#0096
Predictors of Hemorrhage after Partial Nephrectomy for Stage T1 Renal Cell Carcinoma: 10-year Experience from a Regional Medical Center in Eastern China
Y. Yao1, J. Ji1, T. Liu1, J. Mei1, L. Sun1, G. Zhang1
1The Affiliated Hospital of Qingdao University, Urology, Qingdao, China
Introduction:
Hemorrhage is the most frequent postoperative complication of partial nephrectomy (PN). This study aimed to develop and validate a nomogram to predict hemorrhage after PN in patients with stage T1 renal cell carcinoma (RCC).
Material and methods:
Patients diagnosed with stage T1 RCC who underwent PN in our center over a 10-year period were retrospectively reviewed. Hemorrhage was defined as >30 g/L decrease in hemoglobin after surgery, receipt of blood transfusion, presence of arteriovenous fistula or pseudoaneurysm on imaging, or hemorrhage requiring surgical intervention. Univariate and multivariate logistic regression analyses were performed to explore potential risk factors and develop the nomogram. Internal validation was conducted to assess nomogram performance.
Results:
Among the 1015 patients included for analysis, 36 experienced hemorrhage (3.55%). Hypertension (odds ratio [OR], 2.657; 95% confidence interval [CI], 1.262–5.594, P = 0.010), tumor size (OR, 10.213; 95% CI, 3.966–26.297; P <0.001), and Mayo Adhesive Probability (MAP) score (OR, 5.158; 95% CI, 2.448–10.868; P <0.001) were independent predictors for hemorrhage and used to construct the nomogram model. The nomogram model showed a favorable predictive efficacy with area under the receiver operator characteristic curve of 0.805 (95% CI, 0.723–0.888). The corrected area under the curve was 0.799 after 1000 bootstrap resampling. The calibration curve showed its stability. Decision curve analysis and the clinical impact curve showed the nomogram’s clinical applicability in a specific threshold range.