Bai Mingjian, Wang Shilong, Liang Guowei, Cai Ying, Lu Yiyan, Hou Nianzong, Ma Ruiqing, Xu Hongbin, Zhang Man
Clinical Laboratory Medicine, Peking University Ninth School of Clinical Medicine, Beijing, China.
Clinical Laboratory Medicine, Beijing Shijitan Hospital, Capital Medical University, Beijing, China.
Ann Surg Oncol. 2022 Feb;29(2):885-892. doi: 10.1245/s10434-021-10725-4. Epub 2021 Sep 3.
The completeness of cytoreduction is one of the most important prognostic factors for patients with pseudomyxoma peritonei (PMP). To date, no nomograms have been established to predict incomplete cytoreduction (IC) for patients with PMP. The current study therefore proposed a nomogram to predict individual IC risk for PMP patients.
Between 1 June 2013, and 22 November 2019, 144 consecutive PMP patients who underwent cytoreductive surgery (CRS) combined with hyperthermic intraperitoneal chemotherapy (HIPEC) for the first time in our center were included in a retrospective study. Possible predictors of cytoreducibility were analyzed using logistic regression modeling to predict IC for PMP patients. A nomogram was developed based on the multivariate analysis and further investigated for internal validation.
After CRS, the 144 participants were divided into complete CRS (CCRS) (n = 46) and IC (n = 98) subgroups. Four independent predictors (sex, disease duration, anemia, and carbohydrate antigen 19-9 (CA 199)) were included in the prediction model. Then, a nomogram predicting IC was established based on the aforementioned variables, which demonstrated good predictive accuracy (C-index, 0.837; 95 % confidence interval [CI], 0.764-0.894). The predicted probability was close to the actual observed outcome according to the calibration plot.
The current work led to the development of a nomogram capable of predicting IC for PMP patients who demonstrated good performance. Risk stratification by the established nomogram had ability to optimize individual IC prediction and help physicians to establish meticulous preoperative plans.
肿瘤细胞减灭的彻底性是腹膜假黏液瘤（PMP）患者最重要的预后因素之一。迄今为止，尚未建立用于预测PMP患者不完全肿瘤细胞减灭（IC）的列线图。因此，本研究提出了一种列线图来预测PMP患者的个体IC风险。
2013年6月1日至2019年11月22日，本中心144例首次接受肿瘤细胞减灭术（CRS）联合腹腔热灌注化疗（HIPEC）的连续PMP患者纳入一项回顾性研究。使用逻辑回归模型分析肿瘤细胞可减灭性的可能预测因素，以预测PMP患者的IC。基于多变量分析开发了一种列线图，并进一步进行内部验证。
CRS后，144名参与者被分为完全CRS（CCRS）（n = 46）和IC（n = 98）亚组。预测模型纳入了四个独立预测因素（性别、病程、贫血和糖类抗原19-9（CA 199））。然后，基于上述变量建立了预测IC的列线图，其显示出良好的预测准确性（C指数，0.837；95%置信区间[CI]，0.764 - 0.894）。根据校准图，预测概率接近实际观察结果。
目前的工作促成了一种能够预测PMP患者IC的列线图的开发，该列线图表现良好。通过建立的列线图进行风险分层能够优化个体IC预测，并帮助医生制定细致的术前计划。
