Department of Colorectal and Anal Surgery, First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.
Department of Epidemiology and Health Statistics, School of Public Health and Management, Wenzhou Medical University, Wenzhou, China.
Aging Clin Exp Res. 2024 Jul 26;36(1):152. doi: 10.1007/s40520-024-02809-4.
We aimed to develop an elaborative nomogram that predicts cancer-specific survival (CSS) in American and Chinese octogenarians treated with radical resection for CRC.
The patient data of newly diagnosed patients aged 80 years or older who underwent radical resection for CRC from 2010 to 2015 were extracted from the Surveillance, Epidemiology, and End Results (SEER) database and then randomly divided into a training cohort and a validation cohort. The patients collected from our hospital were defined as the external validation cohort. Univariate and multivariate Cox regression was used to select independent predictive factors for the construction of a nomogram to predict 1-, 2- and 3-year CSS.
The multivariate Cox regression model identified age, T stage, N stage, perineural invasion, chemotherapy, tumour deposits, carcinoembryonic antigen level, number of lymph node metastases, and number of solid organ metastases as independent predictors of survival. The C-index of the nomogram for 1-, 2- and 3-year CSS was 0.758, 0.762, and 0.727, respectively, demonstrating significant clinical value and substantial reliability compared to the TNM stage. The calibration curve and area under the curve also indicated considerable predictive accuracy. In addition, decision curve analysis demonstrated desirable net benefits in clinical application.
We constructed a nomogram for predicting the CSS of individual octogenarian patients with CRC who underwent radical resection. The nomogram performed better than the TNM staging system in this particular population and could guide clinicians in clinical follow-up and individual therapeutic plan formulation.
我们旨在开发一个详细的列线图，以预测接受结直肠癌根治性切除术的美国和中国 80 岁以上患者的癌症特异性生存（CSS）。
从 2010 年至 2015 年，从监测、流行病学和最终结果（SEER）数据库中提取了 80 岁或以上接受结直肠癌根治性切除术的新诊断患者的数据，并将其随机分为训练队列和验证队列。从我院收集的患者被定义为外部验证队列。单因素和多因素 Cox 回归用于选择独立的预测因素，以构建预测 1 年、2 年和 3 年 CSS 的列线图。
多因素 Cox 回归模型确定年龄、T 分期、N 分期、神经周围侵犯、化疗、肿瘤沉积、癌胚抗原水平、淋巴结转移数量和实体器官转移数量是生存的独立预测因素。该列线图预测 1 年、2 年和 3 年 CSS 的 C 指数分别为 0.758、0.762 和 0.727，与 TNM 分期相比，具有显著的临床价值和可靠性。校准曲线和曲线下面积也表明了相当高的预测准确性。此外，决策曲线分析表明在临床应用中有理想的净收益。
我们为接受结直肠癌根治性切除术的 80 岁以上患者构建了一个预测 CSS 的列线图。该列线图在该特定人群中的表现优于 TNM 分期系统，可以指导临床医生进行临床随访和个体化治疗计划的制定。
