Endoscopy 2018; 50(04): S67
DOI: 10.1055/s-0038-1637226
ESGE Days 2018 oral presentations
20.04.2018 – Colon: endoscopic resection session 1
Georg Thieme Verlag KG Stuttgart · New York

PREOPERATIVE PREDICTIVE MODEL FOR EN BLOC COLORECTAL ESD (CR-ESD): A SPANISH PROSPECTIVE MULTICENTRE COHORT STUDY

, Endoscopic Resection Working Group (ESD Interest Group) of the Spanish Society of Digestive Endoscopy
JC Marín-Gabriel
1   ‘12 de Octubre’ University Hospital, Gastroenterology. Endoscopy Unit, Madrid, Spain
2   ‘HM Sanchinarro’ University Hospital, Gastroenterology. Endoscopy Unit, Madrid, Spain
,
F Ramos-Zabala
3   ‘HM Montepríncipe’ University Hospital, Gastroenterology. Endoscopy Unit, Boadilla del Monte, Spain
,
F Múgica-Aguinaga
4   Donostia University Hospital, Gastroenterology. Endoscopy Unit, Donostia, Spain
,
E Albéniz Arbizu
5   Complejo Hospitalario de Navarra, Gastroenterology. Endoscopy Unit, Pamplona, Spain
,
J de la Peña-García
6   ‘Marqués de Valdecilla’ University Hospital, Gastroenterology. Endoscopy Unit, Santander, Spain
,
A Sánchez-Yagüe
7   ‘Costa del Sol’ University Hospital, Gastroenterology. Endoscopy Unit, Marbella, Spain
,
C Dolz-Abadía
8   Hospital Son Llatzer, Gastroenterology. Endoscopy Unit, Palma, Spain
,
G Fernández-Esparrach
9   Hospital Clínic i Provincial de Barcelona, Gastroenterology. Endoscopy Unit, Barcelona, Spain
,
A Álvarez-Delgado
10   Complejo Asistencial Universitario de Salamanca. IBSAL, Gastroenterology. Endoscopy Unit, Salamanca, Spain
,
Á Terán-Lantarón
6   ‘Marqués de Valdecilla’ University Hospital, Gastroenterology. Endoscopy Unit, Santander, Spain
,
H Cortés-Pérez
11   ‘Cruces’ University Hospital, Gastroenterology. Endoscopy Unit, Baracaldo, Spain
,
AJ del Pozo-García
1   ‘12 de Octubre’ University Hospital, Gastroenterology. Endoscopy Unit, Madrid, Spain
,
J Díaz-Tasende
1   ‘12 de Octubre’ University Hospital, Gastroenterology. Endoscopy Unit, Madrid, Spain
2   ‘HM Sanchinarro’ University Hospital, Gastroenterology. Endoscopy Unit, Madrid, Spain
› Author Affiliations
Further Information

Publication History

Publication Date:
27 March 2018 (online)

Also available at
 

Aims:

To assess the preoperative factors that are able to predict en bloc CR-ESD.

Methods:

The demographic and clinical characteristics of the patients and lesions were prospectively collected. Morphological features of the tumors and technical factors were recorded.

Results:

We performed ESD in 209 lesions in 208 patients. The recruitment was done in 11 centres from January 2016 to June 2017. An en bloc resection was achieved in 165 lesions (78.9%). The procedure was aborted in 4 (1.9%). The remaining procedures were finished piecemeal (n = 40; 19.1%). In the multivariate analysis, after adjusting by age and sex, the independent predictors for en bloc resection are shown in the following table:

Tab. 1:

Significant predictive factors. Multivariate.

En bloc (n = 165)

Aborted + Piecemeal (n = 44)

OR (95% CI)

p

Experience > 10 cases

153 (81.8)

34 (18.2)

5.8 (1.9 – 17.7)

0.002

< 10 cases

12 (54.5)

10 (45.5)

One endoscopist Yes

160 (82.5)

34 (17.5)

12.2 (3.4 – 43.9)

< 0.0001

No

5 (33.3)

10 (66.7)

Size < 5 cm Yes

148 (84.6)

27 (15.4)

9.2 (3.5 – 23.9)

< 0.0001

No

17 (50)

17 (50)

Absence of prior diathermy Yes

156 (81.3)

36 (18.8)

5.1 (1.5 – 17.6)

0.001

No

9 (52.9)

8 (47.1)

The value of the area under the ROC curve of the predictive model for en bloc resection [logodds =- 6.05 + 2.22 x (size ≤5 cm) + 1.63 x (absence of prior diathermic injury) + 2.51 x (one endoscopist) + 1.76 x (centre case load > 10)] was 0.81 (95% CI: 0.74 – 0.88).

Conclusions:

A preoperative predictive model combining size, prior attempts of resection and the experience in ESD provided good diagnostic performance to predict a successful en bloc ESD.