Nomogram for Predicting Osteoradionecrosis After Fibula Free Flap for Mandibular Reconstruction.
Abstract
[BACKGROUND] Osteoradionecrosis (ORN) is a severe complication following radiotherapy (RT), particularly after mandibular reconstruction with a fibula free flap. Risk prediction remains challenging due to limited data.
[METHODS] We conducted a multicenter retrospective study including 294 patients who underwent fibula free flap reconstruction and adjuvant RT. A predictive nomogram for ORN was developed using logistic regression with stepwise backward selection, validated via 10-fold cross-validation.
[RESULTS] ORN occurred in 9.9% of patients. Eight variables were retained in the final model, which demonstrated excellent discrimination (AUC = 0.94) and good calibration (mean absolute error = 0.017). The optimal threshold for classification was 0.30, with the model achieving a sensitivity of 1.0, specificity of 0.80, and an overall accuracy of 0.82.
[CONCLUSION] This is the first nomogram developed to predict ORN following fibula free flap mandibular reconstruction. It provides a personalized risk estimate, supporting individualized clinical decision-making and improved pre- and postoperative planning. Prospective validation is warranted.
[METHODS] We conducted a multicenter retrospective study including 294 patients who underwent fibula free flap reconstruction and adjuvant RT. A predictive nomogram for ORN was developed using logistic regression with stepwise backward selection, validated via 10-fold cross-validation.
[RESULTS] ORN occurred in 9.9% of patients. Eight variables were retained in the final model, which demonstrated excellent discrimination (AUC = 0.94) and good calibration (mean absolute error = 0.017). The optimal threshold for classification was 0.30, with the model achieving a sensitivity of 1.0, specificity of 0.80, and an overall accuracy of 0.82.
[CONCLUSION] This is the first nomogram developed to predict ORN following fibula free flap mandibular reconstruction. It provides a personalized risk estimate, supporting individualized clinical decision-making and improved pre- and postoperative planning. Prospective validation is warranted.
추출된 의학 개체 (NER)
| 유형 | 영어 표현 | 한국어 / 풀이 | UMLS CUI | 출처 | 등장 |
|---|---|---|---|---|---|
| 시술 | free flap
|
피판재건술 | dict | 4 |
MeSH Terms
Humans; Osteoradionecrosis; Free Tissue Flaps; Retrospective Studies; Male; Middle Aged; Female; Nomograms; Mandibular Reconstruction; Fibula; Aged; Risk Assessment; Adult; Logistic Models; Radiotherapy, Adjuvant
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