口腔和口咽癌手术中气管切开术必要性的预测列线图。

Predictive Nomogram for the Necessity of Tracheotomy During Oral and Oropharyngeal Cancer Surgery.

机构信息

Department of Head and Neck Surgical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People's Republic of China.

Department of Radiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People's Republic of China.

出版信息

Laryngoscope. 2021 May;131(5):E1489-E1495. doi: 10.1002/lary.29121. Epub 2020 Oct 5.

DOI:10.1002/lary.29121

PMID:33016340

Abstract

OBJECTIVES/HYPOTHESIS: The individualized risk of airway obstruction after head and neck cancer surgery is unclear, especially oral and oropharyngeal cancer. The study aimed to establish an individualized predictive model for the necessity of temporary tracheotomy in these patients.

METHODS

Patients who underwent oral and oropharyngeal cancer surgery from 1999 to 2019 were retrospectively reviewed. A nomogram was developed and validated in patients treated from 1999 to 2009 and 2010 to 2019, respectively.

RESULTS

In total, 1551 patients were included. Oropharyngeal cancer, large tumor, midline crossing, preoperative radiation, mandibulectomy, flap reconstruction, and neck dissection were independent risk factors of postoperative airway obstruction in the training group (n = 707). A nomogram incorporating these factors had a C-index of 0.931 and was validated in the testing group (n = 844) (C-index, 0.918). Good calibration curves were observed in both groups.

CONCLUSIONS

The nomogram successfully predicted the individual risk of postoperative airway obstruction for patients with oral and oropharyngeal cancer.

LEVEL OF EVIDENCE

Laryngoscope, 131:E1489-E1495, 2021.

摘要

目的/假设：头颈部癌症手术后气道阻塞的个体化风险尚不清楚，尤其是口腔和口咽癌。本研究旨在为这些患者建立一个临时气管切开术必要性的个体化预测模型。

方法

回顾性分析了 1999 年至 2019 年间接受口腔和口咽癌手术的患者。分别在 1999 年至 2009 年和 2010 年至 2019 年治疗的患者中开发并验证了一个列线图。

结果

共纳入 1551 例患者。口咽癌、大肿瘤、中线交叉、术前放疗、下颌骨切除术、皮瓣重建和颈部清扫术是训练组（n = 707）术后气道阻塞的独立危险因素。纳入这些因素的列线图在训练组（n = 707）中的 C 指数为 0.931，并在测试组（n = 844）中得到验证（C 指数，0.918）。两组均观察到良好的校准曲线。