Risk factors to predict the incidence of surgical adverse events following open or laparoscopic surgery for apparent early stage endometrial cancer: results from a randomised controlled trial
| Autor: | Andrea Garrett, Geoff Otton, David H. Wrede, Russell Hogg, Rhonda Farrell, Anthony McCartney, Martin K. Oehler, Hextan Y.S. Ngan, Bryony Simcock, Russell Land, Karfai Tam, Tom Jobling, Val Gebski, Peter Sykes, Andreas Obermair, Jannah Baker, James L. Nicklin, Srinivas Kondalsamy-Chennakesavan, Tom Manolitsas, Monika Janda, Selvan Pather, Deborah Neesham, Michael Laney, Marcelo Nascimento, Karen Chan, Ian Hammond, Stuart Salfinger, Alison Brand, Lewis Perrin, Yee Leung, Graeme J. Walker, Gregory Robertson, T.Y. Ng |
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| Rok vydání: | 2011 |
| Předmět: |
Laparoscopic surgery
Cancer Research medicine.medical_specialty Time Factors medicine.medical_treatment Logistic regression Hysterectomy Risk Assessment Decision Support Techniques Postoperative Complications Risk Factors Internal medicine medicine Odds Ratio Humans Adverse effect Neoplasm Staging business.industry Endometrial cancer Incidence Australia Reproducibility of Results Odds ratio Nomogram Length of Stay Middle Aged medicine.disease Surgery Endometrial Neoplasms Nomograms Logistic Models Treatment Outcome Oncology Multivariate Analysis Female Laparoscopy business Risk assessment Algorithms |
| Zdroj: | European journal of cancer (Oxford, England : 1990). 48(14) |
| ISSN: | 1879-0852 |
| Popis: | Aims To identify risk factors for major adverse events (AEs) and to develop a nomogram to predict the probability of such AEs in patients who have surgery for apparent early stage endometrial cancer. Methods We used data from 753 patients who were randomised to either total laparoscopic hysterectomy or total abdominal hysterectomy in the LACE trial. Serious adverse events that prolonged hospital stay or postoperative adverse events (using common terminology criteria 3+, CTCAE V3) were considered major AEs. We analysed pre-surgical characteristics that were associated with the risk of developing major AEs by multivariate logistic regression. We identified a parsimonious model by backward stepwise logistic regression. The six most significant or clinically important variables were included in the nomogram to predict the risk of major AEs within 6 weeks of surgery and the nomogram was internally validated. Results Overall, 132 (17.5%) patients had at least one major AE. An open surgical approach (laparotomy), higher Charlson’s medical co-morbidities score, moderately differentiated tumours on curettings, higher baseline Eastern Cooperative Oncology Group (ECOG) score, higher body mass index and low haemoglobin levels were associated with AE and were used in the nomogram. The bootstrap corrected concordance index of the nomogram was 0.63 and it showed good calibration. Conclusions Six pre-surgical factors independently predicted the risk of major AEs. This research might form the basis to develop risk reduction strategies to minimise the risk of AEs among patients undergoing surgery for apparent early stage endometrial cancer. |
| Databáze: | OpenAIRE |
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