Huang et al reported a nomogram for predicting the likelihood of a rectovaginal fistula developing after a low anterior resection for rectal cancer. The authors are from Fujian Medical University in China.
Patient selection: woman with rectal cancer undergoing a low anterior resection
Parameters:
(1) hemoglobin in g/L
(2) tumor location in cm from the anal verge
(3) surgical procedure
(4) hysterectomy
(5) bilateral oophorectomy
Parameter
Finding
Points
hemoglobin
> 120 g/L
0
90.1 to 120 g/L
21.25
<= 90 g/L
100
tumor location
> 5 cm
0
<= 5 cm
56.7
surgical procedure
low anterior resection
0
ultra-low anterior resection
14.28
intersphincteric resection
54.94
hysterectomy
no
0
yes
41.16
bilateral oophorectomy
no
0
yes
66.78
total score =
= SUM(points for all of the parameters)
Interpretation:
• minimum score: 0
• maximum score: 319.62
value of X =
= (0.02862 * (score)) - 5.686
probability of a rectovaginal fistula =
= 1 / (1 + EXP((-1) * X))
Performance:
• The area under the ROC curve is 0.824.
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