Department of Abdominal Oncology, West China Hospital of Medicine, Sichuan University, No.37 Guo Xue Xiang, Chengdu, 610041, Sichuan, People's Republic of China.
Department of Colorectal Surgery, Changhai Hospital, Naval Medical University, Shanghai, China.
Int J Colorectal Dis. 2021 Jun;36(6):1201-1208. doi: 10.1007/s00384-021-03842-9. Epub 2021 Jan 28.
As a kind of secondary tumor of the ovary, ovarian metastasis from colorectal cancer (OMCRC) happens rarely. Prognostic factors of OMCRC are still undetermined. This study was conducted to analyze clinical characteristics and prognostic factors of OMCRC patients.
Data of patients with OMCRC were collected retrospectively from four large-capacity hospitals in China. Kaplan-Meier method was applied to estimate disease-specific overall survival (OS), and multivariate Cox regression analysis was used to identify prognostic factors. A novel nomogram was developed to estimate individual survival probability, whose performance was internally validated using concordance index (C-index) and calibration curve.
Totally, 162 cases were eligible, with a median age at diagnosis of 49 years old. The median size of ovarian metastases was 9.0 cm (95% CI: 8.5-10.4 cm). 93.8% of patients received surgery of ovarian metastases. Median time from CRC diagnosis to metachronous ovarian metastasis was 13.0 months (95% CI: 13.5-17.7 months). Median OS after ovarian metastasis diagnosis was 26.0 months (95% CI: 22.3-29.7 months). Integrating univariate and multivariate analyses, eight factors (including age, menopausal status, primary tumor location, N stage of primary tumor, surgery of primary tumor, differentiation grade, bilateral metastasis, and systemic chemotherapy) were used to develop a novel nomogram, with a C-index of 0.65 (95% CI: 0.595-0.705). Calibration curves indicated relatively good agreement between predicted and actual survival.
This nomogram could be a promising tool to help clinicians to estimate individual survival outcome of patients with OMCRC. Further study is warranted to validate the practicality of this model.
卵巢转移癌是卵巢的一种继发性肿瘤，由结直肠癌（CRC）转移至卵巢的情况较为少见。卵巢转移癌的预后因素仍未确定。本研究旨在分析卵巢转移癌患者的临床特征和预后因素。
本研究回顾性收集了中国 4 家大型医院的卵巢转移癌患者数据。采用 Kaplan-Meier 法估计疾病特异性总生存期（OS），并采用多变量 Cox 回归分析确定预后因素。构建了一个新的列线图来估计个体的生存概率，通过一致性指数（C-index）和校准曲线对其性能进行内部验证。
共纳入 162 例符合条件的患者，诊断时的中位年龄为 49 岁。卵巢转移灶的中位大小为 9.0cm（95%CI：8.5-10.4cm）。93.8%的患者接受了卵巢转移灶的手术治疗。从 CRC 诊断到卵巢转移的中位时间为 13.0 个月（95%CI：13.5-17.7 个月）。卵巢转移诊断后的中位 OS 为 26.0 个月（95%CI：22.3-29.7 个月）。通过单因素和多因素分析，整合 8 个因素（包括年龄、绝经状态、原发肿瘤位置、原发肿瘤 N 分期、原发肿瘤手术、分化程度、双侧转移和全身化疗），构建了一个新的列线图，C-index 为 0.65（95%CI：0.595-0.705）。校准曲线表明，预测生存与实际生存之间具有较好的一致性。
该列线图可能是一种有前途的工具，可以帮助临床医生评估卵巢转移癌患者的个体生存结局。需要进一步的研究来验证该模型的实用性。
