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Nomogram based on the log odds of negative lymph node/T stage can predict the prognosis of patients with colorectal cancer: a retrospective study based on SEER database and external validation in China.

作者信息

Cai Boyong, Zheng Mengli, Li Yimin, Chen Zhicao, Zhong Canxin, Chen Xiaochun, Chen Guiquan

机构信息

Department of Gastroenterology, The Tenth Affiliated Hospital, Southern Medical University (Dongguan People's Hospital), Dongguan, China.

Department of Gastroenterology, The Tenth Affiliated Hospital, Southern Medical University (Dongguan People's Hospital), Dongguan, China

出版信息

BMJ Open. 2024 Dec 20;14(12):e083942. doi: 10.1136/bmjopen-2024-083942.

DOI:10.1136/bmjopen-2024-083942
PMID:39806584
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11667382/
Abstract

OBJECTIVES: This study investigated the prognostic role of log odds of negative lymph node/T stage (LONT) and established a nomogram based on LONT to predict the prognosis in colorectal cancer (CRC) patients. DESIGN: A retrospective cohort study. SETTING AND PARTICIPANTS: We enrolled 80 518 CRC patients from the Surveillance, Epidemiology and End Results database between 2010 and 2015. The dataset was split into a training cohort (56 364 patients) and a validation cohort (24 154 patients) at a ratio of 7:3. Furthermore, 500 CRC patients who underwent surgery in the Tenth Affiliated Hospital of Southern Medical University between 1 January 2017 and 20 December 2018, were recruited as the external validation set. OUTCOME MEASURES: 1-, 3- and 5-year cancer-specific survival (CSS). METHODS: The univariate and multivariate Cox regression analyses were carried out to identify the significant independent prognostic factors of CSS. A nomogram was established based on LONT to predict the prognosis. The performance of the nomogram was comprehensively assessed via the time-dependent receiver operating characteristic curve, concordance index (C-index), calibration curve and decision curve analysis (DCA) comprehensively. Moreover, Kaplan-Meier curves were performed to assess the CSS of the three risk subgroups. RESULT: LONT was a significant independent prognostic factor for CSS (LONT1 vs LONT2, HR=0.670, 95% CI 0.642 to 0.698, p<0.001; LONT1 vs LONT3, HR=0.443, 95% CI 0.420 to 0.467, p<0.001). LONT, age, sex, race, subsite, differentiation, histology, tumour size, T stage, N stage, M stage and chemotherapy were included in the nomogram. The 1-, 3- and 5-year survival area under the curve were 0.856, 0.862 and 0.852, respectively. The C-index of the model was 0.809 (95% CI 0.825 to 0.839) in the model. The calibration curve and DCA verified the favourable predictive performance and clinical application of the nomogram. CONCLUSION: CRC patients with a high LONT had a low incidence of CSS. The nomogram based on LONT could effectively predict the CSS of CRC.

摘要
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/064e/11667382/af43bcfda7d3/bmjopen-14-12-g008.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/064e/11667382/012d4ee27c44/bmjopen-14-12-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/064e/11667382/f7c6e60f9f13/bmjopen-14-12-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/064e/11667382/bfa638147a8c/bmjopen-14-12-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/064e/11667382/3cd803412010/bmjopen-14-12-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/064e/11667382/30835eb77e30/bmjopen-14-12-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/064e/11667382/20c0a6c541d1/bmjopen-14-12-g006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/064e/11667382/9edc4d91b89a/bmjopen-14-12-g007.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/064e/11667382/af43bcfda7d3/bmjopen-14-12-g008.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/064e/11667382/012d4ee27c44/bmjopen-14-12-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/064e/11667382/f7c6e60f9f13/bmjopen-14-12-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/064e/11667382/bfa638147a8c/bmjopen-14-12-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/064e/11667382/3cd803412010/bmjopen-14-12-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/064e/11667382/30835eb77e30/bmjopen-14-12-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/064e/11667382/20c0a6c541d1/bmjopen-14-12-g006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/064e/11667382/9edc4d91b89a/bmjopen-14-12-g007.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/064e/11667382/af43bcfda7d3/bmjopen-14-12-g008.jpg

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引用本文的文献

[1]
Prognostic value of the log odds of negative lymph nodes/T stage ratio (LONT) in postoperative esophageal cancer: a SEER-based study.

Front Oncol. 2025-8-20

本文引用的文献

[1]
Race adjustments in clinical algorithms can help correct for racial disparities in data quality.

Proc Natl Acad Sci U S A. 2024-8-20

[2]
Prognostic significance of negative lymph node count in microsatellite instability-high colorectal cancer.

World J Surg Oncol. 2024-7-19

[3]
Application and subgroup analysis of competing risks model based on different lymph node staging systems in differentiated thyroid cancer.

Updates Surg. 2024-9

[4]
Challenging the Dogma: Stage migration or negative lymph nodes, which of them is the main player on gastric cancer prognosis?

Eur J Surg Oncol. 2024-6

[5]
Log odds of negative lymph nodes/T stage ratio (LONT): A new prognostic tool for differentiated thyroid cancer without metastases in patients aged 55 and older.

Front Endocrinol (Lausanne). 2023

[6]
Survival of Middle Eastern and North African Individuals Diagnosed with Colorectal Cancer: A Population-Based Study in California.

Cancer Epidemiol Biomarkers Prev. 2023-6-1

[7]
Racial/Ethnic and Sex Differences in Somatic Cancer Gene Mutations among Patients with Early-Onset Colorectal Cancer.

Cancer Discov. 2023-3-1

[8]
Current cancer burden in China: epidemiology, etiology, and prevention.

Cancer Biol Med. 2022-8-30

[9]
Long-term outcomes of D2 vs. D3 lymph node dissection for cT2N0M0 colorectal cancer: a multi‑institutional retrospective analysis.

Int J Clin Oncol. 2022-11

[10]
Predictive Value of the Log Odds of Negative Lymph Nodes/T Stage as a Novel Prognostic Factor in Bladder Cancer Patients After Radical Cystectomy.

Front Oncol. 2022-7-19

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