Hao Yan, Liang Zhengyun, Liu Hao, Shan Mengjie, Xia Yijun, Song Kexin, Wang Youbin
Peking Union Medical College, Chinese Academy of Medical Sciences, Peking Union Medical College Hospital, Beijing, China.
Department of Plastic Surgery, Peking Union Medical College Hospital, No.41 Damucang Hutong, Xicheng District, Beijing, China.
Aesthetic Plast Surg. 2023 Apr;47(2):872-879. doi: 10.1007/s00266-022-03187-w. Epub 2022 Nov 21.
Patients with chest keloids undergoing surgery and adjuvant radiotherapy still have a high recurrence rate, which is a critical problem. The level of keloid activity has not been studied, and a nomogram model for predicting keloid recurrence has not been established in previous studies.
A total of 145 patients with chest keloids who underwent surgery and radiotherapy between January 2015 and January 2019 at Peking Union Medical College Hospital were included in our study. Demographic and clinical features and the score of KAAS were analyzed. We compared the area under the curve (AUC) and decision curve analysis (DCA) between KAAS and the Vancouver scar scale (VSS) and established a nomogram model for predicting the risk of recurrence. We used bootstrap and calibration plots to evaluate the performance of the nomogram.
The KAAS can predict recurrence in patients with chest keloids after surgery and radiotherapy. Areas under the curve (AUCs) of KAAS and VSS were 0.858 and 0.711, respectively (p < 0.001). Decision curve analysis (DCA) demonstrated that the KAAS was better than the VSS. Complications after treatment may be risk factors for keloid recurrence. We created a nomogram by using complications and KAAS. The AUC was 0.871 (95% CI 0.812-0.930). The ROC of the model's bootstrap was 0.865 and was well calibrated.
The KAAS can be used to predict the recurrence and we developed a nomogram for predicting the recurrence of chest keloids after surgery and adjuvant radiotherapy.
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接受手术及辅助放疗的胸部瘢痕疙瘩患者复发率仍较高，这是一个关键问题。此前研究尚未对瘢痕疙瘩的活动水平进行研究，也未建立预测瘢痕疙瘩复发的列线图模型。
纳入2015年1月至2019年1月在北京协和医院接受手术及放疗的145例胸部瘢痕疙瘩患者。分析其人口统计学和临床特征以及瘢痕疙瘩活动度评估量表（KAAS）评分。我们比较了KAAS与温哥华瘢痕量表（VSS）的曲线下面积（AUC）及决策曲线分析（DCA），并建立了预测复发风险的列线图模型。我们使用自助法和校准图评估列线图的性能。
KAAS可预测胸部瘢痕疙瘩患者手术及放疗后的复发情况。KAAS和VSS的曲线下面积（AUC）分别为0.858和0.711（p<0.001）。决策曲线分析（DCA）表明KAAS优于VSS。治疗后的并发症可能是瘢痕疙瘩复发的危险因素。我们利用并发症和KAAS创建了一个列线图。AUC为0.871（95%CI 0.812 - 0.930）。该模型自助法的ROC为0.865，且校准良好。
KAAS可用于预测复发情况，我们开发了一个列线图来预测胸部瘢痕疙瘩手术及辅助放疗后的复发情况。
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