Prognostic Significance of Tumor Deposits in Patients With Stage III Colon Cancer: A Nomogram Study
Prognostic Significance of Tumor Deposits in Patients With Stage III Colon Cancer: A Nomogram Study
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DOI：
10.1016/j.jss.2019.07.099
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发表时间：
2020-01-01
影响因子：
2.2
通讯作者：
Chen, Donghan
中科院分区：
文献类型：
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作者：
Zheng, Peilin;Chen, Qiaoxing;Chen, Donghan
背景资料：III期结肠癌的临床特点和肿瘤沉积物的预后意义进行了调查，构建预后nomoglich.Methods：患者的数据从监测，流行病学，和最终结果数据库检索。患者被随机分配到培训或验证队列。采用Kaplan-Meier法分析生存率。在训练队列中，通过考克斯回归建立预后列线图，然后在验证队列中进行检验。诺模图的准确性和歧视性进行了评估，使用一致性指数（C指数）和校准curricules.Results：9246例符合纳入标准，1788（19.3%）有肿瘤存款。仅肿瘤沉积的患者与仅淋巴结转移的患者的生存率相似（P = 0.83）。同时有肿瘤沉积和淋巴结转移者生存率明显低于无肿瘤沉积和淋巴结转移者（P < 0.01）。在多变量考克斯回归分析中，以下因素被确定为独立的预后指标，并采用制定诺模图：肿瘤沉积，年龄，种族，T分期，阳性区域淋巴结的数量，级别和癌胚抗原。在训练队列中，校准曲线显示出良好的一致性，诺模图预测总生存期的一致性指数达到0.727（95%CI：0.71524-0.73876），上级优于美国癌症联合委员会分期系统的一致性指数（0.594，95%CI：0.58224-0.60576）。这些结果支持在validationcohol.Conclusions：肿瘤存款可能是一个独立的预后因素与III期结肠癌患者结肠切除术后。本文构建的列线图准确预测了总生存期。(C)2019爱思唯尔公司All rights reserved.
Background: The clinical characteristics of stage III colon cancer and the prognostic significance of tumor deposits were investigated, to construct a prognostic nomogram.Methods: The data of patients were retrieved from the Surveillance, Epidemiology, and End Results database. Patients were randomized to a training or validation cohort. The Kaplan-Meier method was used to analyze survival rates. In the training cohort, a prognostic nomogram was established via Cox regression and then tested in the validation cohort. The accuracy and discrimination of the nomogram were assessed using concordance indices (C-indices) and calibration curves.Results: Of the 9246 patients meeting the inclusion criteria, 1788 (19.3%) had tumor deposits. Patients with tumor deposits only showed similar survival rates to those with lymph node metastases only (P = 0.83). Compared with these, patients with both tumor deposits and lymph node metastases exhibited significantly worse survival (P < 0.01). In the multivariate Cox regression analyses, the following were identified as independent prognostic indicators and adopted to formulate the nomogram: tumor deposits, age, ethnicity, T stage, the number of positive regional lymph nodes, grade, and carcinoembryonic antigen. In the training cohort, the calibration curve showed good consistency, and the concordance index of the nomogram for predicting overall survival reaches 0.727 (95% CI: 0.71524-0.73876), superior to the concordance index of the American Joint Committee on Cancer staging system (0.594, 95% CI: 0.58224-0.60576). These results are supported in the validation cohort.Conclusions: Tumor deposits may be an independent prognostic factor for patients with stage III colon cancer after colectomy. The nomogram constructed herein accurately predicted overall survival. (C) 2019 Elsevier Inc. All rights reserved.