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  • Greijdanus, Nynke G.Department of Surgery, Radboud University Medical Centre, Radboud Institute for Health Sciences, Nijmegen, Netherlands (author)

Stoma-free survival after rectal cancer resection with anastomotic leakage : development and validation of a prediction model in a large international cohort

  • Article/chapterEnglish2023

Publisher, publication year, extent ...

  • Wolters Kluwer,2023
  • electronicrdacarrier

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  • LIBRIS-ID:oai:DiVA.org:umu-216198
  • https://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-216198URI
  • https://doi.org/10.1097/SLA.0000000000006043DOI
  • http://kipublications.ki.se/Default.aspx?queryparsed=id:154119417URI

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  • Language:English
  • Summary in:English

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  • Subject category:ref swepub-contenttype
  • Subject category:art swepub-publicationtype

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  • Objective: To develop and validate a prediction model (STOMA score) for 1-year stoma-free survival in patients with rectal cancer (RC) with anastomotic leakage (AL).Background: AL after RC resection often results in a permanent stoma.Methods: This international retrospective cohort study (TENTACLE-Rectum) encompassed 216 participating centres and included patients who developed AL after RC surgery between 2014 and 2018. Clinically relevant predictors for 1-year stoma-free survival were included in uni and multivariable logistic regression models. The STOMA score was developed and internally validated in a cohort of patients operated between 2014 and 2017, with subsequent temporal validation in a 2018 cohort. The discriminative power and calibration of the models' performance were evaluated.Results: This study included 2499 patients with AL, 1954 in the development cohort and 545 in the validation cohort. Baseline characteristics were comparable. One-year stoma-free survival was 45.0% in the development cohort and 43.7% in the validation cohort. The following predictors were included in the STOMA score: sex, age, American Society of Anestesiologist classification, body mass index, clinical M-disease, neoadjuvant therapy, abdominal and transanal approach, primary defunctioning stoma, multivisceral resection, clinical setting in which AL was diagnosed, postoperative day of AL diagnosis, abdominal contamination, anastomotic defect circumference, bowel wall ischemia, anastomotic fistula, retraction, and reactivation leakage. The STOMA score showed good discrimination and calibration (c-index: 0.71, 95% CI: 0.66-0.76).Conclusions: The STOMA score consists of 18 clinically relevant factors and estimates the individual risk for 1-year stoma-free survival in patients with AL after RC surgery, which may improve patient counseling and give guidance when analyzing the efficacy of different treatment strategies in future studies.

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  • Wienholts, KiedoDepartment of Surgery, Amsterdam University Medical Centers, University of Amsterdam, Netherlands; Treatment and Quality of Life, Cancer Center Amsterdam, Amsterdam, Netherlands; Imaging and Biomarkers, Cancer Center Amsterdam, Amsterdam, Netherlands (author)
  • Ubels, SanderDepartment of Surgery, Radboud University Medical Centre, Radboud Institute for Health Sciences, Nijmegen, Netherlands (author)
  • Talboom, KevinDepartment of Surgery, Amsterdam University Medical Centers, University of Amsterdam, Netherlands; Treatment and Quality of Life, Cancer Center Amsterdam, Amsterdam, Netherlands; Imaging and Biomarkers, Cancer Center Amsterdam, Amsterdam, Netherlands (author)
  • Hannink, GerjonDepartment of Medical Imaging, Radboud University Medical Centre, Radboud Institute for Health Sciences, Nijmegen, Netherlands (author)
  • Wolthuis, AlbertDepartment of Surgery, Uz Leuven, Leuven, Belgium (author)
  • De Lacy, Francisco B.Department of Gastrointestinal Surgery, Hospital Clinic of Barcelona, University of Barcelona, Barcelona, Spain (author)
  • Lefevre, Jérémie H.Department of Digestive Surgery, Sorbonne Université, AP-HP, Hôpital Saint Antoine, Paris, France (author)
  • Solomon, MichaelDepartment of Surgery, University of Sydney Central Clinical School, NSW, Camperdown, Australia (author)
  • Frasson, MatteoDepartment of Surgery, Valencia University Hospital la Fe, Valencia, Spain (author)
  • Rotholtz, Nicolas§§ Department of Surgery, Hospital Alemán, Buenos Aires, Argentina (author)
  • Denost, QuentinBordeaux Colorectal Institute, Clinique Tivoli, Bordeaux, France (author)
  • Perez, Rodrigo O.Department of Colorectal Surgery, Hospital Alemão Oswaldo Cruz, São Paulo, Brazil (author)
  • Konishi, TsuyoshiDepartment of Colon and Rectal Surgery, Division of Surgery, The University of Texas Md Anderson Cancer Center, TX, Houston, United States (author)
  • Panis, YvesDepartment of Colorectal Surgery, Colorectal Surgery Center, Groupe Hospitalier Privé Ambroise Paré-Hartmann, Neuilly Seine, France (author)
  • Rutegård, Martin,1982-Umeå universitet,Wallenberg centrum för molekylär medicin vid Umeå universitet (WCMM),Institutionen för kirurgisk och perioperativ vetenskap(Swepub:umu)maru0039 (author)
  • Hompes, RoelDepartment of Surgery, Amsterdam University Medical Centers, University of Amsterdam, Netherlands; Treatment and Quality of Life, Cancer Center Amsterdam, Amsterdam, Netherlands; Imaging and Biomarkers, Cancer Center Amsterdam, Amsterdam, Netherlands (author)
  • Rosman, CamielDepartment of Surgery, Radboud University Medical Centre, Radboud Institute for Health Sciences, Nijmegen, Netherlands (author)
  • Van Workum, FransDepartment of Surgery, Canisius Wilhelmina Hospital, Nijmegen, Netherlands (author)
  • Tanis, Pieter J.Department of Surgery, Amsterdam University Medical Centers, University of Amsterdam, Netherlands; Treatment and Quality of Life, Cancer Center Amsterdam, Amsterdam, Netherlands; Imaging and Biomarkers, Cancer Center Amsterdam, Amsterdam, Netherlands; Department of Surgical Oncology and Gastrointestinal Surgery, Erasmus Medical Centre, Rotterdam, Netherlands (author)
  • De Wilt, Johannes H.W.Department of Surgery, Radboud University Medical Centre, Radboud Institute for Health Sciences, Nijmegen, Netherlands (author)
  • Department of Surgery, Radboud University Medical Centre, Radboud Institute for Health Sciences, Nijmegen, NetherlandsDepartment of Surgery, Amsterdam University Medical Centers, University of Amsterdam, Netherlands; Treatment and Quality of Life, Cancer Center Amsterdam, Amsterdam, Netherlands; Imaging and Biomarkers, Cancer Center Amsterdam, Amsterdam, Netherlands (creator_code:org_t)

Related titles

  • In:Annals of Surgery: Wolters Kluwer278:5, s. 772-7800003-49321528-1140

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