Department of Colorectal Surgery, The First Affiliated Hospital of Fujian Medical University, Fuzhou, 350005, China.
Department of Colorectal Surgery, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University, Fuzhou, 350212, China.
Updates Surg. 2024 Oct;76(6):2163-2171. doi: 10.1007/s13304-024-01869-5. Epub 2024 May 10.
The aim was to assess conditional survival for colon mucinous adenocarcinoma (MAC) patients, and to construct nomograms to predict conditional survival probability. Survival analysis was done using conditional survival, which was defined as the probability of surviving additional y years for patients who have survived for x years. The mathematical definition was express as: CS (y|x) = S (x + y)/S (x). Cox regression analyses were used to identify prognostic factors. A nomogram is constructed to predict conditional disease-free survival (DFS) and overall survival (OS) probability according to years that already survive. A total of 179 colon MAC patients were included. The 5-year DFS was 67% after surgery, and the 5-year survival probability of patients, who already survived 1, 2, 3, and 4 years were 75%, 87%, 95%, and 98%, respectively. The 5-year OS was 73% after surgery and increased to 76%, 82%, 88%, and 92% at 1, 2, 3, and 4 years, respectively. Subgroup analyses demonstrated the superiority of conditional survival was more pronounced in advanced stages than in stage I. And pT stage, pN stage, and lymphovascular invasion were significantly associated with DFS and OS. Conditional survival nomograms were constructed to predict the 5-year conditional DFS and OS probability given survival for 1, 2, 3, 4 years after surgery. Conditional survival can provide dynamic survival probability according to years that already survive, especially for patients with advanced stages. Taking into account the years already survived accounted for, novel nomograms contributed to effectively predicting conditional survival.
目的是评估结肠黏液性腺癌（MAC）患者的条件生存，并构建列线图来预测条件生存概率。使用条件生存进行生存分析，其定义为已经生存 x 年的患者再生存 y 年的生存概率。数学定义表示为：CS(y|x)=S(x+y)/S(x)。采用 Cox 回归分析来识别预后因素。根据已经生存的年数，构建列线图来预测条件无病生存（DFS）和总体生存（OS）概率。共纳入 179 例结肠 MAC 患者。手术后 5 年 DFS 为 67%，已经生存 1、2、3 和 4 年的患者 5 年生存概率分别为 75%、87%、95%和 98%。手术后 5 年 OS 为 73%，分别增加至 1、2、3 和 4 年的 76%、82%、88%和 92%。亚组分析表明，在晚期阶段，条件生存的优势比在 I 期更为明显。pT 分期、pN 分期和脉管侵犯与 DFS 和 OS 显著相关。构建了条件生存列线图，以预测手术后 1、2、3、4 年已经生存的情况下，5 年条件 DFS 和 OS 概率。条件生存可以根据已经生存的年数提供动态生存概率，特别是对于晚期患者。考虑到已经生存的年数，新的列线图有助于有效地预测条件生存。
