A quantified risk-scoring system and rating model for postsurgical gastroparesis syndrome in gastric cancer patients

作者:Chen, Xiao-dong; Mao, Chen-chen; Zhang, Wei-teng; Lin, Ji; Wu, Rui-sen; Zhang, Feng-min; Sun, Xiang-wei; Chi, Chu-huai; Shen, Xian*; Wang, Peng-fei*
来源:Journal of Surgical Oncology, 2017, 116(4): 533-544.
DOI:10.1002/jso.24691

摘要

Background and ObjectivesThe study aimed to investigate the relationship between obesity and postsurgical gastroparesis syndrome (PGS), and to construct a scoring system and a risk model to identify patients at high risk. MethodsA total of 634 patients were retrospectively analyzed. Clinical characteristics were evaluated via receiver operating characteristic (ROC) curve analysis. Logistic analysis was performed to determine the independent predictive indicators of PGS. A scoring system consisting of these indicators and a risk-rating model were constructed and evaluated via ROC curve analysis. ResultsBased on the ROC curves, the visceral fat area (VFA) cutoff value for PGS was 94.00. Logistic analysis showed that visceral obesity (VFA94.00cm(2)), the reconstruction technique, and tumor size were independent prognostic factors for PGS. The scoring system could predict PGS reliably with a high area under the ROC curve ([AUC]=0.769). A high-risk rating had a high AUC (AUC I=0.56, AUC II=0.65, and AUC III=0.77), indicating that the risk-rating model could effectively screen patients at high risk of PGS. ConclusionsVisceral obesity defined by VFA effectively predicted PGS. Our scoring system may be a reliable instrument for identifying patients most at risk of PGS.