文献检索文档翻译深度研究
Suppr Zotero 插件Zotero 插件
邀请有礼套餐&价格历史记录

新学期,新优惠

限时优惠:9月1日-9月22日

30天高级会员仅需29元

1天体验卡首发特惠仅需5.99元

了解详情
不再提醒
插件&应用
Suppr Zotero 插件Zotero 插件浏览器插件Mac 客户端Windows 客户端微信小程序
高级版
套餐订阅购买积分包
AI 工具
文献检索文档翻译深度研究
关于我们
关于 Suppr公司介绍联系我们用户协议隐私条款
关注我们

Suppr 超能文献

核心技术专利:CN118964589B侵权必究
粤ICP备2023148730 号-1Suppr @ 2025

横结肠癌死亡概率的预测:基于21469例患者的竞争风险列线图

Prediction of death probability in adenocarcinoma of the transverse colon: competing-risk nomograms based on 21,469 patients.

作者信息

Su Hongbo, Wang Shanshan, Xie Shuping, Huang Liying, Pan Yunlong, Lyu Jun

机构信息

Department of General Surgery, The First Affiliated Hospital of Jinan University, Guangzhou, 510632, Guangdong, China.

Section of Occupational Medicine, Department of Special Medicine, Shanxi Medical University, Taiyuan, 030001, Shanxi, China.

出版信息

J Cancer Res Clin Oncol. 2023 Sep;149(12):10435-10452. doi: 10.1007/s00432-023-04913-w. Epub 2023 Jun 6.


DOI:10.1007/s00432-023-04913-w
PMID:37278827
Abstract

PURPOSE: Tumors in parts of the colon other than the transverse colon have been well studied, but little is known about adenocarcinoma of the transverse colon (ATC).The aim of this study was to construct nomograms using competing-risk model for accurately predicting the probability of cancer-specific and non-cancer-specific death in patients with ATC. METHODS: Data on eligible patients recorded during 2000-2019 in the Surveillance, Epidemiology, and End Results database were extracted and screened. Factors that influencing prognosis were screened for death from ATC (DATC) and death from other causes (DOC) using competing-risk analysis, including univariate and multivariate analyses based on Gray's test and the Fine-Gray model, respectively. Independent prognostic factors were identified and nomograms were constructed. For comparison, we also constructed a Cox model and an AJCC stage-only competing-risk model (AJCC model) for patients with DATC. Performance evaluations of the nomograms and comparison between the models were performed using calibration plots, Harrell's concordance index (C-index), receiver operating characteristic (ROC) curves, and the areas under the ROC curve (AUCs). The nomograms and models were validated using a validation cohort. The net reclassification index, integrated discrimination improvement, decision curves, and risk stratification were not assessed because no accepted methods were suited for competing-risk model. RESULTS: This study included 21,469 patients with ATC, and 17 and 9 independent influencing factors were identified for the construction of DATC nomograms (DATCN) and DOC nomograms (DOCN), respectively. In both the training and validation cohorts, the calibration curves indicated good agreement between the nomogram-based predictions and the actual observations in the two nomograms, respectively. The C-index of the DATCN was higher than 80% (80.3-83.3%) at 1, 3 and 5 years in both the training and validation cohorts, significantly outperforming the AJCC (76.7-78%) and Cox (75.4-79.5%) model. The C-index of the DOCN was also higher than 69% (69.0-73.6%). In terms of ROC curves at each time point, those of the DATCN were very close to the upper-left corner of the coordinate axis in both the training and validation cohorts, and their AUCs were larger than 84% (84.2-85.4%).The AUCs of the AJCC (78.4-81.1%) and Cox (79.4-81.5%) models were significantly lower (p < 0.05), and the curves were closer to the diagonal. The ROC curves of the DOCN was similar to those of the DATCN, and the AUCs were 68.5-74%. The DATCN and DOCN therefore had good consistency, accuracy, and stability, respectively. CONCLUSION: This study was the first to construct competing-risk nomograms for ATC. These nomograms have proved useful for accurately assessing patient prognoses and allowing more-individualized follow-up strategies, thereby reducing the mortality.

摘要

目的:除横结肠外,结肠其他部位的肿瘤已得到充分研究,但关于横结肠癌(ATC)的腺癌却知之甚少。本研究的目的是使用竞争风险模型构建列线图,以准确预测ATC患者癌症特异性死亡和非癌症特异性死亡的概率。 方法:提取并筛选2000 - 2019年监测、流行病学和最终结果数据库中符合条件患者的数据。使用竞争风险分析筛选影响预后的因素,分别基于Gray检验和Fine - Gray模型进行单因素和多因素分析,以确定ATC死亡(DATC)和其他原因死亡(DOC)的因素。确定独立预后因素并构建列线图。为作比较,我们还为DATC患者构建了Cox模型和仅基于美国癌症联合委员会(AJCC)分期的竞争风险模型(AJCC模型)。使用校准图、Harrell一致性指数(C指数)、受试者工作特征(ROC)曲线和ROC曲线下面积(AUC)对列线图进行性能评估并比较各模型。使用验证队列对列线图和模型进行验证。由于没有适用于竞争风险模型的公认方法,因此未评估净重新分类指数、综合判别改善、决策曲线和风险分层。 结果:本研究纳入21469例ATC患者,分别确定了17个和9个独立影响因素用于构建DATC列线图(DATCN)和DOC列线图(DOCN)。在训练队列和验证队列中,校准曲线均表明两个列线图基于列线图的预测与实际观察结果之间具有良好的一致性。DATCN在训练队列和验证队列中的1年、3年和5年C指数均高于80%(80.3 - 83.3%),显著优于AJCC模型(76.7 - 78%)和Cox模型(75.4 - 79.5%)。DOCN的C指数也高于69%(69.0 - 73.6%)。在各时间点的ROC曲线方面,DATCN在训练队列和验证队列中的曲线均非常接近坐标轴的左上角,其AUC大于84%(84.2 - 85.4%)。AJCC模型(78.4 - 81.1%)和Cox模型(79.4 - 81.5%)的AUC显著更低(p < 0.05),曲线更接近对角线。DOCN的ROC曲线与DATCN相似,AUC为68.5 - 74%。因此,DATCN和DOCN分别具有良好的一致性、准确性和稳定性。 结论:本研究首次为ATC构建了竞争风险列线图。这些列线图已被证明有助于准确评估患者预后并制定更个性化的随访策略,从而降低死亡率。

相似文献

[1]
Prediction of death probability in adenocarcinoma of the transverse colon: competing-risk nomograms based on 21,469 patients.

J Cancer Res Clin Oncol. 2023-9

[2]
Comparison of Two Modern Survival Prediction Tools, SORG-MLA and METSSS, in Patients With Symptomatic Long-bone Metastases Who Underwent Local Treatment With Surgery Followed by Radiotherapy and With Radiotherapy Alone.

Clin Orthop Relat Res. 2024-12-1

[3]
Are Current Survival Prediction Tools Useful When Treating Subsequent Skeletal-related Events From Bone Metastases?

Clin Orthop Relat Res. 2024-9-1

[4]
Development and validation of nomograms for predicting survival of locally advanced rectosigmoid junction cancer patients: a SEER database analysis.

Transl Cancer Res. 2025-5-30

[5]
Two web-based dynamically interactive nomograms and risk stratification systems for predicting survival outcomes and guiding treatment in non-metastatic nasopharyngeal carcinoma.

J Cancer Res Clin Oncol. 2023-11

[6]
A prognostic nomogram and risk classification system of elderly patients with extraosseous plasmacytoma: a SEER database analysis.

J Cancer Res Clin Oncol. 2023-12

[7]
Signs and symptoms to determine if a patient presenting in primary care or hospital outpatient settings has COVID-19.

Cochrane Database Syst Rev. 2022-5-20

[8]
OncoE25: an AI model for predicting postoperative prognosis in early-onset stage I-III colon and rectal cancer-a population-based study using SEER with dual-center cohort validation.

J Transl Med. 2025-6-22

[9]
Construction of the survival nomograms for colon cancer patients of different ages based on the SEER database.

J Cancer Res Clin Oncol. 2023-11

[10]
Development and validation of a nomogram for predicting the early death of anaplastic thyroid cancer: a SEER population-based study.

J Cancer Res Clin Oncol. 2023-11

引用本文的文献

[1]
Survival prediction in sigmoid colon cancer patients with liver metastasis: a prospective cohort study.

JNCI Cancer Spectr. 2024-9-2

[2]
New findings in prognostic factor assessment for adenocarcinoma of transverse colon: a comparison study between competing-risk and COX regression analysis.

Front Med (Lausanne). 2024-1-31

本文引用的文献

[1]
Data mining in clinical big data: the frequently used databases, steps, and methodological models.

Mil Med Res. 2021-8-11

[2]
Competing-risks nomogram for predicting cancer-specific death in upper tract urothelial carcinoma: a population-based analysis.

BMJ Open. 2021-7-19

[3]
Competitive Risk Analysis of Prognosis in Patients With Cecum Cancer: A Population-Based Study.

Cancer Control. 2021

[4]
Segmental versus extended colectomy for tumours of the transverse colon: a systematic review and meta-analysis.

Colorectal Dis. 2021-3

[5]
Prognostic Factors in Patients with Rhabdomyosarcoma Using Competing-Risks Analysis: A Study of Cases in the SEER Database.

J Oncol. 2020-9-17

[6]
Brief introduction of medical database and data mining technology in big data era.

J Evid Based Med. 2020-2-22

[7]
Nomogram predicting cancer-specific mortality in early-onset rectal cancer: a competing risk analysis.

Int J Colorectal Dis. 2020-5

[8]
Competing-risks model for predicting the prognosis of penile cancer based on the SEER database.

Cancer Med. 2019-10-27

[9]
Development and validation of a nomogram for osteosarcoma-specific survival: A population-based study.

Medicine (Baltimore). 2019-6

[10]
A Novel Nomogram and Risk Classification System Predicting the Cancer-Specific Survival of Patients with Initially Diagnosed Metastatic Esophageal Cancer: A SEER-Based Study.

Ann Surg Oncol. 2018-10-24

文献AI研究员

20分钟写一篇综述,助力文献阅读效率提升50倍

立即体验

用中文搜PubMed

大模型驱动的PubMed中文搜索引擎

马上搜索

推荐工具

医学文档翻译智能文献检索