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Establishment of nomogram to predict overall survival and cancer-specific survival of local tumor resection in patients with colorectal cancer liver metastasis with unresectable metastases: a large population-based analysis.

作者信息

Hou Songlin, Li Lifa, Hou Huafang, Zhou Tong, Zhou He

机构信息

The Second Department of Gastrointestinal Surgery, The Affiliated Hospital of North Sichuan Medical College, 1 Maoyuan South Road, Nanchong, 637000, Sichuan, People's Republic of China.

Institute of Hepatobiliary, Pancreatic and Intestinal Disease, North Sichuan Medical College, Nanchong, 637000, Sichuan, People's Republic of China.

出版信息

Discov Oncol. 2024 Jul 29;15(1):315. doi: 10.1007/s12672-024-01182-y.


DOI:10.1007/s12672-024-01182-y
PMID:39073708
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11286894/
Abstract

BACKGROUND AND PURPOSE: The tumour-node metastasis (TNM) classification is a common model for evaluating the prognostic value of tumour patients. However, few models have been used to predict the survival outcomes of patients with colorectal cancer liver metastasis (CRLM) with unresectable metastases who received the primary local surgery. Thus, we utilized the Surveillance, Epidemiology, and End Results (SEER) database to establish novel nomograms for predicting the overall survival (OS) and cancer-specific survival (CSS) of these patients. METHODS: Extracted primary data on CRLM patients by local surgery from SEER database. All prognostic factors of OS and CSS were determined by Cox regression analysis. The concordance index (C-index), receiver operating characteristic (ROC) curves and calibration curves were used to further evaluate the accuracy and discrimination of these nomograms. Decision curve analysis (DCA) was executed to evaluate the nomograms for the clinical net benefit. Risk stratification analysis (RSA) was used to evaluate the reliability of them in clinical. RESULTS: 3622 eligible patients were screened and assigned to training cohort (1812) or validation cohort (1810). The age, chemotherapy, tumour grade, primary tumour site, tumour size, lymph node positive rate (LNR), marital status, and carcinoembryonic antigen (CEA) were independent prognostic factors of OS. Additionally, the age, chemotherapy, tumour grade, primary tumour site, tumour size, LNR, and CEA were independent prognostic factors of CSS. The results of C-indexes and ROC curves indicated that the established nomograms exhibited better discrimination power than TNM classification. The calibration curves demonstrated excellent agreement between the predicted and actual survival rates for 1-, 3-, and 5 year OS and CSS. Meanwhile, the validation cohort demonstrated similar results. Background the clinic context, the DCA showed that these nomograms have higher net benefits, and the RSA showed that patients were further divided into low risk, medium risk, and high risk groups according to the predicted scores from nomograms. And, the Kaplan-Meier curve and log-rank test showed that the survival differences among the three groups are statistically significant. CONCLUSIONS: The prognostic nomograms showed very high accuracy, identifiability, and clinical practicality in predicting the OS and CSS of CRLM patients with unresectable metastases treated by local surgery at 1-, 3-, and 5 years, which might improve individualized predictions of survival risks and help clinicians formulate treatment plans.

摘要
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cae5/11286894/9af9b2d9903c/12672_2024_1182_Fig9_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cae5/11286894/f8e02c9d15d0/12672_2024_1182_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cae5/11286894/d348da6902bf/12672_2024_1182_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cae5/11286894/0ef129bd8d04/12672_2024_1182_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cae5/11286894/8f184201a5f5/12672_2024_1182_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cae5/11286894/261a8c09393f/12672_2024_1182_Fig5_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cae5/11286894/6fec8704fea5/12672_2024_1182_Fig6_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cae5/11286894/d6c2b1cebd1f/12672_2024_1182_Fig7_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cae5/11286894/dc1db6fa726b/12672_2024_1182_Fig8_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cae5/11286894/9af9b2d9903c/12672_2024_1182_Fig9_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cae5/11286894/f8e02c9d15d0/12672_2024_1182_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cae5/11286894/d348da6902bf/12672_2024_1182_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cae5/11286894/0ef129bd8d04/12672_2024_1182_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cae5/11286894/8f184201a5f5/12672_2024_1182_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cae5/11286894/261a8c09393f/12672_2024_1182_Fig5_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cae5/11286894/6fec8704fea5/12672_2024_1182_Fig6_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cae5/11286894/d6c2b1cebd1f/12672_2024_1182_Fig7_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cae5/11286894/dc1db6fa726b/12672_2024_1182_Fig8_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cae5/11286894/9af9b2d9903c/12672_2024_1182_Fig9_HTML.jpg

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引用本文的文献

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本文引用的文献

[1]
Local Therapy Improves Survival for Early Recurrence After Resection of Colorectal Liver Metastases.

Ann Surg Oncol. 2024-4

[2]
Combination Treatment of Intratumoral Vidutolimod, Radiosurgery, Nivolumab, and Ipilimumab for Microsatellite Stable Colorectal Carcinoma With Liver Metastases.

Clin Colorectal Cancer. 2023-12

[3]
Novel nomogram to predict the overall survival of postoperative patients with gastric signet.

BMC Gastroenterol. 2023-8-16

[4]
Preoperative chemotherapy prior to primary tumour resection for asymptomatic synchronous unresectable colorectal liver-limited metastases: The RECUT multicenter randomised controlled trial.

Eur J Cancer. 2023-9

[5]
Primary tumor resection in patients with unresectable colorectal cancer with synchronous metastases could improve the activity of poly-chemotherapy: A trial-level meta-analysis.

Surg Oncol. 2022-9

[6]
Marital Status, Living Arrangement, and Cancer Recurrence and Survival in Patients with Stage III Colon Cancer: Findings from CALGB 89803 (Alliance).

Oncologist. 2022-6-8

[7]
Development and Validation of a Prognostic Nomogram for Predicting Cancer-Specific Survival in Patients With Lymph Node Positive Bladder Cancer: A Study Based on SEER Database.

Front Oncol. 2022-2-3

[8]
Data mining in clinical big data: the frequently used databases, steps, and methodological models.

Mil Med Res. 2021-8-11

[9]
Liver-First Approach for Synchronous Colorectal Metastases: Analysis of 7360 Patients from the LiverMetSurvey Registry.

Ann Surg Oncol. 2021-12

[10]
Nomogram for predicting overall survival in colorectal cancer with distant metastasis.

BMC Gastroenterol. 2021-3-4

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