Shall we score? The SHALL-WE score for optimizing sclerotherapy in superficial lymphatic malformations.

IF 1.8 3区医学 Q2 PEDIATRICS

Pediatric Surgery International Pub Date : 2026-09-17 DOI:10.1007/s00383-026-06631-z

Hiromasa Takei, Mototoshi Kato, Satoko Yamagishi, Yohei Yamada, Motohiro Kano, Yoshiaki Kinoshita, Michio Ozeki, Shunsuke Nosaka, Takeshi Hirabayashi, Naonori Kawakubo, Tomoro Hishiki, Keita Terui, Tomoaki Taguchi, Shigeru Ueno, Akihiro Fujino

{"title":"Shall we score? The SHALL-WE score for optimizing sclerotherapy in superficial lymphatic malformations.","authors":"Hiromasa Takei, Mototoshi Kato, Satoko Yamagishi, Yohei Yamada, Motohiro Kano, Yoshiaki Kinoshita, Michio Ozeki, Shunsuke Nosaka, Takeshi Hirabayashi, Naonori Kawakubo, Tomoro Hishiki, Keita Terui, Tomoaki Taguchi, Shigeru Ueno, Akihiro Fujino","doi":"10.1007/s00383-026-06631-z","DOIUrl":null,"url":null,"abstract":"Purpose: No standardized tool guides the decision of when to escalate beyond sclerotherapy in lymphatic malformations (LMs). We developed the SHALL-WE score (Severity, Histology, And Location-Lymphatic malformation: When to Escalate) to define the optimal sclerotherapy threshold in superficial LMs.Methods: We analyzed 709 patients with superficial LMs from a nationwide survey in Japan. Multivariable logistic regression identified predictors of treatment success, used to construct the SHALL-WE score (0-3 points): head and neck location, non-cystic histology, and severe disease (1 point each). The optimal threshold was the session count beyond which success rates fell below the overall mean (63.0%).Results: Treatment success rates decreased with increasing score (score 0: 71.6%, 1: 64.1%, 2: 43.6%, 3: 20.0%; p < 0.001). Optimal thresholds were two sessions for score 0, one for score 1, and early escalation for scores 2-3. Patients managed within thresholds had higher success rates (71.9% vs. 51.2%; adjusted OR 1.921, 95% CI 1.340-2.753, p < 0.001).Conclusion: The SHALL-WE score defines when sclerotherapy is unlikely to succeed and treatment escalation should be considered. Prospective external validation is warranted.","PeriodicalId":19832,"journal":{"name":"Pediatric Surgery International","volume":"42 1","pages":""},"PeriodicalIF":1.8000,"publicationDate":"2026-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13585900/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Pediatric Surgery International","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s00383-026-06631-z","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"PEDIATRICS","Score":null,"Total":0}

引用次数: 0

Abstract

Purpose: No standardized tool guides the decision of when to escalate beyond sclerotherapy in lymphatic malformations (LMs). We developed the SHALL-WE score (Severity, Histology, And Location-Lymphatic malformation: When to Escalate) to define the optimal sclerotherapy threshold in superficial LMs.

Methods: We analyzed 709 patients with superficial LMs from a nationwide survey in Japan. Multivariable logistic regression identified predictors of treatment success, used to construct the SHALL-WE score (0-3 points): head and neck location, non-cystic histology, and severe disease (1 point each). The optimal threshold was the session count beyond which success rates fell below the overall mean (63.0%).

Results: Treatment success rates decreased with increasing score (score 0: 71.6%, 1: 64.1%, 2: 43.6%, 3: 20.0%; p < 0.001). Optimal thresholds were two sessions for score 0, one for score 1, and early escalation for scores 2-3. Patients managed within thresholds had higher success rates (71.9% vs. 51.2%; adjusted OR 1.921, 95% CI 1.340-2.753, p < 0.001).

Conclusion: The SHALL-WE score defines when sclerotherapy is unlikely to succeed and treatment escalation should be considered. Prospective external validation is warranted.

查看原文本刊更多论文

我们得分好吗？优化浅表淋巴畸形硬化治疗的SHALL-WE评分。

目的：没有标准化的工具来指导淋巴畸形（LMs）的硬化治疗何时升级。我们开发了SHALL-WE评分（严重程度、组织学和位置-淋巴畸形：何时升级）来定义浅表LMs的最佳硬化治疗阈值。方法：我们分析了709例来自日本全国范围内的浅表LMs患者。多变量逻辑回归确定了治疗成功的预测因素，用于构建SHALL-WE评分（0-3分）：头颈部位置、非囊性组织学和严重疾病（各1分）。最佳阈值是会话数，超过该值成功率低于总体平均值（63.0%）。结果：治疗成功率随评分的增加而下降（评分0:71.6%,1:64.1%,2:43.6%,3:20.0%）。结论：SHALL-WE评分定义了硬化治疗不太可能成功的情况，应考虑增加治疗。前瞻性的外部验证是必要的。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Pediatric Surgery International 医学-外科

CiteScore

3.00

自引率

5.60%

发文量

215

审稿时长

3-6 weeks

期刊介绍： Pediatric Surgery International is a journal devoted to the publication of new and important information from the entire spectrum of pediatric surgery. The major purpose of the journal is to promote postgraduate training and further education in the surgery of infants and children. The contents will include articles in clinical and experimental surgery, as well as related fields. One section of each issue is devoted to a special topic, with invited contributions from recognized authorities. Other sections will include: -Review articles- Original articles- Technical innovations- Letters to the editor