Current status and predictive model construction of postoperative complications in patients with retroperitoneal tumor_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

ZHANG Xiaolu ¹ , LIU Xiaoyan ¹ , HUANG Jing ¹ , ZHANG Lin ¹ ,  ZHAO Jichun ²

1. Department of Vascular Surgery, West China Hospital, Sichuan University / West China School of Nursing, Sichuan University, Chengdu 610041, P. R. China;
2. Department of Vascular Surgery, West China Hospital, Sichuan University, Chengdu 610041, P. R. China;

Corresponding author：

ZHAO Jichun, Email: zhaojc3@126.com

Keywords：

retroperitoneal tumor; complication; prediction model; nomogram

DOI：

10.7507/1007-9424.202208091

Video：

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Objective To analyze the current status and risk factors of postoperative complications in patients with retroperitoneal tumor (RPT) and to establish a nomogram for predicting the occurrence of postoperative complications. Methods The clinicopathologic data of patients with RPT who met the inclusion criteria in the West China Hospital of Sichuan University from June 2019 to May 2022 were retrospectively collected. The risk factors of postoperative complications were analyzed by using univariate and multivariate analyses, and the nomogram was constructed based on the risk factors and validated. Results A total of 205 patients were collected in this study, 70 (34.1%) of whom had postoperative complications. The multivariate analysis results of logistic regression showed that the preoperative serum albumin ＜35 g/L [OR=2.355, 95%CI (1.256, 4.416), P=0.008], tumor sarcoma [OR=2.498, 95%CI (1.219, 5.120), P=0.012], and visceral resection [OR=2.008, 95%CI (1.042, 3.868), P=0.037] increased the probability of postoperative complications for the patients with RPT. The area under the receiver operating characteristic curve of the nomogram based on the risk factors in predicting the occurrence of postoperative complications was 0.704 [95%CI (0.626, 0.781), P<0.001]. The consistency index of the nomogram by internal verification was 0.704 [95%CI (0.628, 0.779)]. The calibration curve of the nomogram showed that the predicted value was basically consistent with the actual value, the Hosmer-Lemeshow goodness-of-fit test model had a good goodness-of-fit (χ²=3.407, P=0.906). Conclusions From the results of this study, the tumor sarcoma, lower preoperative serum albumin, and visceral resection are associated with postoperative complications for patients with RPT. The nomogram based on risk factors has a good predictive value for postoperative complications.

Citation： ZHANG Xiaolu, LIU Xiaoyan, HUANG Jing, ZHANG Lin, ZHAO Jichun. Current status and predictive model construction of postoperative complications in patients with retroperitoneal tumor. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2023, 30(2): 198-203. doi: 10.7507/1007-9424.202208091 Copy

1.	Tirotta F, Parente A, Hodson J, et al. Cumulative burden of postoperative complications in patients undergoing surgery for primary retroperitoneal sarcoma. Ann Surg Oncol, 2021, 28(12): 7939-7949.
2.	Wong P, Kassam Z, Springer AN, et al. Long-term quality of life of retroperitoneal sarcoma patients treated with pre-operative radiotherapy and surgery. Cureus, 2017, 9(10): e1764. doi: 10.7759/cureus.1764.
3.	Lim HJ, Ong CJ, Skanthakumar T, et al. Retrospective quality of life study in patients with retroperitoneal sarcoma in an Asian population. Health Qual Life Outcomes, 2020, 18(1): 270. doi: 10.1186/s12955-020-01491-0.
4.	MacNeill AJ, Gronchi A, Miceli R, et al. Postoperative morbidity after radical resection of primary retroperitoneal sarcoma: a report from the Transatlantic RPS Working Group. Ann Surg, 2018, 267(5): 959-964.
5.	Fiore M, Brunelli C, Miceli R, et al. A prospective observational study of multivisceral resection for retroperitoneal sarcoma: clinical and patient-reported outcomes 1 year after surgery. Ann Surg Oncol, 2021, 28(7): 3904-3916.
6.	Bosma E, Pullens MJ, de Vries J, et al. The impact of complications on quality of life following colorectal surgery: a prospective cohort study to evaluate the Clavien-Dindo classification system. Colorectal Dis, 2016, 18(6): 594-602.
7.	Kirov KM, Xu HP, Crenn P, et al. Role of nutritional status in the early postoperative prognosis of patients operated for retroperitoneal liposarcoma (RLS): a single center experience. Eur J Surg Oncol, 2019, 45(2): 261-267.
8.	李国瑞. 原发性腹膜后肉瘤联合器官切除的临床研究. 青岛: 青岛大学, 2021.
9.	杨帆. 腹膜后肿瘤的影像诊断、手术及术后并发症的回顾性研究. 广州: 南方医科大学, 2019.
10.	Nizri E, Netanyahu Y, Gerstenhaber F, et al. Severe postoperative complications are associated with impaired survival in primary but not in recurrent retroperitoneal sarcoma. Ann Surg Oncol, 2021, 28(5): 2693-2699.
11.	卢帅行, 张丽霞, 龚辰, 等. 术后预后营养指数与肝细胞癌切除术后严重并发症的关系. 中国普外基础与临床杂志, 2022, 29(10): 1344-1349.
12.	庄惠杰, 拾锦. 围手术期不同营养干预方案对结直肠癌患者术后营养状态、免疫状况及并发症的影响. 中国医学创新, 2022, 19(16): 149-153.
13.	刘燕燕, 张明军. 预后营养指数对进展期胃癌患者术后并发症及短期生存率的影响分析. 临床输血与检验, 2022, 24(2): 230-235.
14.	Previtali P, Fiore M, Colombo J, et al. Malnutrition and perioperative nutritional support in retroperitoneal sarcoma patients: results from a prospective study. Ann Surg Oncol, 2020, 27(6): 2025-2032.
15.	黄靖, 刘莉, 刘莉慧, 等. 营养风险与腹膜后肿瘤患者住院时间的相关性研究. 肿瘤代谢与营养电子杂志, 2020, 7(2): 178-182.
16.	Improta L, Tzanis D, Bouhadiba T, et al. Overview of primary adult retroperitoneal tumours. Eur J Surg Oncol, 2020, 46(9): 1573-1579.
17.	郭锦辉. 单中心原发性腹膜后肉瘤的预后分析. 青岛: 青岛大学, 2020.
18.	Fairweather M, Wang J, Jo VY, et al. Incidence and adverse prognostic implications of histopathologic organ invasion in primary retroperitoneal sarcoma. J Am Coll Surg, 2017, 224(5): 876-883.
19.	Kuru O, Boyraz G, Uckan H, et al. Retroperitoneal nodal metastasis in primary adult type granulosa cell tumor of the ovary: can routine lymphadenectomy be omitted? Eur J Obstet Gynecol Reprod Biol, 2017, 219: 70-73.
20.	郭丽娜, 李云超, 孙占峰, 等. 影响原发性腹膜后肿瘤手术患者预后的危险因素分析. 世界华人消化杂志, 2021, 29(9): 461-466.
21.	查立超, 李修霞, 周斌, 等. 原发性腹膜后肉瘤预后研究进展. 腹部外科, 2020, 33(4): 314-316.

1. Tirotta F, Parente A, Hodson J, et al. Cumulative burden of postoperative complications in patients undergoing surgery for primary retroperitoneal sarcoma. Ann Surg Oncol, 2021, 28(12): 7939-7949.
2. Wong P, Kassam Z, Springer AN, et al. Long-term quality of life of retroperitoneal sarcoma patients treated with pre-operative radiotherapy and surgery. Cureus, 2017, 9(10): e1764. doi: 10.7759/cureus.1764.
3. Lim HJ, Ong CJ, Skanthakumar T, et al. Retrospective quality of life study in patients with retroperitoneal sarcoma in an Asian population. Health Qual Life Outcomes, 2020, 18(1): 270. doi: 10.1186/s12955-020-01491-0.
4. MacNeill AJ, Gronchi A, Miceli R, et al. Postoperative morbidity after radical resection of primary retroperitoneal sarcoma: a report from the Transatlantic RPS Working Group. Ann Surg, 2018, 267(5): 959-964.
5. Fiore M, Brunelli C, Miceli R, et al. A prospective observational study of multivisceral resection for retroperitoneal sarcoma: clinical and patient-reported outcomes 1 year after surgery. Ann Surg Oncol, 2021, 28(7): 3904-3916.
6. Bosma E, Pullens MJ, de Vries J, et al. The impact of complications on quality of life following colorectal surgery: a prospective cohort study to evaluate the Clavien-Dindo classification system. Colorectal Dis, 2016, 18(6): 594-602.
7. Kirov KM, Xu HP, Crenn P, et al. Role of nutritional status in the early postoperative prognosis of patients operated for retroperitoneal liposarcoma (RLS): a single center experience. Eur J Surg Oncol, 2019, 45(2): 261-267.
8. 李国瑞. 原发性腹膜后肉瘤联合器官切除的临床研究. 青岛: 青岛大学, 2021.
9. 杨帆. 腹膜后肿瘤的影像诊断、手术及术后并发症的回顾性研究. 广州: 南方医科大学, 2019.
10. Nizri E, Netanyahu Y, Gerstenhaber F, et al. Severe postoperative complications are associated with impaired survival in primary but not in recurrent retroperitoneal sarcoma. Ann Surg Oncol, 2021, 28(5): 2693-2699.
11. 卢帅行, 张丽霞, 龚辰, 等. 术后预后营养指数与肝细胞癌切除术后严重并发症的关系. 中国普外基础与临床杂志, 2022, 29(10): 1344-1349.
12. 庄惠杰, 拾锦. 围手术期不同营养干预方案对结直肠癌患者术后营养状态、免疫状况及并发症的影响. 中国医学创新, 2022, 19(16): 149-153.
13. 刘燕燕, 张明军. 预后营养指数对进展期胃癌患者术后并发症及短期生存率的影响分析. 临床输血与检验, 2022, 24(2): 230-235.
14. Previtali P, Fiore M, Colombo J, et al. Malnutrition and perioperative nutritional support in retroperitoneal sarcoma patients: results from a prospective study. Ann Surg Oncol, 2020, 27(6): 2025-2032.
15. 黄靖, 刘莉, 刘莉慧, 等. 营养风险与腹膜后肿瘤患者住院时间的相关性研究. 肿瘤代谢与营养电子杂志, 2020, 7(2): 178-182.
16. Improta L, Tzanis D, Bouhadiba T, et al. Overview of primary adult retroperitoneal tumours. Eur J Surg Oncol, 2020, 46(9): 1573-1579.
17. 郭锦辉. 单中心原发性腹膜后肉瘤的预后分析. 青岛: 青岛大学, 2020.
18. Fairweather M, Wang J, Jo VY, et al. Incidence and adverse prognostic implications of histopathologic organ invasion in primary retroperitoneal sarcoma. J Am Coll Surg, 2017, 224(5): 876-883.
19. Kuru O, Boyraz G, Uckan H, et al. Retroperitoneal nodal metastasis in primary adult type granulosa cell tumor of the ovary: can routine lymphadenectomy be omitted? Eur J Obstet Gynecol Reprod Biol, 2017, 219: 70-73.
20. 郭丽娜, 李云超, 孙占峰, 等. 影响原发性腹膜后肿瘤手术患者预后的危险因素分析. 世界华人消化杂志, 2021, 29(9): 461-466.
21. 查立超, 李修霞, 周斌, 等. 原发性腹膜后肉瘤预后研究进展. 腹部外科, 2020, 33(4): 314-316.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Current status and predictive model construction of postoperative complications in patients with retroperitoneal tumor

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