Department of Colorectal Surgery, the Second Affiliated Hospital of Harbin Medical University, Harbin, 150086, China.
Sci Rep. 2022 Mar 25;12(1):5214. doi: 10.1038/s41598-022-09228-3.
Exploring a modified stage (mStage) for pN0 colon cancer patients. 39,637 pN0 colon cancer patients were collected from the SEER database (2010-2015) (development cohort) and 455 pN0 colon cancer patients from the Second Affiliated Hospital of Harbin Medical University (2011-2015) (validation cohort). The optimal lymph nodes examined (LNE) stratification for cancer-specific survival (CSS) was obtained by X-tile software in the development cohort. LNE is combined with conventional T stage to form the mStage. The novel N stage was built based on the LNE (N0a: LNE ≥ 26, N0b: LNE = 11-25 and N0c: LNE ≤ 10). The mStage include mStageA (T1N0a, T1N0b, T1N0c and T2N0a), mStageB (T2N0b, T2N0c and T3N0a), mStageC (T3N0b), mStageD (T3N0c, T4aN0a and T4bN0a), mStageE (T4aN0b and T4bN0b) and mStageF (T4aN0c and T4bN0c). Cox regression model showed that mStage was an independent prognostic factor. AUC showed that the predictive accuracy of mStage was better than the conventional T stage for 5-year CSS in the development (0.700 vs. 0.678, P < 0.001) and validation cohort (0.649 vs. 0.603, P = 0.018). The C-index also showed that mStage had a superior model-fitting. Besides, calibration curves for 3-year and 5-year CSS revealed good consistencies between observed and predicted survival rates. For pN0 colon cancer patients, mStage might be superior to conventional T stage in predicting the prognosis.
探索 pN0 结肠癌患者的改良分期（mStage）。从 SEER 数据库（2010-2015 年）中收集了 39637 例 pN0 结肠癌患者（开发队列），并从哈尔滨医科大学第二附属医院（2011-2015 年）收集了 455 例 pN0 结肠癌患者（验证队列）。X-tile 软件在开发队列中获得了用于癌症特异性生存（CSS）的最佳检查淋巴结（LNE）分层。LNE 与传统 T 分期相结合形成 mStage。基于 LNE 构建了新的 N 分期（N0a：LNE≥26，N0b：LNE=11-25，N0c：LNE≤10）。mStage 包括 mStageA（T1N0a、T1N0b、T1N0c 和 T2N0a）、mStageB（T2N0b、T2N0c 和 T3N0a）、mStageC（T3N0b）、mStageD（T3N0c、T4aN0a 和 T4bN0a）、mStageE（T4aN0b 和 T4bN0b）和 mStageF（T4aN0c 和 T4bN0c）。Cox 回归模型表明 mStage 是一个独立的预后因素。AUC 显示，在开发队列（0.700 与 0.678，P<0.001）和验证队列（0.649 与 0.603，P=0.018）中，mStage 对 5 年 CSS 的预测准确性优于传统 T 分期。C 指数也表明 mStage 具有更好的模型拟合。此外，3 年和 5 年 CSS 的校准曲线显示，观察到的生存率与预测的生存率之间具有良好的一致性。对于 pN0 结肠癌患者，mStage 可能在预测预后方面优于传统 T 分期。
