Plan
Vol 48 - N° 7
Article 102414- août 2024 Retour au numéro
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