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Permanent stoma rates after anterior resection for rectal cancer: risk prediction scoring using preoperative variables
BACKGROUND: A permanent stoma after anterior resection for rectal cancer is common. Preoperative counselling could be improved by providing individualized accurate prediction modelling. METHODS: Patients who underwent anterior resection between 2007 and 2015 were identified from the Swedish Colorect...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Oxford University Press
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10364873/ https://www.ncbi.nlm.nih.gov/pubmed/34508549 http://dx.doi.org/10.1093/bjs/znab260 |
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author | Back, E Häggström, J Holmgren, K Haapamäki, M M Matthiessen, P Rutegård, J Rutegård, M |
author_facet | Back, E Häggström, J Holmgren, K Haapamäki, M M Matthiessen, P Rutegård, J Rutegård, M |
author_sort | Back, E |
collection | PubMed |
description | BACKGROUND: A permanent stoma after anterior resection for rectal cancer is common. Preoperative counselling could be improved by providing individualized accurate prediction modelling. METHODS: Patients who underwent anterior resection between 2007 and 2015 were identified from the Swedish Colorectal Cancer Registry. National Patient Registry data were added to determine presence of a stoma 2 years after surgery. A training set based on the years 2007–2013 was employed in an ensemble of prediction models. Judged by the area under the receiving operating characteristic curve (AUROC), data from the years 2014–2015 were used to evaluate the predictive ability of all models. The best performing model was subsequently implemented in typical clinical scenarios and in an online calculator to predict the permanent stoma risk. RESULTS: Patients in the training set (n = 3512) and the test set (n = 1136) had similar permanent stoma rates (13.6 and 15.2 per cent). The logistic regression model with a forward/backward procedure was the most parsimonious among several similarly performing models (AUROC 0.67, 95 per cent c.i. 0.63 to 0.72). Key predictors included co-morbidity, local tumour category, presence of metastasis, neoadjuvant therapy, defunctioning stoma use, tumour height, and hospital volume; the interaction between age and metastasis was also predictive. CONCLUSION: Using routinely available preoperative data, the stoma outcome at 2 years after anterior resection for rectal cancer can be predicted fairly accurately. |
format | Online Article Text |
id | pubmed-10364873 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Oxford University Press |
record_format | MEDLINE/PubMed |
spelling | pubmed-103648732023-07-31 Permanent stoma rates after anterior resection for rectal cancer: risk prediction scoring using preoperative variables Back, E Häggström, J Holmgren, K Haapamäki, M M Matthiessen, P Rutegård, J Rutegård, M Br J Surg Original Articles BACKGROUND: A permanent stoma after anterior resection for rectal cancer is common. Preoperative counselling could be improved by providing individualized accurate prediction modelling. METHODS: Patients who underwent anterior resection between 2007 and 2015 were identified from the Swedish Colorectal Cancer Registry. National Patient Registry data were added to determine presence of a stoma 2 years after surgery. A training set based on the years 2007–2013 was employed in an ensemble of prediction models. Judged by the area under the receiving operating characteristic curve (AUROC), data from the years 2014–2015 were used to evaluate the predictive ability of all models. The best performing model was subsequently implemented in typical clinical scenarios and in an online calculator to predict the permanent stoma risk. RESULTS: Patients in the training set (n = 3512) and the test set (n = 1136) had similar permanent stoma rates (13.6 and 15.2 per cent). The logistic regression model with a forward/backward procedure was the most parsimonious among several similarly performing models (AUROC 0.67, 95 per cent c.i. 0.63 to 0.72). Key predictors included co-morbidity, local tumour category, presence of metastasis, neoadjuvant therapy, defunctioning stoma use, tumour height, and hospital volume; the interaction between age and metastasis was also predictive. CONCLUSION: Using routinely available preoperative data, the stoma outcome at 2 years after anterior resection for rectal cancer can be predicted fairly accurately. Oxford University Press 2021-09-11 /pmc/articles/PMC10364873/ /pubmed/34508549 http://dx.doi.org/10.1093/bjs/znab260 Text en © The Author(s) 2021. Published by Oxford University Press on behalf of BJS Society Ltd. https://creativecommons.org/licenses/by/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Original Articles Back, E Häggström, J Holmgren, K Haapamäki, M M Matthiessen, P Rutegård, J Rutegård, M Permanent stoma rates after anterior resection for rectal cancer: risk prediction scoring using preoperative variables |
title | Permanent stoma rates after anterior resection for rectal cancer: risk prediction scoring using preoperative variables |
title_full | Permanent stoma rates after anterior resection for rectal cancer: risk prediction scoring using preoperative variables |
title_fullStr | Permanent stoma rates after anterior resection for rectal cancer: risk prediction scoring using preoperative variables |
title_full_unstemmed | Permanent stoma rates after anterior resection for rectal cancer: risk prediction scoring using preoperative variables |
title_short | Permanent stoma rates after anterior resection for rectal cancer: risk prediction scoring using preoperative variables |
title_sort | permanent stoma rates after anterior resection for rectal cancer: risk prediction scoring using preoperative variables |
topic | Original Articles |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10364873/ https://www.ncbi.nlm.nih.gov/pubmed/34508549 http://dx.doi.org/10.1093/bjs/znab260 |
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