Evidence map›Paper›PMID 36157368›Full record

ArticleWorld journal of gastrointestinal surgery2022

Nomogram to predict permanent stoma in rectal cancer patients after sphincter-saving surgery.

Chih-Yu Kuo, Po-Li Wei, Chia-Che Chen, Yen-Kuang Lin, Li-Jen Kuo

Abstract read
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Article in World journal of gastrointestinal surgery, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

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1citing papers in PubMed
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1 · What the graph read from it

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3 · Its place in the literature

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1 citing paper in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

5 authors.

Chih-Yu KuoDepartment of Surgery, Taipei Medical University Hospital, Taipei 11031, Taiwan.
Po-Li WeiDivision of Colorectal Surgery, Department of Surgery, Taipei Medical University Hospital, Taipei 11031, Taiwan.
Chia-Che ChenDivision of Colorectal Surgery, Department of Surgery, Taipei Medical University Hospital, Taipei 11031, Taiwan.
Yen-Kuang LinGraduate Institute of Athletics and Coaching Science, National Taiwan Sport University, Taoyuan 33301, Taiwan.
Li-Jen KuoDivision of Colorectal Surgery, Department of Surgery, Taipei Medical University Hospital, Taipei 11031, Taiwan.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundApproximately 20 percent of patients with a tumour localized in the low rectum still encounter the possibility of requiring permanent stoma (PS), which can cause drastic changes in lifestyle and physical perceptions.

aimTo determine the risk factors for PS and to develop a prediction model to predict the probability of PS in rectal cancer patients after sphincter-saving surgery.

methodsA retrospective cohort of 421 rectal cancer patients who underwent radical surgery at Taipei Medical University Hospital between January 2012 and December 2020 was included in this study. Univariate and multivariate analyses were performed to identify the independent risk factors for PS. A nomogram was developed according to the independent risk factors obtained in the multivariate analysis. The performance of the nomogram was assessed using a receiver operating characteristic curve and a calibration curve.

resultsThe PS rate after sphincter-saving surgery was 15.1% (59/391) in our study after a median follow-up of 47.3 mo (range 7-114 mo). Multivariate logistic regression analysis demonstrated that local recurrence, perirectal abscess, anastomosis site stenosis, perineural invasion, tumor size and operative time were independent risk factors for PS. These identified risk factors were incorporated into the nomogram, and the concordance index of this model was 0.903 (95%CI: 0.851-0.955). According to the calibration curves, the nomogram represents a perfect prediction model.

conclusionSeveral risk factors for PS after sphincter-saving surgery were identified. Our nomogram exhibited perfect predictive ability and will improve a physician's ability to communicate the benefits and risks of various treatment options in shared decision making.

Indexed as

NomogramPermanent stomaRectal cancerRisk factorShared decision makingSphincter-saving operation

Identifiers

PMID36157368
PMCPMC9453330

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