Related Experiment Video
Updated: Aug 6, 2026
Competing-Risk Nomogram for Predicting Cancer-Specific Survival in Multiple Primary Colorectal Cancer Patients after Surgery
Published on: September 27, 2024
Pre-operative Nutritional Risk Screening 2002-based nomograms for predicting post-operative complications after
Ran Chu1, Wenna Hu2, Dehui Zhang2
1Shandong Provincial Hospital Affiliated to Shandong First Medical University, Department of Obstetrics and Gynecology, Jinan, China; Shandong First Medical University, Shandong Key Laboratory of Reproductive Research and Birth Defect Prevention, Jinan, China; Shandong Provincial Hospital Affiliated to Shandong First Medical University, Shandong Provincial Health Commission Key Laboratory of Prevention and Treatment for Major Gynecological Diseases, Jinan, China; Shandong Provincial Hospital Affiliated to Shandong First Medical University, Gynecology Laboratory, Jinan, China.
Objective:
Malnutrition is common in ovarian cancer and may increase post-operative morbidity, yet standardized nutritional screening tools are rarely used in perioperative risk prediction models. This study aimed to develop and validate nomograms for predicting clinically significant perioperative complications after cytoreductive surgery for ovarian cancer, incorporating Nutritional Risk Screening 2002 as a key predictor.
Methods:
This multi-center retrospective cohort study included patients with ovarian cancer undergoing cytoreductive surgery at 3 tertiary hospitals between January 2021 and December 2024. The primary outcome was Clavien-Dindo grade ≥II complications during hospitalization. Two logistic regression-based nomograms were developed: a pre-operative model (model 1) and a perioperative model with intra-operative variables (model 2). Performance was evaluated by area under the receiver operating characteristic curve, calibration, decision curve analysis, net re-classification improvement, and integrated discrimination improvement.
Results:
A total of 867 patients were assigned to a development cohort (n = 607) and a validation cohort (n = 260). The overall incidence of Clavien-Dindo grade ≥II complications was 18.0% (156/867). Model 1 achieved area under the receiver operating characteristic curves of 0.675 and 0.665 in the development and validation cohorts, respectively, while model 2 achieved area under the receiver operating characteristic curves of 0.694 and 0.692. Both models showed acceptable calibration and potential clinical utility. Compared with model 1, model 2 improved risk re-classification, with significant net re-classification improvement and integrated discrimination improvement in the development cohort and significant integrated discrimination improvement in the validation cohort.
Conclusions:
Nomograms incorporating Nutritional Risk Screening 2002 may support preliminary risk stratification for clinically significant perioperative complications after cytoreductive surgery for ovarian cancer. Further external validation and prospective evaluation are warranted.
