Prediction of anastomotic leakage after esophagectomy for esophageal cancer: a nomogram study integrating systemic inflammation indices and clinical factors.
Nomogram predicted anastomotic leakage after esophagectomy with AUC of 0.813
Prediction of anastomotic leakage after esophagectomy for esophageal cancer: a nomogram study integrating systemic inflammation indices and clinical factors.
Esophageal cancer remains one of the leading causes of cancer-related mortality worldwide.
This study aims to develop and validate a predictive model for assessing the risk of anastomotic leakage in esophageal cancer patients undergoing esophagectomy, based on comprehensive clinical and laboratory variables.
This retrospective cohort study included 650 esophageal cancer patients who underwent esophagectomy between January 2015 and May 2025, divided into a training set (n = 455) and a validation set (n = 195) at 7:3 ratio.
higher scores mean more accurate leak prediction, 1.0 would be perfect
Seven significant predictors of anastomotic leakage were identified in the training set: age, neoadjuvant radiotherapy, C-reactive protein-albumin-lymphocyte (CALLY) index, hypertension, neutrophil-to-lymphocyte ratio (neutrophil-to-lymphocyte ratio), neutrophil-to-monocyte ratio (neutrophil-to-monocyte ratio), and platelet-to-lymphocyte ratio (platelet-to-lymphocyte ratio).
The validation cohort demonstrated moderate predictive accuracy (AUC = 0.763), with consistent net benefits observed across different risk thresholds in decision curve analysis.
In conclusion, this study established a potentially useful predictive model for anastomotic leakage risk, which may facilitate individualized risk stratification, guide perioperative decision-making, and ultimately contribute to reducing anastomotic leakage incidence and improving postoperative recovery.