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Peer-reviewedCC BY-NC 4.0Cancer Control: Journal of the Moffitt Cancer Center

Ovarian Cancer Lymphocele Risk: A Delphi-Based Retrospective Model Development and Validation

  • Lingjia Lu1,2
  • Tao Zhang1,2
  • Yingfan Zhu1,3
  • Li Zhao1,2
  • Jiali Xu1
  • Qingyi Zhang4
  • Chanyuan Li1,5
  • Xiaodong Wu1,2
  • Xiaodong Cheng1,2,6,7
7 affiliations
  1. 1Department of Gynecologic Oncology, Women’s Hospital, School of Medicine, Zhejiang University, Hangzhou, China
  2. 2Zhejiang Provincial Clinical Research Center for Obstetrics and Gynecology, Hangzhou, China
  3. 3Zhejiang University Clinical Medical Research Center, Hangzhou, China
  4. 4Chongqing Medical University, Chongqing, China
  5. 5Division of Engineering in Medicine, Brigham and Women’s Hospital, Harvard University, Boston, MA, USA
  6. 6Zhejiang Provincial Key Laboratory of Precision Diagnosis and Therapy for Major Gynecological Diseases, Women’s Hospital, School of Medicine, Zhejiang University, Hangzhou, China
  7. 7Zhejiang Provincial Key Laboratory of Traditional Chinese Medicine for Reproductive Health Research, Hangzhou, China
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Abstract

Introduction: Lymphocele is a common complication following gynecologic cancer surgery. Given that lymphadenectomy for ovarian cancer differs from that for other gynecologic malignancies, it is essential to determine whether the risk factors for postoperative lymphocele are specific to this patient population.

Method: A Delphi study was conducted to identify risk factors for postoperative lymphocele in ovarian cancer and to establish eligibility criteria for an institutional development cohort. Based on these findings, we retrospectively collected clinicopathological data from patients who underwent ovarian cancer staging surgery at our institution between 2019 and 2024. Postoperative lymphocele and baseline clinical variables were compared using chi-square tests and regression analyses. A nomogram for predicting lymphocele risk was developed using the least absolute shrinkage and selection operator (LASSO) method, and its performance was evaluated using calibration curves and decision curve analysis (DCA).

Results: Following three rounds of the Delphi survey, 13 risk factors met the criteria for expert consensus and boundary definition. Among 324 patients with ovarian cancer, multivariate analysis revealed that open surgery, a higher number of retrieved lymph nodes, and adjuvant therapy were independently associated with lymphocele. LASSO regression selected age, hypertension, diabetes, anemia, surgical approach, lymphadenectomy details (number and extent), lymph node metastasis, drainage, and adjuvant therapy as predictors for the nomogram. The model demonstrated good predictive performance (C-index: 0.784), which was confirmed by calibration and decision curve analyses.

Conclusion: By incorporating the Delphi method into the development of our prediction model, we achieved a more comprehensive identification of risk factors for postoperative lymphocele in ovarian cancer than previously reported. We anticipate that this innovative model will facilitate broader adoption in future clinical practice and research.

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Cite

BibTeXRIS
BibTeX
@article{lu2026ovarian,
  title = {{Ovarian Cancer Lymphocele Risk: A Delphi-Based Retrospective Model Development and Validation}},
  author = {Lingjia Lu and Tao Zhang and Yingfan Zhu and Li Zhao and Jiali Xu and Qingyi Zhang and Chanyuan Li and Xiaodong Wu and Xiaodong Cheng},
  journal = {Cancer Control: Journal of the Moffitt Cancer Center},
  year = {2026},
  month = sep,
  doi = {10.1177/10732748261490458},
  url = {https://doi.org/10.1177/10732748261490458},
  note = {CC BY-NC 4.0},
}
RIS
TY  - JOUR
TI  - Ovarian Cancer Lymphocele Risk: A Delphi-Based Retrospective Model Development and Validation
AU  - Lingjia Lu
AU  - Tao Zhang
AU  - Yingfan Zhu
AU  - Li Zhao
AU  - Jiali Xu
AU  - Qingyi Zhang
AU  - Chanyuan Li
AU  - Xiaodong Wu
AU  - Xiaodong Cheng
PY  - 2026
DA  - 2026/09/16
JO  - Cancer Control: Journal of the Moffitt Cancer Center
DO  - 10.1177/10732748261490458
UR  - https://doi.org/10.1177/10732748261490458
AB  - Introduction: Lymphocele is a common complication following gynecologic cancer surgery. Given that lymphadenectomy for ovarian cancer differs from that for other gynecologic malignancies, it is essential to determine whether the risk factors for postoperative lymphocele are specific to this patient population.  Method: A Delphi study was conducted to identify risk factors for postoperative lymphocele in ovarian cancer and to establish eligibility criteria for an institutional development cohort. Based on these findings, we retrospectively collected clinicopathological data from patients who underwent ovarian cancer staging surgery at our institution between 2019 and 2024. Postoperative lymphocele and baseline clinical variables were compared using chi-square tests and regression analyses. A nomogram for predicting lymphocele risk was developed using the least absolute shrinkage and selection operator (LASSO) method, and its performance was evaluated using calibration curves and decision curve analysis (DCA).  Results: Following three rounds of the Delphi survey, 13 risk factors met the criteria for expert consensus and boundary definition. Among 324 patients with ovarian cancer, multivariate analysis revealed that open surgery, a higher number of retrieved lymph nodes, and adjuvant therapy were independently associated with lymphocele. LASSO regression selected age, hypertension, diabetes, anemia, surgical approach, lymphadenectomy details (number and extent), lymph node metastasis, drainage, and adjuvant therapy as predictors for the nomogram. The model demonstrated good predictive performance (C-index: 0.784), which was confirmed by calibration and decision curve analyses.  Conclusion: By incorporating the Delphi method into the development of our prediction model, we achieved a more comprehensive identification of risk factors for postoperative lymphocele in ovarian cancer than previously reported. We anticipate that this innovative model will facilitate broader adoption in future clinical practice and research.
SN  - 1073-2748
SN  - 1526-2359
ER  -