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Nomogram for predicting the probability of permanent stoma in patients with acute obstructive colorectal cancer

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Abstract

Background

Acute obstructive colorectal cancer is a high-risk emergency among colorectal cancer (CRC). Approximately 20% of CRC patients are associated with a permanent stoma, which greatly affects the lifestyle of patients. This study aimed to investigate risk factors for predicting permanent stoma (PS) in patients with acute obstructive colorectal cancer.

Methods

We retrospectively analyzed the clinical-pathological features of patients with acute obstructive colorectal cancer who underwent treatments from our hospital between January 2015 and December 2020. Univariate and multivariate logistic regression analyses were used to evaluate the risk factors for predicting PS chances of CRC patients using a nomogram method. Furthermore, the operating characteristic (ROC) curve and area under the ROC curve (AUC) were used to assess the discrimination power of the nomogram. Calibration plot was used to evaluate nomogram’s calibration.

Results

A total of 98 patients with acute obstructive colorectal cancer were enrolled in this study, including 24 PS patients with permanent stoma and 74 non-PS patients. Multivariate analysis showed that age [odds ratio (OR): 1.068, 95% confidence interval (CI): 1.006 ~ 1.135, P = 0.032], carcinoembryonic antigen (CEA) [OR: 1.015, 95% CI: 1.003 ~ 1.028, P = 0.013], and surgical method [emergency group vs. stent group, OR: 14.066, 95% CI: 3.625 ~ 54.572, p < 0.001] were independent risk factors for PS. These risk factors were incorporated into a nomogram and showed that the AUC of the nomogram was 0.867 (95% CI: 0.782–0.951). The calibration plot got consistent with prediction for PS in the nomogram.

Conclusion

Age, CEA, and surgical method were independent risk factors for PS in patients with acute obstructive colorectal cancer. Our nomogram has favorable predictive power for PS in CRC patients.

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Data availability

The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.

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Funding

This study was supported by the Hospital Research Project of Shanghai Sixth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine (Grant No.: YNHG201911).

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Authors and Affiliations

  1. Department of General Surgery, Shanghai Sixth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, 600 Yishan Road, Shanghai, 200233, China

    Nengquan Sheng, Jun Yan, Zhigang Wang & Zhenqian Wu

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  1. Nengquan Sheng
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Contributions

Nengquan Sheng and Zhenqian Wu contributed to the study conception and design. All authors collected the data and performed the data analysis. All authors contributed to the interpretation of the data and the completion of figures and tables. All authors contributed to the drafting of the article and final approval of the submitted version.

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Correspondence to Zhenqian Wu.

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The authors declare no competing interests.

Ethics approval and consent to participate

This study was approved by the Ethics Committee of the Shanghai Sixth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine (No.: 2020–018). All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Written informed consent was obtained from the participants before the study.

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Sheng, N., Yan, J., Wang, Z. et al. Nomogram for predicting the probability of permanent stoma in patients with acute obstructive colorectal cancer. Langenbecks Arch Surg 408, 121 (2023). https://doi.org/10.1007/s00423-023-02859-8

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