Construction and clinical validation of a machine learning-based nomogram model for predicting lymphatic leakage following radical prostatectomy
10.3969/j.issn.1006-5725.2025.21.012
- VernacularTitle:腹腔镜下根治性前列腺切除术后淋巴漏风险预测模型的构建与验证
- Author:
Xiudong YANG
1
;
Xing LIU
;
Xin LIU
;
Yan JIANG
;
Wei WANG
;
Zongbin HE
;
Sha HUANG
;
Meihong WEN
;
Yazhen LIU
Author Information
1. 南方医科大学珠江医院泌尿外科(广东 广州 510282)
- Publication Type:Journal Article
- Keywords:
machine learning;
radical prostatectomy;
lymphatic leakage;
predictive model;
risk factors
- From:
The Journal of Practical Medicine
2025;41(21):3378-3384
- CountryChina
- Language:Chinese
-
Abstract:
Objective To identify risk factors associated with lymphatic leakage after laparoscopic radical prostatectomy(LRP)and to develop a machine learning-based nomogram for predicting such outcomes to support clinical prevention strategies.Methods We retrospectively analyzed perioperative data from 248 patients who underwent radical prostatectomy for prostate cancer between January 2020 and January 2024.Independent risk factors were identified through univariate and multivariate logistic regression analyses.A predictive model was developed,and its diagnostic performance was assessed by the area under the receiver operating characteristic curve(AUC).Five-fold cross-validation was performed to evaluate the model's generalizability.A nomogram was subsequently constructed to facilitate individualized risk quantification.Results Among the 248 patients,89(35.9%)developed lymphatic leakage,while 159(64.1%)did not.Independent risk factors for lymphatic leakage included intraopera-tive lymph node dissection(OR=5.415,95%CI:2.167～13.532,P<0.001),intraoperative plasma transfusion(OR=2.952,95%CI:1.524～5.718,P=0.001),and postoperative fasting duration of≥2 days(OR=1.412,95%CI:1.089～1.829,P=0.009).The predictive model showed good discrimination and calibration(AUC=0.711,95%CI:0.647～0.776,P<0.001;sensitivity:0.764;specificity:0.597).Model robustness was confirmed through five-fold cross-validation(training set AUC=0.822;test set AUC=0.829).The nomogram provided a clinically useful tool for quantifying individual risk of lymphatic leakage.Conclusions Intraoperative lymph node dissection,plasma transfusion,and postoperative fasting lasting≥2 days are independent risk factors for lymphatic leakage following radical prostatectomy.The validated predictive model demonstrates favorable clinical utility.
