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

Vu Trung, Kien ; Abou-Ali, Einas ; Gulla, Aiste ; Soares, Kevin ; Caillol, Fabrice ; Paik, Woo H. ; Napoleon, Bertrand ; Halimi, Asif ; Masaryk, Viliam and Bruno, Marco J. , et al. (2025) In Gastrointestinal Endoscopy 102(4). p.602-606
Abstract

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),... (More)

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.

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author collaboration
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Gastrointestinal Endoscopy
volume
102
issue
4
pages
5 pages
publisher
Elsevier
external identifiers
  • scopus:105012834183
  • pmid:40449630
ISSN
0016-5107
DOI
10.1016/j.gie.2025.03.1333
language
English
LU publication?
yes
additional info
Publisher Copyright: © 2025 American Society for Gastrointestinal Endoscopy
id
5e035e60-9eea-4e6c-9104-15a380690a16
date added to LUP
2026-01-27 16:54:42
date last changed
2026-01-28 10:39:01
@article{5e035e60-9eea-4e6c-9104-15a380690a16,
  abstract     = {{<p>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 &lt; .001). The AUROC was 0.792 (training) and 0.708 (validation). Conclusions: The SDLD score predicts R1 in EP and aids in treatment decisions.</p>}},
  author       = {{Vu Trung, Kien and Abou-Ali, Einas and Gulla, Aiste and Soares, Kevin and Caillol, Fabrice and Paik, Woo H. and Napoleon, Bertrand and Halimi, Asif and Masaryk, Viliam and Bruno, Marco J. and Pérez-Cuadrado-Robles, Enrique and Bolm, Louisa and Seyfried, Steffen and Petrone, Maria C. and Yilmaz, Bengisu and Vollmer, Charles and Berger, Arthur and Maggino, Laura and Schemmer, Peter and Wichmann, Dörte and Karam, Elias and Dugic, Ana and Kunovsky, Lumir and Regner, Sara and Gaujoux, Sebastien and Hollenbach, Marcus}},
  issn         = {{0016-5107}},
  language     = {{eng}},
  number       = {{4}},
  pages        = {{602--606}},
  publisher    = {{Elsevier}},
  series       = {{Gastrointestinal Endoscopy}},
  title        = {{Development and validation of the SDLD score : a simplified tool to predict successful endoscopic papillectomy in ampullary lesions}},
  url          = {{http://dx.doi.org/10.1016/j.gie.2025.03.1333}},
  doi          = {{10.1016/j.gie.2025.03.1333}},
  volume       = {{102}},
  year         = {{2025}},
}