Department of Surgery, Division of Gastrointestinal Surgery, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 271, Cheonbo-ro, Uijeongbu-si, Gyeonggi-do, 11765, Republic of Korea.
Department of Surgery, Division of Gastrointestinal Surgery, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, 93, Jungbu-daero, Paldal-gu, Suwon-si, Gyeonggi-do, 16247, Republic of Korea.
BMC Cancer. 2023 Jun 23;23(1):580. doi: 10.1186/s12885-023-11050-7.
Weight changes after gastrectomy affect not only quality of life but also prognosis and survival. However, it remains challenging to predict the weight changes of individual patients. Using clinicopathological variables, we built a user-friendly tool to predict weight change after curative gastrectomy for gastric cancer.
The clinical data of 984 patients who underwent curative gastrectomy between 2009 and 2013 were retrospectively reviewed and analyzed. Multivariate logistic regression was performed to identify variables predictive of postoperative weight change. A nomogram was developed and verified via bootstrap resampling.
Age, sex, performance status, body mass index, extent of resection, pathological stage, and postoperative weight change significantly influenced postoperative weight recovery. Postoperative levels of hemoglobin, albumin, ferritin and total iron-binding capacity were significant covariates. The nomogram performed well (concordance index = 0.637); calibration curves indicated appropriate levels of agreement. We developed an online weight prediction calculator based on the nomogram ( http://gc-weightchange.com/en/front/ ).
The novel, Web-calculator based on the predictive model allows surgeons to explore patient weight patterns quickly. The model identifies patients at high risk for weight loss after gastrectomy; such patients require multidisciplinary medical support.
胃切除术后的体重变化不仅影响生活质量,还影响预后和生存。然而,预测个体患者的体重变化仍然具有挑战性。我们使用临床病理变量构建了一个易于使用的工具,以预测胃癌根治性胃切除术后的体重变化。
回顾性分析了 2009 年至 2013 年间接受根治性胃切除术的 984 例患者的临床资料。采用多变量逻辑回归分析确定术后体重变化的预测变量。通过自举重采样开发并验证了列线图。
年龄、性别、身体状况、体重指数、切除范围、病理分期和术后体重变化明显影响术后体重恢复。术后血红蛋白、白蛋白、铁蛋白和总铁结合力水平是显著的协变量。该列线图表现良好(一致性指数=0.637);校准曲线表明存在适当的一致性水平。我们基于列线图开发了一个在线体重预测计算器(http://gc-weightchange.com/en/front/)。
基于预测模型的新型网络计算器允许外科医生快速探索患者的体重模式。该模型确定了胃切除术后体重减轻风险较高的患者;这些患者需要多学科的医疗支持。