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Title: 腸管利用尿路変向を行った開腹膀胱全摘除術における術前因子を用いた周術期重度合併症予測ノモグラムの作成の試み
Other Titles: The Development of the Preoperative Nomogram Predicting Major Perioperative Complications after Radical Cystectomy with Ileal Conduit or Orthotopic Neobladder
Authors: 山田, 修平  KAKEN_name
大澤, 崇宏  KAKEN_name
安部, 崇重  KAKEN_name
高田, 徳容  KAKEN_name
松本, 隆児  KAKEN_name
伊藤, 陽一  KAKEN_name
菊地, 央  KAKEN_name
宮島, 直人  KAKEN_name
土屋, 邦彦  KAKEN_name
丸山, 覚  KAKEN_name
村井, 祥代  KAKEN_name
篠原, 信雄  KAKEN_name
Author's alias: Yamada, Shuhei
Osawa, Takahiro
Abe, Takashige
Takada, Norikata
Matsumoto, Ryuji
Ito, Yoichi M
Kikuchi, Hiroshi
Miyajima, Naoto
Tsuchiya, Kunihiko
Maruyama, Satoru
Murai, Sachiyo
Shinohara, Nobuo
Keywords: Bladder cancer
Radical cystectomy
Issue Date: 31-Dec-2019
Publisher: 泌尿器科紀要刊行会
Journal title: 泌尿器科紀要 = Acta urologica Japonica
Volume: 65
Issue: 12
Start page: 495
End page: 499
Abstract: Radical cystectomy (RC) is the gold standard for managing muscle-invasive and high-risknon-muscleinvasive bladder cancer, but is accompanied by non-negligible operative risk. The aim of this study is to identify preoperative variables to predict major perioperative complications after RC and to develop a nomogram using the cohort from multiple institutions in Japan. We retrospectively reviewed 668 patients who underwent open RC with ileal conduit or neobladder at Hokkaido University hospital and 20 affiliated institutions between 1997 and 2010. Complications occurring within 90 days of surgery were graded using modified Clavien classification system. We defined modified Clavien grade 3 or more as major complications and performed univariate and multivariate logistic regression analyses. Predictive accuracy of the nomogram was evaluated with the area under the receiver operating characteristics curve (AUC). A total of 528 men and 140 women were included in this study. There were a total of 160/668 patients (24%) with major perioperative complications. A multivariate model identified gender (OR : 1. 63, p=0. 04), cardiovascular comorbidity (OR : 1.48, p=0.03) and simultaneous nephroureterectomy (OR : 2.81, p=0. 01) as independent predictors. Using these 3 variables, a nomogram was developed with the AUC of 0.58. Predictive performance of our nomogram showed only fair performance ; but at least, we identified male, cardiovascular comorbidity and simultaneous nephroureterectomy as independent predictors of perioperative major complications.
Rights: 許諾条件により本文は2021/01/01に公開
DOI: 10.14989/ActaUrolJap_65_12_495
PubMed ID: 31933333
Appears in Collections:Vol.65 No.12

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