Construction of an individualized nomogram model for predicting the risk of pharyngocutaneous fistula in postoperative patients with laryngeal carcinoma
CHEN Qingsi1, YANG Yeqin2, WENG Chengjie2, LIN Liqin1, DAI Chaohui1, CHEN Chengshui3
1.Department of Otolaryngology, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325015, China; 2.School of Nursing, Wenzhou Medical University,Wenzhou 325035, China; 3.Department of Respiratory and Critical Care Medicine, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325015, China
CHEN Qingsi,YANG Yeqin,WENG Chengjie, et al. Construction of an individualized nomogram model for predicting the risk of pharyngocutaneous fistula in postoperative patients with laryngeal carcinoma[J]. JOURNAL OF WEZHOU MEDICAL UNIVERSITY, 2022, 52(6): 472-477.
Abstract：Objective: To construct an individualized nomogram model for predicting the risk of pharyngocutaneous fistula in postoperative patients with laryngeal carcinoma. Methods: Altogether 252 patients who underwent total laryngectomy or partial laryngectomy in the First Affiliated Hospital of Wenzhou Medical University from January 2018 to July 2021 were divided into pharyngocutaneous fistula group (n=49) and non-pharyngocutaneous fistula group (n=203) according to whether pharyngocutaneous fistula occurred after operation. The data were compared between the two groups. Univariate analysis and Logistic regression analysis were made of the influencing factors of pharyngocutaneous fistula in patients with laryngeal carcinoma after operation; the risk prediction model was established and the nomogram was drawn; C-index, calibration curve and Hosmer-Lemeshow test were used to evaluate the prediction value of the model. Results: Tumor stage, preoperative radiotherapy history, nutritional risk and intraoperative flap repair were independent risk factors for pharyngocutaneous fistula in patients with postoperative laryngeal carcinoma. The calculated C-index was 0.842 (95%CI=0.776-0.908). The calibration curve confirmed that the predicted results of the model were in good
agreement with the actual results and Hosmer-Lemeshow goodness of fit test (χ2=7.564, P=0.477). Conclusion:Tumor stage, preoperative radiotherapy history, nutritional risk and intraoperative flap repair can increase the incidence of pharyngocutaneous fistula in patients with postoperative laryngeal carcinoma. The nomogram prediction model can effectively predict the incidence of pharyngocutaneous fistula after laryngeal carcinoma surgery.
