Xueliang Ding1, Xiaodong Yang1, Dafu Wu1, Yaguang Huang1, Yanwen Dai1, Jiajing Li2, Weilong Chang3, Mozhen Chi4, Shaobo Tian5. 1. Department of Clinical Laboratory, Affiliated Renhe Hospital of China Three Gorges University, Yichang, 443001, China. 2. Department of Pathology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, China. 3. Department of Gastrointestinal Surgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, China. changwl365@foxmail.com. 4. Department of Scientific Research, Affiliated Renhe Hospital of China Three Gorges University, Yichang, 443001, China. cmzchina@163.com. 5. Department of Gastrointestinal Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China. tianshaobogut@163.com.
Abstract
PURPOSE: This research aimed to explore prognostic factors for early-onset colorectal cancer (EO-CRC) patients with liver metastasis (LM) and develop nomogram for predicting cancer-specific survival (CSS) probability quantitatively. METHODS: Our study included 4368 EO-CRC patients with LM registered in the Surveillance, Epidemiology, and End Results (SEER) database between 2010 and 2017. Potential prognostic factors for EO-CRC patients with LM were identified by multivariable Cox regression analysis. Prognostic nomogram was subsequently constructed based on these prognostic factors. The discriminative ability, calibration, and clinical usefulness of the nomogram were assessed by the area under the receiver operating characteristic (ROC) curves (AUC), calibration curves, and decision curve analysis (DCA). RESULTS: In the training cohort, marital status, primary tumor location, histopathological grade, T stage, number of metastatic organs, carcinoembryonic antigen (CEA), perineural invasion (PI), surgery of primary site, chemotherapy, radiation therapy, and metastatic lymph nodes ratio (LNR) were prognostic factors for cancer-specific mortality of EO-CRC patients with LM. The 1-, 2-, and 3-year AUC values of the prognostic nomogram were 0.777, 0.781, and 0.788, respectively. Calibration curves indicated acceptable agreement between nomogram-predicted survival and actual observed survival at 1, 2, and 3 years. DCA curves exhibited good positive net benefits in the prognostic model in most threshold probabilities at different time points. All of these results were reproducible in the validation cohort. CONCLUSIONS: This study identified prognostic factors for EO-CRC patients with LM and developed a prognostic nomogram with good performance and clinical usability, which may help clinicians make better treatment decisions.
PURPOSE: This research aimed to explore prognostic factors for early-onset colorectal cancer (EO-CRC) patients with liver metastasis (LM) and develop nomogram for predicting cancer-specific survival (CSS) probability quantitatively. METHODS: Our study included 4368 EO-CRC patients with LM registered in the Surveillance, Epidemiology, and End Results (SEER) database between 2010 and 2017. Potential prognostic factors for EO-CRC patients with LM were identified by multivariable Cox regression analysis. Prognostic nomogram was subsequently constructed based on these prognostic factors. The discriminative ability, calibration, and clinical usefulness of the nomogram were assessed by the area under the receiver operating characteristic (ROC) curves (AUC), calibration curves, and decision curve analysis (DCA). RESULTS: In the training cohort, marital status, primary tumor location, histopathological grade, T stage, number of metastatic organs, carcinoembryonic antigen (CEA), perineural invasion (PI), surgery of primary site, chemotherapy, radiation therapy, and metastatic lymph nodes ratio (LNR) were prognostic factors for cancer-specific mortality of EO-CRC patients with LM. The 1-, 2-, and 3-year AUC values of the prognostic nomogram were 0.777, 0.781, and 0.788, respectively. Calibration curves indicated acceptable agreement between nomogram-predicted survival and actual observed survival at 1, 2, and 3 years. DCA curves exhibited good positive net benefits in the prognostic model in most threshold probabilities at different time points. All of these results were reproducible in the validation cohort. CONCLUSIONS: This study identified prognostic factors for EO-CRC patients with LM and developed a prognostic nomogram with good performance and clinical usability, which may help clinicians make better treatment decisions.
Authors: Kristie A Blum; Frank G Keller; Sharon Castellino; Anh Phan; Christopher R Flowers Journal: Br J Haematol Date: 2018-08-10 Impact factor: 6.998
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Authors: Lei Huang; Lina Jansen; Yesilda Balavarca; Esther Molina-Montes; Masoud Babaei; Lydia van der Geest; Valery Lemmens; Liesbet Van Eycken; Harlinde De Schutter; Tom B Johannesen; Claus W Fristrup; Michael B Mortensen; Maja Primic-Žakelj; Vesna Zadnik; Nikolaus Becker; Thilo Hackert; Margit Mägi; Tiziana Cassetti; Romano Sassatelli; Robert Grützmann; Susanne Merkel; Ana F Gonçalves; Maria J Bento; Péter Hegyi; Gábor Lakatos; Andrea Szentesi; Michel Moreau; Tony van de Velde; Annegien Broeks; Milena Sant; Pamela Minicozzi; Vincenzo Mazzaferro; Francisco X Real; Alfredo Carrato; Xavier Molero; Marc G Besselink; Núria Malats; Markus W Büchler; Petra Schrotz-King; Hermann Brenner Journal: Gut Date: 2017-11-20 Impact factor: 23.059