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.	李國瑞. 原發性腹膜后肉瘤聯合器官切除的臨床研究. 青島: 青島大學, 2021.
9.	楊帆. 腹膜后腫瘤的影像診斷、手術及術后并發癥的回顧性研究. 廣州: 南方醫科大學, 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.	盧帥行, 張麗霞, 龔辰, 等. 術后預后營養指數與肝細胞癌切除術后嚴重并發癥的關系. 中國普外基礎與臨床雜志, 2022, 29(10): 1344-1349.
12.	莊惠杰, 拾錦. 圍手術期不同營養干預方案對結直腸癌患者術后營養狀態、免疫狀況及并發癥的影響. 中國醫學創新, 2022, 19(16): 149-153.
13.	劉燕燕, 張明軍. 預后營養指數對進展期胃癌患者術后并發癥及短期生存率的影響分析. 臨床輸血與檢驗, 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.	黃靖, 劉莉, 劉莉慧, 等. 營養風險與腹膜后腫瘤患者住院時間的相關性研究. 腫瘤代謝與營養電子雜志, 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.	郭錦輝. 單中心原發性腹膜后肉瘤的預后分析. 青島: 青島大學, 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.	郭麗娜, 李云超, 孫占峰, 等. 影響原發性腹膜后腫瘤手術患者預后的危險因素分析. 世界華人消化雜志, 2021, 29(9): 461-466.
21.	查立超, 李修霞, 周斌, 等. 原發性腹膜后肉瘤預后研究進展. 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. 李國瑞. 原發性腹膜后肉瘤聯合器官切除的臨床研究. 青島: 青島大學, 2021.
9. 楊帆. 腹膜后腫瘤的影像診斷、手術及術后并發癥的回顧性研究. 廣州: 南方醫科大學, 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. 盧帥行, 張麗霞, 龔辰, 等. 術后預后營養指數與肝細胞癌切除術后嚴重并發癥的關系. 中國普外基礎與臨床雜志, 2022, 29(10): 1344-1349.
12. 莊惠杰, 拾錦. 圍手術期不同營養干預方案對結直腸癌患者術后營養狀態、免疫狀況及并發癥的影響. 中國醫學創新, 2022, 19(16): 149-153.
13. 劉燕燕, 張明軍. 預后營養指數對進展期胃癌患者術后并發癥及短期生存率的影響分析. 臨床輸血與檢驗, 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. 黃靖, 劉莉, 劉莉慧, 等. 營養風險與腹膜后腫瘤患者住院時間的相關性研究. 腫瘤代謝與營養電子雜志, 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. 郭錦輝. 單中心原發性腹膜后肉瘤的預后分析. 青島: 青島大學, 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. 郭麗娜, 李云超, 孫占峰, 等. 影響原發性腹膜后腫瘤手術患者預后的危險因素分析. 世界華人消化雜志, 2021, 29(9): 461-466.
21. 查立超, 李修霞, 周斌, 等. 原發性腹膜后肉瘤預后研究進展. 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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