2026-09-16T17:21:42Zhttps://gredos.usal.es/oai/request

oai:gredos.usal.es:10366/1610322025-04-30T19:28:15Zcom_10366_3974com_10366_3947com_10366_3946com_10366_3823col_10366_3975

Greijdanus, Nynke G. Wienholts, Kiedo Ubels, Sander Talboom, Kevin Hannink, Gerjon Wolthuis, Albert de Lacy, Francisco B. Lefevre, Jérémie H. Solomon, Michael Frasson, Matteo Rotholtz, Nicolas Denost, Quentin Perez, Rodrigo O. Konishi, Tsuyoshi Panis, Yves Rutegård, Martin Hompes, Roel Rosman, Camiel Van Workum, Frans Tanis, Pieter J. De Wilt, Johannes H.W. Alcázar Montero, José Antonio TENTACLE-Rectum Collaborative Group 2024-12-10T17:03:41Z 2024-12-10T17:03:41Z 2023 Greijdanus, N. G., Wienholts, K., Ubels, S., Talboom, K., Hannink, G., Wolthuis, A., De Lacy, F. B., Lefevre, J. H., Solomon, M., Frasson, M., Rotholtz, N., Denost, Q., Perez, R. O., Konishi, T., Panis, Y., Rutegård, M., Hompes, R., Rosman, C., Van Workum, F., … TENTACLE-Rectum Collaborative Group. (2023). Stoma-free survival after rectal cancer resection with anastomotic leakage: Development and validation of a prediction model in a large international cohort. Annals of Surgery. https://doi.org/10.1097/SLA.0000000000006043 0003-4932 http://hdl.handle.net/10366/161032 10.1097/SLA.0000000000006043 1528-1140 Objective: To develop and validate a prediction model (STOMA score) for 1-year stoma-free survival in patients with rectal cancer (RC) with anastomotic leakage (AL). Background: AL after RC resection often results in a permanent stoma. Methods: This international retrospective cohort study (TENTACLE-Rectum) encompassed 216 participating centres and included patients who developed AL after RC surgery between 2014 and 2018. Clinically relevant predictors for 1-year stoma-free survival were included in uni and multivariable logistic regression models. The STOMA score was developed and internally validated in a cohort of patients operated between 2014 and 2017, with subsequent temporal validation in a 2018 cohort. The discriminative power and calibration of the models' performance were evaluated. Results: This study included 2499 patients with AL, 1954 in the development cohort and 545 in the validation cohort. Baseline characteristics were comparable. One-year stoma-free survival was 45.0% in the development cohort and 43.7% in the validation cohort. The following predictors were included in the STOMA score: sex, age, American Society of Anestesiologist classification, body mass index, clinical M-disease, neoadjuvant therapy, abdominal and transanal approach, primary defunctioning stoma, multivisceral resection, clinical setting in which AL was diagnosed, postoperative day of AL diagnosis, abdominal contamination, anastomotic defect circumference, bowel wall ischemia, anastomotic fistula, retraction, and reactivation leakage. The STOMA score showed good discrimination and calibration (c-index: 0.71, 95% CI: 0.66-0.76). Conclusions: The STOMA score consists of 18 clinically relevant factors and estimates the individual risk for 1-year stoma-free survival in patients with AL after RC surgery, which may improve patient counseling and give guidance when analyzing the efficacy of different treatment strategies in future studies. The study was funded by the Medtronic External Research Program. eng Lippincott, Williams & Wilkins Atribución 4.0 Internacional http://creativecommons.org/licenses/by/4.0/ info:eu-repo/semantics/openAccess Anastomotic leakage Logistic regression model Permanent stoma Prediction model Rectal cancer Stomafree survival STOMA score Colorectal Surgery Colorectal Neoplasms Peritoneal Stomata 3207.13 Oncología 3213 Cirugía estomas peritoneales cirugía colorrectal neoplasias colorrectales Stoma-free Survival After Rectal Cancer Resection With Anastomotic Leakage info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion https://doi.org/10.1097/SLA.0000000000006043 https://journals.lww.com/annalsofsurgery/fulltext/2023/11000/stoma_free_survival_after_rectal_cancer_resection.19.aspx Annals of Surgery 278 5 772 780