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The following is a summary of “Individualized prediction of stent patency in malignant colonic obstruction: development and validation of a prognostic model,” published in the April 2025 issue of the World Journal of Surgical Oncology by Wan et al.

Self-expandable metallic stents (SEMS) are widely used as a palliative treatment for patients with primary malignant colonic obstruction. However, predicting stent patency duration remains a clinical challenge, which limits optimal patient management and treatment planning. This study aimed to develop and validate a predictive model to estimate stent patency following SEMS placement in patients with malignant colonic obstruction, thereby facilitating individualized clinical decision-making.

The study retrospectively analyzed data from patients diagnosed with primary malignant colonic obstruction who underwent SEMS placement. A total of 121 patients were included in the training cohort, from which relevant clinical variables were extracted and subjected to univariate and multivariate Cox proportional hazards regression analyses to identify independent predictors of stent patency. These variables were incorporated into a prognostic nomogram designed to predict time-specific probabilities of stent function. The performance of the nomogram was evaluated using a time-dependent area under the receiver operating characteristic curve at multiple time points (30, 90, 180, and 360 days). External validation of the model was conducted using an independent cohort of 36 patients.

Three clinical factors—pre-chemotherapy status (P < 0.001), duration of obstruction prior to intervention (P = 0.005), and post-chemotherapy status (P < 0.001)—were identified as significant independent predictors of stent patency and incorporated into the final model. In the training cohort, the nomogram demonstrated excellent discriminatory power, with AUCs of 0.898 at 30 days, 0.778 at 90 days, 0.728 at 180 days, and 0.844 at 360 days. In the validation cohort, the model maintained acceptable performance, with AUCs of 0.654, 0.745, 0.777, and 0.740 at the corresponding time points. These results indicate consistent predictive accuracy across different follow-up periods. The nomogram, designed for ease of clinical use, provides individualized risk assessment and can support more informed decision-making regarding follow-up and adjunct therapies.

This study presents a clinically applicable and statistically robust nomogram for predicting stent patency in patients undergoing SEMS placement for malignant colonic obstruction. The model, based on three readily available clinical variables, demonstrated strong predictive ability in both internal and external datasets. While the findings suggest potential utility in guiding personalized management strategies, further prospective and multi-institutional validation is warranted to confirm generalizability and support the integration of these strategies into routine clinical practice.

Source: wjso.biomedcentral.com/articles/10.1186/s12957-025-03782-6