Internal validation and decision curve analysis of a preoperative nomogram predicting a postoperative complication in pheochromocytoma surgery: An international study.


Journal

International journal of urology : official journal of the Japanese Urological Association
ISSN: 1442-2042
Titre abrégé: Int J Urol
Pays: Australia
ID NLM: 9440237

Informations de publication

Date de publication:
May 2020
Historique:
received: 28 08 2019
accepted: 11 02 2020
pubmed: 3 4 2020
medline: 28 4 2021
entrez: 3 4 2020
Statut: ppublish

Résumé

To develop a preoperative nomogram that would predict the risk of a postoperative complication for pheochromocytoma patients undergoing adrenalectomy using an international database. We retrospectively analyzed preoperative variables and postoperative outcomes in patients who underwent adrenalectomy for pheochromocytoma in three institutions from 2000 to 2017. Internal validation of a generated nomogram was carried out with receiver operating characteristics, calibration plots, and decision curve analyses. A total of 153 patients who had undergone 166 adrenalectomies were included in the study. Overall, post-adrenalectomy complications were seen in 30% of patients, whereas 9.6% of patients sustained a Clavien ≥3a complication. Independent predictors of a complication were a history of hypertension, body mass index, tumor size, and Charlson Comorbidity Index score. On internal validation, the multivariable model generated a nomogram that predicted a postoperative complication or clinically hemodynamic event with an area under the curve of 0.86, showed good calibration and had an overall net benefit. An internally validated nomogram combining body mass index, Charlson Comorbidity Index score and tumor size can predict the probability of a post-adrenalectomy complication in those with and without hypertension. The model, the first of its kind in pheochromocytoma surgery, identifies patients at risk of a postoperative complication at the time of their presentation with pheochromocytoma.

Identifiants

pubmed: 32236993
doi: 10.1111/iju.14221
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

463-468

Commentaires et corrections

Type : CommentIn
Type : CommentIn

Informations de copyright

© 2020 The Japanese Urological Association.

Références

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Auteurs

John Phillips (J)

Department of Urology, Westchester Medical Center/New York Medical College, Valhalla, New York, USA.

Jonathan Bloom (J)

Urologic Oncology Branch, National Institutes of Health, Bethesda, Maryland, USA.

Vidhush Yarlagadda (V)

Departments of, Department of, Urology, University of Alabama at Birmingham, Birmingham, Alabama, USA.

Luciana Schultz (L)

and, Department of, Pathology, University of Alabama at Birmingham, Birmingham, Alabama, USA.

Jennifer Gordetsky (J)

Departments of, Department of, Urology, University of Alabama at Birmingham, Birmingham, Alabama, USA.
and, Department of, Pathology, University of Alabama at Birmingham, Birmingham, Alabama, USA.

Fabio Y Tanno (FY)

Division of Urology, Hospital Clinics of São Paulo, University of São Paulo Medical School, São Paulo, Brazil.

Jose L Chambo (JL)

Division of Urology, Hospital Clinics of São Paulo, University of São Paulo Medical School, São Paulo, Brazil.

Madson Q Almeida (MQ)

Division of Urology, Hospital Clinics of São Paulo, University of São Paulo Medical School, São Paulo, Brazil.

Maria Cbv Fragoso (MC)

Division of Urology, Hospital Clinics of São Paulo, University of São Paulo Medical School, São Paulo, Brazil.

Miguel Srougi (M)

Division of Urology, Hospital Clinics of São Paulo, University of São Paulo Medical School, São Paulo, Brazil.

Victor Srougi (V)

Division of Urology, Hospital Clinics of São Paulo, University of São Paulo Medical School, São Paulo, Brazil.

Soroush Rais-Bahrami (S)

Departments of, Department of, Urology, University of Alabama at Birmingham, Birmingham, Alabama, USA.
Department of Radiology, University of Alabama at Birmingham, Birmingham, Alabama, USA.
O'Neal Comprehensive Cancer Center at UAB, University of Alabama at Birmingham, Birmingham, Alabama, USA.

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