Nomographic predictive models for complications after minimally invasive esophagectomy: Current status and future perspectives

Table 5 List of risk predictive nomograms developed for prediction of post esophagectomy morbidity

Ref.	Study size and period	Procedure	Morbidity predicted using nomogram	Risk factors influencing morbidity	Statistical significance
Yu et al[92], 2021	604 (2018-2020)	Open esophagectomy (53%) + MIE (47%)	Anastomotic leak	Smoking index, ASA score, anastomosis level (chest/neck, anastomotic technique, prognostic nutrition index	AUC = 0.766
Tong et al[93], 2022	969 (NS)	MIE	Pulmonary complications	Age, high BMI, smoking, FEV1/FVC, chemoradiotherapy, blood loss, general anesthesia, operative time, conversion to thoracotomy	C index = 0.654
Jin et al[94], 2022	609 (2015-2019)	MIE	Post operative pneumonia	Age, gender, abdominal phase approach, thoracic operative time, duration of chest tube placement, anastomotic leakage, RLN palsy	C index = 0.77
					AUC = 0.66
Su et al[95], 2023	308 (2018-2022)	MIE	Anastomotic leak	Age, post operative delirium, pleural adhesions, post operative pulmonary complication, raised TLC, low lymphocyte	C index = 0.96
					AUC = 0.96
Chen et al[9], 2022	285 (NS)	MIE (McKeowns esophagectomy)	Anastomotic leak	Aortic calcification, preexisting heart disease, obesity, low FEV1	C index = 0.67
Xi et al[96], 2020	119 (2019-2020)	Open esophagectomy (15%) + MIE (85%)	Post operative morbidity	BMI, ASA score, diabetes, eSAS (blood loss, lowest MAP, lowest HR)	C index = 0.903 (internal validation) 0.967 (external validation)
Zhong et al[50], 2025	747 (2019-2024)	MIE	Serious adverse events	Age, alcohol consumption, COPD, neoadjuvant radiotherapy, tumour size, FEV1, calcium, hemoglobin, albumin	AUC = 0.793

A C index (Concordance index) more than 0.7 suggests good discriminative capacity of the predictive model. A value less than 0.5 indicates discrimination by random chance and a value of 1.0 represents perfect discrimination. MIE: Minimally invasive esophagectomy; ASA: American Society of Anesthesia; AUC: Area under the curve for receiver operating characteristic curve; BMI: Body mass index; FEV1: Forced expiratory volume in 1 second; FVC: Forced vital capacity; RLN: Recurrent laryngeal nerve; TLC: Total leucocyte count; eSAS: Esophageal surgical Apgar score; MAP: Mean arterial pressure; COPD: Chronic obstructive pulmonary disease; HR: Hazard ratio.