YUAN Zhen 1,2 , CUI Hao 1,2 , LIANG Wenquan 1 , CAO Bo 1 , HUANG Jun 1,2 , SONG Liqiang 1,2 , LIU Guibin 1,2 , DU Jiajun 1 , WEI Bo 1 , CHEN Lin 1 , ZHANG Kecheng 1
  • 1. Department of General Surgery, The First Medical Center, Chinese PLA General Hospital, Beijing 100853, P. R. China;
  • 2. School of Medicine, Nankai University, Tianjin 300071, P. R. China;
ZHANG Kecheng, Email: zhangkecheng@301hospital.com.cn
gastric cancer; neoadjuvant chemotherapy; postoperative complications; risk factors; nomogram
10.7507/1007-9424.202304040
Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables References Cited by

Objective To analyze the risk factors influencing major postoperative complications (MPC) after minimally invasive radical gastrectomy for gastric cancer following neoadjuvant chemotherapy (NACT), and to construct a nomogram for accurately predicting MPC risk factors, and provide a reference for clinical decision-making. Methods The gastric cancer patients who underwent minimally invasive radical gastrectomy in the Department of General Surgery of the First Medical Center of the Chinese PLA General Hospital from February 2012 to December 2022 and met the inclusion criteria of this study were retrospectively collected. The univariate and multivariate logistic regression model were used to evaluate the risk factors influencing MPC and a nomogram model was constructed. The MPC were defined as Clavien-Dindo classification grade Ⅱ and beyond. The area under the receiver operating characteristic curve (AUC) and the calibration curve were used to evaluate the discrimination and accuracy of the nomogram model. Results A total of 362 patients were included in this study, among whom 65 cases (18.0%) experienced MPC. The multivariate logistic regression analysis showed that the age ≥58 years old, body mass index (BMI) ≥25 kg/m2, tumor long diameter ≥30 mm, operative time ≥300 min, and preoperative neutrophil-to-lymphocyte ratio (NLR) ≥3.7 were the risk factors influencing MPC. The nomogram model constructed using the above variables showed that the AUC (95%CI) was 0.731 (0.662, 0.801) in predicting the risk of MPC. The calibration curves showed that the prediction curve of the nomogram in predicting the MPC was agree well with the actual MPC (Hosmer-Lemeshow test: χ2=9.293, P=0.056). Conclusion From the results of this study, nomogram model constructed by combining age, BMI, tumor long diameter, operative time, and preoperative NLR can distinguish between patients with and without MPC after minimally invasive radical gastrectomy for gastric cancer following NACT, and has a better accuracy.

Citation： YUAN Zhen, CUI Hao, LIANG Wenquan, CAO Bo, HUANG Jun, SONG Liqiang, LIU Guibin, DU Jiajun, WEI Bo, CHEN Lin, ZHANG Kecheng. Nomogram to predict major postoperative complications in gastric cancer patients undergoing minimally invasive radical gastrectomy following neoadjuvant chemotherapy. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2023, 30(7): 788-794. doi: 10.7507/1007-9424.202304040 Copy