Chan Kim1, Woo Ram Kim2, Ki-Yeol Kim3, Hong Jae Chon1, Seung Hoon Beom4, Hyojoong Kim1, Minkyu Jung4, Sang Joon Shin4, Nam Kyu Kim5, Joong Bae Ahn6. 1. Department of Medical Oncology, CHA Bundang Medical Center, CHA University, Seongnam, Korea. 2. Department of Surgery, CHA Bundang Medical Center, CHA University, Seongnam, Korea. 3. Dental Education Research Center, Brain Korea 21 Project, Yonsei University College of Dentistry, Seoul, Korea. 4. Division of Medical Oncology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea. 5. Department of Surgery, Yonsei University College of Medicine, Seoul, Korea. 6. Division of Medical Oncology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea. Electronic address: vvswm513@yuhs.ac.
Abstract
BACKGROUND: Patients with stage I colorectal cancer (CRC) have excellent prognosis after curative surgery. However, approximately 5% to 10% of patients experience recurrence and have a poor prognosis. Because the incidence of stage I CRC is increasing with active screening programs worldwide, a more accurate and easy-to-use predictive tool for recurrence is becoming more important. This study aimed to develop a predictive nomogram for recurrence in stage I CRC. PATIENTS AND METHODS: A total of 1538 patients who underwent curative surgery for stage I CRC were enrolled. Predictive factors for recurrence were determined by multivariate Cox regression model and were used to develop a predictive nomogram. This model was internally validated, and performance was evaluated through calibration plots. RESULTS: The cumulative recurrence rate at 5 years after surgery for stage I CRC was 5.3%. In multivariate Cox analysis, independent predictors of recurrence were tumor location at rectum, pT2 stage, and presence of lymphovascular invasion. The 5-year recurrence rate was significantly different depending on the number of risk factors (0.7% for 0, 5.8% for 1, and 9.7% for ≥ 2 risk factors). On this basis, a nomogram for recurrence-free survival was developed and internally validated. The concordance index of the nomogram was 0.71, and the performance was acceptable. CONCLUSION: We developed and internally validated a nomogram that can predict postoperative recurrence in stage I CRC patients. This nomogram may be used to more accurately stratify the risk of recurrence and to perform personalized postoperative surveillance in stage I CRC patients.
BACKGROUND:Patients with stage I colorectal cancer (CRC) have excellent prognosis after curative surgery. However, approximately 5% to 10% of patients experience recurrence and have a poor prognosis. Because the incidence of stage I CRC is increasing with active screening programs worldwide, a more accurate and easy-to-use predictive tool for recurrence is becoming more important. This study aimed to develop a predictive nomogram for recurrence in stage I CRC. PATIENTS AND METHODS: A total of 1538 patients who underwent curative surgery for stage I CRC were enrolled. Predictive factors for recurrence were determined by multivariate Cox regression model and were used to develop a predictive nomogram. This model was internally validated, and performance was evaluated through calibration plots. RESULTS: The cumulative recurrence rate at 5 years after surgery for stage I CRC was 5.3%. In multivariate Cox analysis, independent predictors of recurrence were tumor location at rectum, pT2 stage, and presence of lymphovascular invasion. The 5-year recurrence rate was significantly different depending on the number of risk factors (0.7% for 0, 5.8% for 1, and 9.7% for ≥ 2 risk factors). On this basis, a nomogram for recurrence-free survival was developed and internally validated. The concordance index of the nomogram was 0.71, and the performance was acceptable. CONCLUSION: We developed and internally validated a nomogram that can predict postoperative recurrence in stage I CRC patients. This nomogram may be used to more accurately stratify the risk of recurrence and to perform personalized postoperative surveillance in stage I CRC patients.
Authors: Wei Xu; Yazhou He; Yuming Wang; Xue Li; Jane Young; John P A Ioannidis; Malcolm G Dunlop; Evropi Theodoratou Journal: BMC Med Date: 2020-06-26 Impact factor: 8.775
Authors: Seyed M Qaderi; Boris Galjart; Cornelis Verhoef; Gerrit D Slooter; Miriam Koopman; Robert H A Verhoeven; Johannes H W de Wilt; Felice N van Erning Journal: Int J Colorectal Dis Date: 2021-04-04 Impact factor: 2.571
Authors: Olatunji B Alese; Wei Zhou; Renjian Jiang; Katerina Zakka; Zhonglu Huang; Chimuanya Okoli; Walid L Shaib; Mehmet Akce; Maria Diab; Christina Wu; Bassel F El-Rayes Journal: Front Oncol Date: 2021-12-09 Impact factor: 6.244