Tianwen Luo1, Yutong Wang2, Xuefeng Shan3, Ye Bai4, Chun Huang5, Guangcan Li6, Hongmei Wang7. 1. Department of Medical and Education Office, The First Affiliated Hospital of Chongqing Medical University, Chongqing, People's Republic of China. 2. Department of Epidemiology and Biostatistics, The First Affiliated Hospital, Army Medical University, Chongqing, People's Republic of China. 3. Department of Pharmacy, The First Affiliated Hospital of Chongqing Medical University, Chongqing, People's Republic of China. 4. Department of Epidemiology and Health Statistics, School of Public Health and Management, Chongqing Medical University, Chongqing, People's Republic of China. 5. Department of Cardiothoracic Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, People's Republic of China. 6. Department of Pharmacy, The People's Hospital of Kaizhou District, No. 8, Ankang Road, Hanfeng Street, Kaizhou District, Chongqing, 405400, People's Republic of China. 179368757@qq.com. 7. Department of Pharmacy, The First Affiliated Hospital of Chongqing Medical University, No. 1, Youyi Road, Yuanjiagang, Yuzhong District, Chongqing, 400016, People's Republic of China. wanghongmei225@126.com.
Abstract
BACKGROUND: The identification of the homogeneous and heterogeneous risk factors for different types of metastases in colorectal cancer (CRC) may shed light on the aetiology and help individualize prophylactic treatment. The present study characterized the incidence differences and identified the homogeneous and heterogeneous risk factors associated with distant metastases in CRC. METHODS: CRC patients registered in the SEER database between 2010 and 2016 were included in this study. Logistic regression was used to analyse homogeneous and heterogeneous risk factors for the occurrence of different types of metastases. Nomograms were constructed to predict the risk for developing metastases, and the performance was quantitatively assessed using the receiver operating characteristics (ROC) curve and calibration curve. RESULTS: A total of 204,595 eligible CRC patients were included in our study, and 17.07% of them had distant metastases. The overall incidences of liver metastases, lung metastases, bone metastases, and brain metastases were 15.34%, 5.22%, 1.26%, and 0.29%, respectively. The incidence of distant metastases differed by age, gender, and the original CRC sites. Poorly differentiated grade, more lymphatic metastasis, higher carcinoembryonic antigen (CEA), and different metastatic organs were all positively associated with four patterns of metastases. In contrast, age, sex, race, insurance status, position, and T stage were heterogeneously associated with metastases. The calibration and ROC curves exhibited good performance for predicting distant metastases. CONCLUSIONS: The incidence of distant metastases in CRC exhibited distinct differences, and the patients had homogeneous and heterogeneous associated risk factors. Although limited risk factors were included in the present study, the established nomogram showed good prediction performance.
BACKGROUND: The identification of the homogeneous and heterogeneous risk factors for different types of metastases in colorectal cancer (CRC) may shed light on the aetiology and help individualize prophylactic treatment. The present study characterized the incidence differences and identified the homogeneous and heterogeneous risk factors associated with distant metastases in CRC. METHODS:CRCpatients registered in the SEER database between 2010 and 2016 were included in this study. Logistic regression was used to analyse homogeneous and heterogeneous risk factors for the occurrence of different types of metastases. Nomograms were constructed to predict the risk for developing metastases, and the performance was quantitatively assessed using the receiver operating characteristics (ROC) curve and calibration curve. RESULTS: A total of 204,595 eligible CRCpatients were included in our study, and 17.07% of them had distant metastases. The overall incidences of liver metastases, lung metastases, bone metastases, and brain metastases were 15.34%, 5.22%, 1.26%, and 0.29%, respectively. The incidence of distant metastases differed by age, gender, and the original CRC sites. Poorly differentiated grade, more lymphatic metastasis, higher carcinoembryonic antigen (CEA), and different metastatic organs were all positively associated with four patterns of metastases. In contrast, age, sex, race, insurance status, position, and T stage were heterogeneously associated with metastases. The calibration and ROC curves exhibited good performance for predicting distant metastases. CONCLUSIONS: The incidence of distant metastases in CRC exhibited distinct differences, and the patients had homogeneous and heterogeneous associated risk factors. Although limited risk factors were included in the present study, the established nomogram showed good prediction performance.
Authors: Andrew M D Wolf; Elizabeth T H Fontham; Timothy R Church; Christopher R Flowers; Carmen E Guerra; Samuel J LaMonte; Ruth Etzioni; Matthew T McKenna; Kevin C Oeffinger; Ya-Chen Tina Shih; Louise C Walter; Kimberly S Andrews; Otis W Brawley; Durado Brooks; Stacey A Fedewa; Deana Manassaram-Baptiste; Rebecca L Siegel; Richard C Wender; Robert A Smith Journal: CA Cancer J Clin Date: 2018-05-30 Impact factor: 508.702
Authors: Kirsten Bibbins-Domingo; David C Grossman; Susan J Curry; Karina W Davidson; John W Epling; Francisco A R García; Matthew W Gillman; Diane M Harper; Alex R Kemper; Alex H Krist; Ann E Kurth; C Seth Landefeld; Carol M Mangione; Douglas K Owens; William R Phillips; Maureen G Phipps; Michael P Pignone; Albert L Siu Journal: JAMA Date: 2016-06-21 Impact factor: 56.272
Authors: Gonzalo Tapia Rico; Timothy J Price; Christos Karapetis; Cynthia Piantadosi; Rob Padbury; Amitesh Roy; Guy Maddern; James Moore; Scott Carruthers; David Roder; Amanda R Townsend Journal: Cancer Biol Med Date: 2017-11 Impact factor: 4.248