Yuqiang Li1, Wenxue Liu2,3, Zhongyi Zhou1, Heming Ge1, Lilan Zhao4, Heli Liu1, Xiangping Song1, Dan Wang1, Qian Pei1, Fengbo Tan1. 1. Department of Gastrointestinal Surgery, Xiangya Hospital, Central South University, Changsha, China. 2. Department of Rheumatology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China. 3. Department of Cardiology, Xiangya Hospital, Central South University, Changsha, China. 4. Department of Thoracic surgery, Fujian Provincial Hospital, Fuzhou, China.
Abstract
BACKGROUND: The incidence of colorectal cancer in patients younger than 50 years has been increasing in recent years. OBJECTIVE: Develop and validate prognostic nomograms predicting overall survival (OS) and cancer-specific survival (CSS) for early-onset locally advanced colon cancer (EOLACC) based on the Surveillance, Epidemiology, and End Results (SEER) database. RESULTS: The entire cohort comprised 13,755 patients with EOLACC. The nomogram predicting OS for EOLACC displayed that T stage contributed the most to prognosis, followed by N stage, regional nodes examined (RNE) and surgery. The nomogram predicting CSS for EOLACC demonstrated similar results. Various methods identified the discriminating superiority of the nomograms. X-tile software was used to classify patients into high-risk, medium-risk, and low-risk according to the risk score of the nomograms. The risk stratification effectively avoided the survival paradox. CONCLUSIONS: We established and validated nomograms for predicting OS and CSS based on a national cohort of almost 13,000 EOLACC patients. The nomograms could effectively solve the issue of survival paradox of the AJCC staging system and be an excellent tool to integrate the clinical characteristics to guide the therapeutic choice for EOLACC patients. METHODS: Nomograms were constructed based on the SEER database and the Cox regression model.
BACKGROUND: The incidence of colorectal cancer in patients younger than 50 years has been increasing in recent years. OBJECTIVE: Develop and validate prognostic nomograms predicting overall survival (OS) and cancer-specific survival (CSS) for early-onset locally advanced colon cancer (EOLACC) based on the Surveillance, Epidemiology, and End Results (SEER) database. RESULTS: The entire cohort comprised 13,755 patients with EOLACC. The nomogram predicting OS for EOLACC displayed that T stage contributed the most to prognosis, followed by N stage, regional nodes examined (RNE) and surgery. The nomogram predicting CSS for EOLACC demonstrated similar results. Various methods identified the discriminating superiority of the nomograms. X-tile software was used to classify patients into high-risk, medium-risk, and low-risk according to the risk score of the nomograms. The risk stratification effectively avoided the survival paradox. CONCLUSIONS: We established and validated nomograms for predicting OS and CSS based on a national cohort of almost 13,000 EOLACCpatients. The nomograms could effectively solve the issue of survival paradox of the AJCC staging system and be an excellent tool to integrate the clinical characteristics to guide the therapeutic choice for EOLACCpatients. METHODS: Nomograms were constructed based on the SEER database and the Cox regression model.
Authors: Michael J O'Connell; Ian Lavery; Greg Yothers; Soonmyung Paik; Kim M Clark-Langone; Margarita Lopatin; Drew Watson; Frederick L Baehner; Steven Shak; Joffre Baker; J Wayne Cowens; Norman Wolmark Journal: J Clin Oncol Date: 2010-08-02 Impact factor: 44.544
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