Development and validation of a nomogram to predict the risk factors of major complications after radical rectal cancer surgery

作者全名："Lv, Quan; Yuan, Ye; Qu, Shu-Pei; Diao, Yu-Hang; Hai, Zhan-Xiang; Xiang, Zheng; Peng, Dong"

作者地址："[Lv, Quan; Yuan, Ye; Qu, Shu-Pei; Diao, Yu-Hang; Hai, Zhan-Xiang; Xiang, Zheng; Peng, Dong] Chongqing Med Univ, Affiliated Hosp 1, Dept Gastrointestinal Surg, Chongqing, Peoples R China"

通信作者："Peng, D (通讯作者)，Chongqing Med Univ, Affiliated Hosp 1, Dept Gastrointestinal Surg, Chongqing, Peoples R China."

来源：FRONTIERS IN ONCOLOGY

ESI学科分类：CLINICAL MEDICINE

WOS号：WOS:001196264400001

JCR分区：Q2

影响因子：3.5

年份：2024

卷号：14

期号：　

开始页：　

结束页：　

文献类型：Article

关键词：rectal cancer; surgery; complications; nomogram; risk factors

摘要："Purpose The aim of this study was to establish a validated nomogram to predict risk factors for major post-operative complications in patients with rectal cancer (RC) by analyzing the factors contributing to major post-operative complications in RC patients. Methods We retrospectively collected baseline and surgical information on patients who underwent RC surgery between December 2012 and December 2022 at a single-center teaching hospital. The entire cohort was randomly divided into two subsets (60% of the data for development, 40% for validation). Independent risk factors for major post-operative complications were identified using multivariate logistic regression analyses, and predictive models were developed. Area under the curve (AUC) was calculated using receiver operating characteristic curve (ROC) to assess predictive probability, calibration curves were plotted to compare the predicted probability of the nomogram with the actual probability, and the clinical efficacy of the nomogram was assessed using decision curve analysis (DCA). Results Our study included 3151 patients who underwent radical surgery for RC, including 1892 in the development set and 1259 in the validation set. Forty (2.1%) patients in the development set and 26 (2.1%) patients in the validation set experienced major post-operative complications. Through multivariate logistic regression analysis, age (p<0.01, OR=1.044, 95% CI=1.016-1.074), pre-operative albumin (p<0.01, OR=0.913, 95% CI=0.866-0.964), and open surgery (p<0.01, OR=2.461, 95% CI=1.284-4.761) were identified as independent risk factors for major post-operative complications in RC, and a nomogram prediction model was established. The AUC of the ROC plot for the development set was 0.7161 (95% Cl=0.6397-0.7924), and the AUC of the ROC plot for the validation set was 0.7191 (95% CI=0.6182-0.8199). The predicted probabilities in the calibration curves were highly consistent with the actual probabilities, which indicated that the prediction model had good predictive ability. The DCA also confirmed the good clinical performance of the nomogram. Conclusion In this study, a validated nomogram containing three predictors was created to identify risk factors for major complications after radical RC surgery. Due to its accuracy and convenience, it could contribute to personalized management of patients in the perioperative period."

基金机构：CQMU Program for Youth Innovation in Future Medicine [W0190]

基金资助正文："The author(s) declare financial support was received for the research, authorship, and/or publication of this article. This study is supported by CQMU Program for Youth Innovation in Future Medicine (W0190)."