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一种预测胃癌全胃切除术后早期并发症的新型列线图。

A Novel Nomogram for Prediction of Early Postoperative Complications of Total Gastrectomy for Gastric Cancer.

作者信息

Zhang Jiawen, Jiang Linhua, Zhu Xinguo

机构信息

Department of General Surgery, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, People's Republic of China.

出版信息

Cancer Manag Res. 2021 Oct 2;13:7579-7591. doi: 10.2147/CMAR.S333172. eCollection 2021.

Abstract

BACKGROUND

Accurate prediction of postoperative complications is especially important for the formulation of treatment plans for patients with total gastrectomy (TG) for gastric cancer (GC). The purpose of this study was to establish a risk assessment model for early postoperative complications.

METHODS

This retrospective study involved 363 patients with GC who underwent TG from January 2019 to December 2020. The influencing factors were explored by univariate and multivariable logistic regression; then, a nomogram was established and verified by internal verification.

RESULTS

Linear stapler (OR=2.501, P=0.030), age (OR=1.052, P =0.024), blood transfusion (yes) (OR=2.450, P =0.021), one-time consumables for surgery (or=1.000, P =0.022), number of total lymph nodes (OR=1.060, P =0.011) and number of positive lymph nodes (OR=1.054, P =0.029) were independent risk factors for early postoperative complications in TG, and nomogram model was constructed. The C-index of primary cohort, modeling cohort and validation cohort was 0.787, 0.754 and 0.912. The calibration curves showed good accuracy.

CONCLUSION

This study used the indicators available before and during surgery to establish a nomogram model for early postoperative complications of total gastrectomy for gastric cancer, which found that linear stapler (LS), blood transfusion, one-time consumables for surgery, number of total lymph nodes and number of positive lymph nodes were factors.

摘要

背景

准确预测术后并发症对于制定胃癌全胃切除术(TG)患者的治疗方案尤为重要。本研究的目的是建立早期术后并发症的风险评估模型。

方法

这项回顾性研究纳入了2019年1月至2020年12月期间接受TG的363例胃癌患者。通过单因素和多因素逻辑回归探索影响因素;然后,建立列线图并通过内部验证进行验证。

结果

直线切割吻合器(OR=2.501,P=0.030)、年龄(OR=1.052,P=0.024)、输血(是)(OR=2.450,P=0.021)、手术一次性耗材(OR=1.000,P=0.022)、总淋巴结数(OR=1.060,P=0.011)和阳性淋巴结数(OR=1.054,P=0.029)是TG术后早期并发症的独立危险因素,并构建了列线图模型。初级队列、建模队列和验证队列的C指数分别为0.787、0.754和0.912。校准曲线显示出良好的准确性。

结论

本研究利用手术前和手术期间可用的指标建立了胃癌全胃切除术后早期并发症的列线图模型,发现直线切割吻合器、输血、手术一次性耗材、总淋巴结数和阳性淋巴结数是相关因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/37a3/8495149/08e1743bdf7f/CMAR-13-7579-g0001.jpg

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