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Nomogram to Predict Incomplete Cytoreduction for Pseudomyxoma Peritonei

  • Peritoneal Surface Malignancy
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Backgrounds

The completeness of cytoreduction is one of the most important prognostic factors for patients with pseudomyxoma peritonei (PMP). To date, no nomograms have been established to predict incomplete cytoreduction (IC) for patients with PMP. The current study therefore proposed a nomogram to predict individual IC risk for PMP patients.

Methods

Between 1 June 2013, and 22 November 2019, 144 consecutive PMP patients who underwent cytoreductive surgery (CRS) combined with hyperthermic intraperitoneal chemotherapy (HIPEC) for the first time in our center were included in a retrospective study. Possible predictors of cytoreducibility were analyzed using logistic regression modeling to predict IC for PMP patients. A nomogram was developed based on the multivariate analysis and further investigated for internal validation.

Results

After CRS, the 144 participants were divided into complete CRS (CCRS) (n = 46) and IC (n = 98) subgroups. Four independent predictors (sex, disease duration, anemia, and carbohydrate antigen 19-9 (CA 199)) were included in the prediction model. Then, a nomogram predicting IC was established based on the aforementioned variables, which demonstrated good predictive accuracy (C-index, 0.837; 95 % confidence interval [CI], 0.764–0.894). The predicted probability was close to the actual observed outcome according to the calibration plot.

Conclusions

The current work led to the development of a nomogram capable of predicting IC for PMP patients who demonstrated good performance. Risk stratification by the established nomogram had ability to optimize individual IC prediction and help physicians to establish meticulous preoperative plans.

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Acknowledgments

We thank Shilong Wang for setting up the PMP follow-up database. We also thank LetPub (www.letpub.com) for its linguistic assistance during the preparation of this report.

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Authors and Affiliations

  1. Clinical Laboratory Medicine, Peking University Ninth School of Clinical Medicine, Beijing, China

    Mingjian Bai & Man Zhang

  2. Clinical Laboratory Medicine, Beijing Shijitan Hospital, Capital Medical University, Beijing, China

    Mingjian Bai & Man Zhang

  3. Beijing Key Laboratory of Urinary Cellular Molecular Diagnostics, Beijing, China

    Mingjian Bai & Man Zhang

  4. Department of Myxoma, Aerospace Center Hospital, Beijing, China

    Shilong Wang, Ying Cai, Ruiqing Ma & Hongbin Xu

  5. Department of Clinical Laboratory, Aerospace Center Hospital, Beijing, China

    Guowei Liang

  6. Department of Pathology, Aerospace Center Hospital, Beijing, China

    Yiyan Lu

  7. Department of Hand and Foot Surgery, Zibo Central Hospital, Zibo, Shandong Province, China

    Nianzong Hou

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  1. Mingjian Bai
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  2. Shilong Wang
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  8. Hongbin Xu
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  9. Man Zhang
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Correspondence to Man Zhang.

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Bai, M., Wang, S., Liang, G. et al. Nomogram to Predict Incomplete Cytoreduction for Pseudomyxoma Peritonei. Ann Surg Oncol 29, 885–892 (2022). https://doi.org/10.1245/s10434-021-10725-4

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  • DOI: https://doi.org/10.1245/s10434-021-10725-4

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