Development and validation of a predictive model for severe complications following ovarian cancer cytoreductive surgery combined with hyperthermic intraperitoneal chemotherapy
To construct and validate a risk prediction model for severe complications in ovarian cancer patients undergoing cytoreductive surgery combined with hyperthermic intraperitoneal chemotherapy (CRS-HIPEC). Patients who underwent CRS-HIPEC were enrolled from January 2021 to June 2025 and were randomly divided (4:1) into training and validation sets. Predictors of severe complications were identified and integrated into a nomogram. The nomogram's performance was evaluated through calibration, discrimination, and clinical utility. a total of 391 patients were included, with 313 in the training set and 78 in the validation set. Severe complications were diagnosed in 142(36.3%) patients, including 113(36.1%) in the training set and 29(37.2%) in the validation set. The final model incorporated four predictors: nutritional risk screening score (NRS-2002), high-sensitivity C-reactive protein, PCI, and operative duration. The nomogram demonstrated robust discrimination, with AUCs of 0.888 (95% CI 0.853-0.924) in training set and 0.857 (95% CI 0.767-0.950) in validation set. The Hosmer-Lemeshow tests for the model training and validation sets were χ Severe complications are common after CRS-HIPEC. Independent risk factors include high-sensitivity C-reactive protein, nutritional risk screening score, PCI, and operative duration. The visualized nomogram and risk stratification provided in this study conceptualize a preliminary framework for differentiated management pathways.