Construction of a nomogram prediction model for the risk of conversion to open chest during thoracoscopic lobectomy in lung cancer patients
- VernacularTitle:肺癌患者胸腔镜下肺叶切除术中转开胸风险列线图预测模型的构建
- Author:
Bing LI
1
;
Ping CHEN
;
Ning ZHANG
;
Xiaowei CHEN
;
Jianxia GUO
;
Ping ZHOU
Author Information
- Keywords: lung cancer; thoracoscopic lobectomy; change to thoracotomy; nomogram
- From: China Journal of Endoscopy 2024;30(10):1-8
- CountryChina
- Language:Chinese
- Abstract: Objective Construction of a nomogram prediction model for the risk of conversion from thoracoscopic lobectomy to thoracotomy in patients with lung cancer.Methods 160 patients who underwent thoracoscopic lobectomy for lung cancer from August 2021 to February 2023 were selected and randomly divided into a modeling group(112 cases)and a validation group(48 cases),the modeling group was divided into an open-chest group and an non open-chest group according to whether or not they were converted to open-chest intraoperatively;Multivariate Logistic regression analysis(Enter method)was applied to analyze the risk factors of change to thoracotomy during thoracoscopic lobectomy for lung cancer patients;R software was applied to construct column chart models and evaluate the predictive performance of the models.Results In this study,39 out of 112 lung cancer patients changed to thoracotomy during thoracoscopic lobectomy,with an incidence rate of 34.82%.There were statistical differences between the open-chest group and the non open-chest group in terms of age,pulmonary tuberculosis,tumor location(upper lobe of lung),and pleural adhesions(P＜0.05).The results of multivariate Logistic regression analysis showed that age≥65 years,presence of tuberculosis,tumor location(upper lobe of lung),and presence of pleural adhesions were risk factors(P＜0.05).The validation results of the modeling group showed that the area under the receiver operator characteristic curve(ROC curve)(AUC)was 0.857,with a good discrimination,the H-L test showed a good consistency(χ2=5.34,P=0.502).The AUC of external validation was 0.917,with a good discrimination,the H-L test with a good consistency(χ2=6.21,P=0.414).Conclusion Age≥65 years old,presence of pulmonary tuberculosis,tumor location(upper lobe of lung),and pleural adhesions are risk factors for change to thoracotomy in lung cancer patients undergoing thoracoscopic lobectomy.The column chart model constructed based on this has good discrimination and consistency,and can intuitively predict the risk of thoracoscopic lobectomy to change to thoracotomy in lung cancer patients.
