Nomogram for Predicting Early-Tracheostomy Decannulation in Patients Undergoing Partial Laryngectomy

Area of Science:

• Oncology
• Surgical Oncology
• Laryngology

Background:

• Laryngeal cancer treatment often involves partial laryngectomy, potentially requiring tracheostomy.
• Early tracheostomy decannulation is a crucial indicator of successful laryngeal function recovery.
• Predicting decannulation facilitates optimized patient management and resource allocation.

Purpose of the Study:

• To identify predictive factors for early tracheostomy decannulation after partial laryngectomy for laryngeal cancer.
• To develop and validate a nomogram predicting the probability of decannulation within one month.

Main Methods:

• Retrospective analysis of 141 patients with laryngeal cancer undergoing laryngeal function preservation surgery.
• Multivariate logistic regression to identify independent predictors of early decannulation.
• Validation using Receiver Operating Characteristic (ROC) curves, calibration curves, and decision curve analysis.

Main Results:

• 82 out of 141 patients (58.2%) achieved early decannulation.
• Independent predictors for early decannulation included younger age, non-smoking history, specific surgical modalities, and absence of a drainage tube.
• The developed nomogram demonstrated good discriminative capacity (AUC=0.756) and clinical utility.

Conclusions:

• A nomogram incorporating age, smoking history, surgical modality, and drainage tube status effectively predicts early tracheostomy decannulation.
• This tool can assist clinicians in managing patients undergoing partial laryngectomy for laryngeal cancer.
• The nomogram aids in anticipating decannulation timelines and optimizing postoperative care.