Estimating the unknown parameters of the natural history of metachronous colorectal cancer using discrete-event simulation.
Estimating the unknown parameters of the natural history of metachronous colorectal cancer using discrete-event simulation.
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DOI：
10.1177/0272989x10391809
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发表时间：
2011-07
期刊：
影响因子：
--
通讯作者：
Cima RR
中科院分区：
文献类型：
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作者：
Erenay FS;Alagoz O;Banerjee R;Cima RR
异时性结直肠癌（MCRC）的自然史的一些方面，如从腺瘤性息肉到MCRC的进展速度，是未知的。本研究的目的是估计一组揭示MCRC一些未知特征的参数。作者开发了一个计算机模拟模型，模拟原发性结直肠癌（CRC）治疗后5年期间MCRC的进展。他们利用罗切斯特市梅奥诊所284名结直肠癌患者的纵向数据获得了模拟模型的输入。在患者队列中，5年MCRC发病率和全因死亡率分别为7.4%和12.7%。统计分析显示，5年MCRC发病率与性别相关（P = 0.05），全因死亡率和crc相关死亡率均与年龄相关（P < 0.001和P = 0.01）。从腺瘤性息肉到MCRC和从MCRC到转移性MCRC的估计年概率分别为0.14和0.28。MCRC和转移性MCRC治疗后的年死亡率估计分别为0.06和0.26。未发现的MCRC导致的估计年死亡率为0.16。结果表明，MCRC，特别是在女性中，可能比以前的研究表明的更常见。此外，从临床数据和模拟模型的结果得出的统计数据表明，性别和年龄影响MCRC的进展。
Some aspects of the natural history of metachronous colorectal cancer (MCRC), such as the rate of progression from adenomatous polyp to MCRC, are unknown. The objective of this study is to estimate a set of parameters revealing some of these unknown characteristics of MCRC. The authors developed a computer simulation model that mimics the progression of MCRC for a 5-year period following the treatment of primary colorectal cancer (CRC). They obtained the inputs of the simulation model using longitudinal data for 284 CRC patients from the Mayo Clinic, Rochester. Five-year MCRC incidence and all-cause mortality were 7.4% and 12.7% in the patient cohort, respectively. Statistical analysis showed that 5-year MCRC incidence was associated with gender (P = 0.05), whereas both all-cause and CRC-related mortalities were associated with age (P < 0.001 and P = 0.01). Estimated annual probabilities of progression from adenomatous polyp to MCRC and from MCRC to metastatic MCRC were 0.14 and 0.28, respectively. Annual probabilities of mortality after MCRC and metastatic MCRC treatments were estimated to be 0.06 and 0.26, respectively. The estimated annual probability of mortality due to undetected MCRC was 0.16. The results imply that MCRC, especially in women, may be more common than suggested by previous studies. In addition, statistics derived from the clinical data and results of the simulation model indicate that gender and age affect the progression of MCRC.