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A Nomogram with the Keloid Activity Assessment Scale for Predicting the Recurrence of Chest Keloid after Surgery and Radiotherapy

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Abstract

Background

Patients with chest keloids undergoing surgery and adjuvant radiotherapy still have a high recurrence rate, which is a critical problem. The level of keloid activity has not been studied, and a nomogram model for predicting keloid recurrence has not been established in previous studies.

Methods

A total of 145 patients with chest keloids who underwent surgery and radiotherapy between January 2015 and January 2019 at Peking Union Medical College Hospital were included in our study. Demographic and clinical features and the score of KAAS were analyzed. We compared the area under the curve (AUC) and decision curve analysis (DCA) between KAAS and the Vancouver scar scale (VSS) and established a nomogram model for predicting the risk of recurrence. We used bootstrap and calibration plots to evaluate the performance of the nomogram.

Results

The KAAS can predict recurrence in patients with chest keloids after surgery and radiotherapy. Areas under the curve (AUCs) of KAAS and VSS were 0.858 and 0.711, respectively (p < 0.001). Decision curve analysis (DCA) demonstrated that the KAAS was better than the VSS. Complications after treatment may be risk factors for keloid recurrence. We created a nomogram by using complications and KAAS. The AUC was 0.871 (95% CI 0.812–0.930). The ROC of the model’s bootstrap was 0.865 and was well calibrated.

Conclusions

The KAAS can be used to predict the recurrence and we developed a nomogram for predicting the recurrence of chest keloids after surgery and adjuvant radiotherapy.

Level of Evidence IV

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Abbreviations

AUC:

Area under the curve

DCA:

Decision curve analysis

KAAS:

Keloid activity assessment scale

VSS:

Vancouver scar scale

CI:

Confidence interval

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Funding

This study was supported by the Beijing Municipal Commission of Science and Technology (Z191100006619009) as well as the National Natural Science Foundation of China (81871538).

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Authors and Affiliations

  1. Department of Plastic Surgery, Peking Union Medical College Hospital, No.41 Damucang Hutong, Xicheng District, Beijing, China

    Hao Liu, Kexin Song & Youbin Wang

  2. Peking Union Medical College, Chinese Academy of Medical Sciences, Peking Union Medical College Hospital, Beijing, China

    Yan Hao, Zhengyun Liang, Mengjie Shan & Yijun Xia

Authors
  1. Yan Hao
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  2. Zhengyun Liang
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  7. Youbin Wang
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Corresponding author

Correspondence to Youbin Wang.

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Ethical Approval

This study was approved by the ethics committee of the Institutional Review Board of PUMCH (Ethic Review Number: S-K1765). All patients agreed to use their pictures in this study, and they cannot be recognized.

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Hao, Y., Liang, Z., Liu, H. et al. A Nomogram with the Keloid Activity Assessment Scale for Predicting the Recurrence of Chest Keloid after Surgery and Radiotherapy. Aesth Plast Surg 47, 872–879 (2023). https://doi.org/10.1007/s00266-022-03187-w

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  • DOI: https://doi.org/10.1007/s00266-022-03187-w

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