Nanchang University, Nanchang, China.
Department of General Surgery, Longnan people's Hospital, Longnan, China.
Cancer Med. 2023 Jul;12(14):15037-15053. doi: 10.1002/cam4.6166. Epub 2023 May 31.
Small intestine cancer (SIC) is difficult to diagnose early and presents a poor prognosis due to distant metastasis. This study aimed to develop nomograms for diagnosing and assessing the prognosis of SIC with distant metastasis.
Patients diagnosed with SIC between 2010 and 2015 were included from the Surveillance, Epidemiology and End Results database. Univariate and multifactor analysis determined independent risk factors for distant metastasis and prognostic factors for overall and cancer-specific survival. We then constructed the corresponding three nomograms and assessed the diagnostic accuracy of the nomograms by net reclassification improvement, receiver operating characteristic curves and calibration curves, assessed the clinical utility by decision curve analysis.
The cohort consisted of 6697 patients, of whom 1299 had distant metastasis at diagnosis. Tstage, Nstage, age, tumor size, grade, and histological type were independent risk factors for distant metastasis. Age, histological type, T stage, N stage, grade, tumor size, whether receiving surgery, number of lymph nodes removed, and the presence of bone or lung metastases were predictors of both overall survival and cancer-specific survival. The nomograms showed excellent accuracy in predicting distant metastasis and prognosis.
Nomograms were developed and validated for SIC patients with distant metastasis, aiding physicians in making rational and personalized clinical decisions.
小肠癌（SIC）早期诊断困难，且由于远处转移预后较差。本研究旨在建立用于诊断和评估伴有远处转移的 SIC 的预后的列线图。
从监测、流行病学和最终结果数据库中纳入 2010 年至 2015 年间诊断为 SIC 的患者。单因素和多因素分析确定了远处转移的独立危险因素和总生存期及癌症特异性生存期的预后因素。然后构建相应的三个列线图，并通过净重新分类改善、接收者操作特征曲线和校准曲线评估列线图的诊断准确性，通过决策曲线分析评估临床实用性。
该队列包括 6697 例患者，其中 1299 例在诊断时发生远处转移。T 分期、N 分期、年龄、肿瘤大小、分级和组织学类型是远处转移的独立危险因素。年龄、组织学类型、T 分期、N 分期、分级、肿瘤大小、是否接受手术、切除的淋巴结数量以及是否存在骨或肺转移是总生存期和癌症特异性生存期的预测因素。列线图在预测远处转移和预后方面具有出色的准确性。
为伴有远处转移的 SIC 患者开发并验证了列线图，有助于医生做出合理和个性化的临床决策。
