Influencing factors and construction of a nomogram predictive model for postoperative anastomotic leak in patients with carcinoma of the esophagus and gastroesophageal junction
- VernacularTitle:食管癌和食管胃交界部癌术后吻合口瘘影响因素及列线图模型构建
- Author:
Hao PENG
1
;
Siqi SHENG
2
;
Jing CHEN
3
;
Maitiasen MAIRHABA
1
;
Haizhu SONG
4
;
Jun YI
1
Author Information
1. Department of Cardiothoracic Surgery, Jinling Hospital Affiliated to Nanjing University School of Medicine, Nanjing, 210002, P. R. China
2. Department of Oncology, Jinling Hospital Affiliated to Nanjing University School of Medicine, Nanjing, 210002, P. R. China
3. Department of Cardiothoracic Surgery, Jinling Clinical Medical College, Nanjing University of Traditional Chinese Medicine, Nanjing, 210002, P. R. China
4. Department of Oncology, Jinling Hospital Affiliated to Nanjing University School of Medicine, Nanjing, 210002, P. R. China 3.
- Publication Type:Journal Article
- Keywords:
Esophageal cancer;
gastroesophageal junction carcinoma;
anastomotic leak;
nomogram predictive model
- From:
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery
2025;32(02):208-215
- CountryChina
- Language:Chinese
-
Abstract:
Objective To analyze the influencing factors for postoperative anastomotic leak (AL) in carcinoma of the esophagus and gastroesophageal junction and construct a nomogram predictive model. Methods The patients who underwent radical esophagectomy at Jinling Hospital Affiliated to Nanjing University School of Medicine from January 2018 to June 2020 were included in this study. Relevant variables were screened using univariate and multivariate logistic regression analyses. A nomogram was then developed to predict the risk factors associated with postoperative AL. The predictive performance of the nomogram was validated using the receiver operating characteristic (ROC) curve. Results A total of 468 patients with carcinoma of the esophagus and gastroesophageal junction were included in the study, comprising 354 males and 114 females, with a mean age of (62.8±7.2) years. The tumors were predominantly located in the middle or lower esophagus, and 51 (10.90%) patients experienced postoperative AL. Univariate logistic regression analysis indicated that age, body mass index (BMI), tumor location, preoperative albumin levels, diabetes mellitus, anastomosis technique, anastomosis site, and C-reactive protein (CRP) levels were potentially associated with AL (P<0.05). Multivariate logistic regression analysis identified age, BMI, tumor location, diabetes mellitus, anastomosis technique, and CRP levels as independent risk factors for AL (P<0.05). A nomogram was developed based on the findings from the multivariate logistic regression analysis. The area under the receiver operating characteristic (ROC) curve was 0.803, indicating a strong concordance between the actual observations and the predicted outcomes. Furthermore, decision curve analysis demonstrated that the newly established nomogram holds significant value for clinical decision-making. Conclusion The predictive model for postoperative AL in patients with carcinoma of the esophagus and gastroesophageal junction demonstrates strong predictive validity and is essential for guiding clinical monitoring, early detection, and preventive strategies.
