KEY TAKEAWAYS
- The study aimed to identify preoperative predictors of PS in rectal cancer and develop a predictive nomogram.
- Researchers found 6 risk factors for PS and developed a nomogram with an ROC of 0.7758 to aid surgical decision-making.
For patients with rectal cancer, the utilization of temporary ileostomy (TI) has proven effective in minimizing the occurrence of severe complications post-surgery, such as anastomotic leaks; however, some patients are unable to reverse in time or even develop a permanent stoma (PS).
Chenglin Tang and the team aimed to determine the preoperative predictors associated with TS failure and develop and validate appropriate predictive models to improve patients’ quality of life.
They performed an inclusive analysis of 403 patients with rectal cancer who underwent TI between January 2017 and December 2021. Patients were randomly divided into either the developmental group (70%) or the validation group (30%). Independent risk factors for PS were determined using univariate and multivariate logistic regression analyses.
Subsequently, a nomogram was constructed, and the prediction probability was estimated by calculating the area under the curve (AUC) using receiver operating characteristic (ROC) analysis. A calibration plot was used to evaluate the nomogram calibration.
Multivariate logistic regression analysis demonstrated significant associations between the occurrence of PS and various factors in this patient cohort, including tumor location (OR = 6.631, P = 0.005), tumor markers (OR = 2.309, P = 0.035), American Society of Anesthesiologists (ASA) score (OR = 4.784, P = 0.004), T4 stage (OR = 2.880, P = 0.036), lymph node metastasis (OR = 4.566, P = 0.001), and distant metastasis (OR = 4.478, P = 0.036).
Furthermore, a preoperative nomogram was constructed based on these data and subsequently validated in an independent validation group.
The study concluded that 6 independent preoperative risk factors were associated with the development of PS following rectal cancer resection. A validated nomogram was developed, demonstrating an area under the ROC curve of 0.7758, which can assist surgeons in formulating better surgical options, such as colostomy, for patients at high risk of PS.
This study received funding from the Health Appropriate Technology Promotion Project of Chongqing in 2023.
Source: https://pubmed.ncbi.nlm.nih.gov/39039481/
Tang C, He F, Yang F, et al. (2024). “Development and validation of a nomogram for preoperatively predicting permanent stoma after rectal cancer surgery with ileostomy: a retrospective cohort study.” BMC Cancer. 2024 Jul 22;24(1):874. doi: 10.1186/s12885-024-12642-7. PMID: 39039481.
