Delli Carpini Giovanni, Sopracordevole Francesco, Cicoli Camilla, Bernardi Marco, Giuliani Lucia, Fichera Mariasole, Clemente Nicolò, Del Fabro Anna, Di Giuseppe Jacopo, Giannella Luca, Busato Enrico, Ciavattini Andrea
Gynecologic Section, Department of Odontostomatologic and Specialized Clinical Sciences, Università Politecnica delle Marche, 60131 Ancona, Italy.
Gynecological Oncology Unit, IRCCS CRO, Centro di Riferimento Oncologico, National Cancer Institute, 33081 Aviano, Italy.
Curr Oncol. 2024 Dec 31;32(1):21. doi: 10.3390/curroncol32010021.
Surgery is the cornerstone of vulvar cancer treatment, but it is associated with a significant risk of complications that may impact prognosis, particularly in older patients with multiple comorbidities. The objective of this study was to evaluate the role of age, comorbidities, and frailty in predicting postoperative complications after vulvar cancer surgery and to develop a predictive nomogram. A retrospective cohort study was conducted, including patients who underwent surgery for vulvar cancer at two Italian institutions from January 2018 to December 2023. A logistic regression model for the rate of Clavien-Dindo 2+ 30-days complications was run, considering the age-adjusted Charlson Comorbidity Index (AACCI), body mass index (BMI), and frailty as exposures. Lesion characteristics and surgical procedures were considered as confounders. Among the 225 included patients, 50 (22.2%) had a grade 2+ complication. The predictive score of the nomogram ranged from 44 to 140. The AACCI (0-64 points) and BMI (0-100 points) were independently associated with a risk of complications. A nomogram including the AACCI and BMI predicts the risk of complications for patients undergoing surgery for vulvar cancer. The preoperative determination of the risk of complications enables surgical planning and allows a tailored peri- and postoperative management plan.
手术是外阴癌治疗的基石，但它与可能影响预后的严重并发症风险相关，尤其是在患有多种合并症的老年患者中。本研究的目的是评估年龄、合并症和虚弱在预测外阴癌手术后并发症中的作用，并开发一种预测列线图。进行了一项回顾性队列研究，纳入了2018年1月至2023年12月在两家意大利机构接受外阴癌手术的患者。以年龄调整的Charlson合并症指数（AACCI）、体重指数（BMI）和虚弱作为暴露因素，对Clavien-Dindo 2+ 30天并发症发生率进行逻辑回归模型分析。病变特征和手术操作被视为混杂因素。在纳入的225例患者中，50例（22.2%）发生了2级以上并发症。列线图的预测分数范围为44至140。AACCI（0 - 64分）和BMI（0 - 100分）与并发症风险独立相关。包含AACCI和BMI的列线图可预测接受外阴癌手术患者的并发症风险。术前确定并发症风险有助于手术规划，并允许制定个性化的围手术期和术后管理计划。
