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A Novel Clinical Nomogram for Predicting Overall Survival in Patients with Emergency Surgery for Colorectal Cancer

Background: Long-term survival after emergency colorectal cancer surgery is low, and its estimation is most frequently neglected, with priority given to the immediate prognosis. This study aimed to propose an effective nomogram to predict overall survival in these patients. Materials and methods: We...

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Autores principales: Constantin, Georgiana Bianca, Firescu, Dorel, Mihailov, Raul, Constantin, Iulian, Ștefanopol, Ioana Anca, Iordan, Daniel Andrei, Ștefănescu, Bogdan Ioan, Bîrlă, Rodica, Panaitescu, Eugenia
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10145637/
https://www.ncbi.nlm.nih.gov/pubmed/37108961
http://dx.doi.org/10.3390/jpm13040575
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author Constantin, Georgiana Bianca
Firescu, Dorel
Mihailov, Raul
Constantin, Iulian
Ștefanopol, Ioana Anca
Iordan, Daniel Andrei
Ștefănescu, Bogdan Ioan
Bîrlă, Rodica
Panaitescu, Eugenia
author_facet Constantin, Georgiana Bianca
Firescu, Dorel
Mihailov, Raul
Constantin, Iulian
Ștefanopol, Ioana Anca
Iordan, Daniel Andrei
Ștefănescu, Bogdan Ioan
Bîrlă, Rodica
Panaitescu, Eugenia
author_sort Constantin, Georgiana Bianca
collection PubMed
description Background: Long-term survival after emergency colorectal cancer surgery is low, and its estimation is most frequently neglected, with priority given to the immediate prognosis. This study aimed to propose an effective nomogram to predict overall survival in these patients. Materials and methods: We retrospectively studied 437 patients who underwent emergency surgery for colorectal cancer between 2008 and 2019, in whom we analyzed the clinical, paraclinical, and surgical parameters. Results: Only 30 patients (6.86%) survived until the end of the study. We identified the risk factors through the univariate Cox regression analysis and a multivariate Cox regression model. The model included the following eight independent prognostic factors: age > 63 years, Charlson score > 4, revised cardiac risk index (RCRI), LMR (lymphocytes/neutrophils ratio), tumor site, macroscopic tumoral invasion, surgery type, and lymph node dissection (p < 0.05 for all), with an AUC (area under the curve) of 0.831, with an ideal agreement between the predicted and observed probabilities. On this basis, we constructed a nomogram for prediction of overall survival. Conclusions: The nomogram created, on the basis of a multivariate logistic regression model, has a good individual prediction of overall survival for patients with emergency surgery for colon cancer and may support clinicians when informing patients about prognosis.
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spelling pubmed-101456372023-04-29 A Novel Clinical Nomogram for Predicting Overall Survival in Patients with Emergency Surgery for Colorectal Cancer Constantin, Georgiana Bianca Firescu, Dorel Mihailov, Raul Constantin, Iulian Ștefanopol, Ioana Anca Iordan, Daniel Andrei Ștefănescu, Bogdan Ioan Bîrlă, Rodica Panaitescu, Eugenia J Pers Med Article Background: Long-term survival after emergency colorectal cancer surgery is low, and its estimation is most frequently neglected, with priority given to the immediate prognosis. This study aimed to propose an effective nomogram to predict overall survival in these patients. Materials and methods: We retrospectively studied 437 patients who underwent emergency surgery for colorectal cancer between 2008 and 2019, in whom we analyzed the clinical, paraclinical, and surgical parameters. Results: Only 30 patients (6.86%) survived until the end of the study. We identified the risk factors through the univariate Cox regression analysis and a multivariate Cox regression model. The model included the following eight independent prognostic factors: age > 63 years, Charlson score > 4, revised cardiac risk index (RCRI), LMR (lymphocytes/neutrophils ratio), tumor site, macroscopic tumoral invasion, surgery type, and lymph node dissection (p < 0.05 for all), with an AUC (area under the curve) of 0.831, with an ideal agreement between the predicted and observed probabilities. On this basis, we constructed a nomogram for prediction of overall survival. Conclusions: The nomogram created, on the basis of a multivariate logistic regression model, has a good individual prediction of overall survival for patients with emergency surgery for colon cancer and may support clinicians when informing patients about prognosis. MDPI 2023-03-24 /pmc/articles/PMC10145637/ /pubmed/37108961 http://dx.doi.org/10.3390/jpm13040575 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Constantin, Georgiana Bianca
Firescu, Dorel
Mihailov, Raul
Constantin, Iulian
Ștefanopol, Ioana Anca
Iordan, Daniel Andrei
Ștefănescu, Bogdan Ioan
Bîrlă, Rodica
Panaitescu, Eugenia
A Novel Clinical Nomogram for Predicting Overall Survival in Patients with Emergency Surgery for Colorectal Cancer
title A Novel Clinical Nomogram for Predicting Overall Survival in Patients with Emergency Surgery for Colorectal Cancer
title_full A Novel Clinical Nomogram for Predicting Overall Survival in Patients with Emergency Surgery for Colorectal Cancer
title_fullStr A Novel Clinical Nomogram for Predicting Overall Survival in Patients with Emergency Surgery for Colorectal Cancer
title_full_unstemmed A Novel Clinical Nomogram for Predicting Overall Survival in Patients with Emergency Surgery for Colorectal Cancer
title_short A Novel Clinical Nomogram for Predicting Overall Survival in Patients with Emergency Surgery for Colorectal Cancer
title_sort novel clinical nomogram for predicting overall survival in patients with emergency surgery for colorectal cancer
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10145637/
https://www.ncbi.nlm.nih.gov/pubmed/37108961
http://dx.doi.org/10.3390/jpm13040575
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