Key result
A clinical model predicts anastomotic leakage after rectal cancer resection with an AUC of 0.70.
Why the study?
Risk factors for anastomotic leakage after laparoscopic rectal cancer resection were identified to develop a prediction model for AL risk.
What are the risk factors for anastomotic leakage after laparoscopic rectal cancer resection?
Cohort (n=185)
What are the risk factors for anastomotic leakage after laparoscopic rectal cancer resection?
Effect estimate: AUC 0.70 (95% CI 0.598-0.795)
A prediction model incorporating BMI, preoperative radiochemotherapy, tumor size, and surgical time can evaluate the risk of anastomotic leakage after laparoscopic rectal cancer resection with moderate accuracy (AUC 0.70).
May aid risk stratification after rectal resection; hypothesis-generating from Level 3 data and requires validation.
OBJECTIVE: This study was performed to identify risk factors for anastomotic leakage (AL) and combine these factors to create a prediction model for the risk of AL after laparoscopic rectal cancer resection. METHODS: This retrospective study involved 185 patients with rectal cancer who underwent laparoscopic resection from March 2012 to February 2017. Five risk factors were analyzed by multivariate analysis. A prediction model was established by combining the risk factors from the multivariate analysis, and the accuracy of the model was evaluated by a receiver operating characteristic curve. RESULTS: The overall AL rate was 17.84%. The multivariate analysis identified the following independent risk factors for AL: high body mass index (odds ratio [OR], 3.009; 95% confidence interval [CI], 1.127-7.125), preoperative radiochemotherapy (OR, 3.778; 95% CI, 1.168-12.219), larger tumor size (OR, 2.710; 95% CI, 1.119-6.562), and longer surgical time (OR, 2.476; 95% CI, 1.033-5.932). We established a prediction model that can evaluate the risk of AL by determining the predictive probability. The area under the curve for the model's predictive performance was 0.70 (95% CI, 0.598-0.795). CONCLUSION: A prediction model was created to predict the risk of AL after laparoscopic rectal cancer resection.
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Shiwakoti et al. (2020) conducted a cohort in rectal cancer (n=185). Prediction model (high BMI, preoperative radiochemotherapy, larger tumor size, longer surgical time) was evaluated on Anastomotic leakage (AL) (AUC 0.70, 95% CI 0.598-0.795). A prediction model incorporating high BMI, preoperative radiochemotherapy, larger tumor size, and longer surgical time predicted anastomotic leakage with an AUC of 0.70 (95% CI, 0.598-0.795).
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