预测细胞还原性手术和高温腹腔内化疗后的术后并发症:回顾性队列研究
Lorena Martin-Roman1, Shigeki Kusamura2, Marcello Guaglio2
1Department of Surgery, Colorectal and Peritoneal Oncology Centre, Christie Foundation Trust, Manchester, UK.
BJS open
|August 12, 2025
概括
一个新的诺莫图谱预测了在细胞还原性手术和使用手术前因素的高热性腹腔内化疗后的严重并发症. 这种工具有助于临床决策和患者同意腹膜表面恶性瘤治疗.
科学领域:
- 手术瘤学手术瘤学
- 在瘤学瘤学.
- 医疗信息学 医疗信息学
背景情况:
- 细胞还原性手术 (CRS) 和高热性腹腔内化疗 (HIPEC) 是对腹腔表面恶性瘤的复杂治疗方法.
- 高发病率需要对患者安全和知情同意进行强有力的风险评估.
- 预测工具对于优化患者选择和管理期望至关重要.
研究的目的:
- 开发和验证一个用于预测严重的术后并发症的诺姆图.
- 确定与治疗致病率相关的关键手术前变量.
- 为CRS和HIPEC中风险分层提供临床工具.
主要方法:
- 分析了接受CRS和HIPEC治疗的1039名患者的前性数据.
- 患者被随机分配到导出 (70%) 和验证 (30%) 队列.
- 用二进制物流回归和ROC分析来构建和评估预测名ogram.
主要成果:
- 整体并发症率为37.7%,重新手术率为12.7%.
- 关键预测因素包括年龄,BMI,组织学,瘤位置,白细胞计数和营养指数.
- 诺米图表表现出良好的预测性能,AUC为0.707.
结论:
- 一个经过验证的纳米图,包含了手术前的变量,可以准确预测严重的术后并发症.
- 这种工具可以帮助临床医生做出手术决策,并加强患者咨询.
- 该名图为CRS和HIPEC程序的风险评估提供了一种实用的方法.
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