Nomogram to predict the risk and survival of synchronous bone metastasis in colorectal cancer: a population-based real-world analysis
Nomogram to predict the risk and survival of synchronous bone metastasis in colorectal cancer: a population-based real-world analysis
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DOI：
10.1007/s00384-020-03612-z
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发表时间：
2020-05-16
影响因子：
2.8
通讯作者：
Cai, Guoxiang
中科院分区：
文献类型：
--
作者：
Han, Lingyu;Dai, Weixing;Cai, Guoxiang
目的结直肠癌骨转移（BM）可明显影响患者的生活质量，对BM患者的整体管理是当前临床实践的热点。方法收集2010-2015年监测、流行病学和最终结果（SEER）数据库中的52，859例患者。经倾向评分匹配（PSM）后，采用BM的癌症特异性生存期（CCS）和总生存期（OS）评估生存概率差异。采用Logistic回归分析BM的危险因素;采用考克斯比例风险回归分析BM患者OS的影响因素。随后，构建诺模图，并使用受试者工作曲线（ROC）来确认诺模图的有效性。结果342例（0.65%）患者被诊断为同步BM。PSM后，16个变量平衡。肿瘤部位、组织学、分级、T分期、N分期、CEA、放化疗、手术和肝/肺/脑转移与BM相关，而组织学、分级、T分期、N分期、CEA、化疗、手术和肝/肺转移是BM生存的决定因素。应用诺模图，ROC曲线证明了预测效果。结论结直肠癌伴BM患者的实际生存率较低。列线图可以预测结直肠癌患者BM的发生率和BM患者的生存率。
Purpose Bone metastasis (BM) can obviously affect the quality of life of patients in colorectal cancer (CRC), and the whole management of patients with BM would be attractive in current clinical practice. Methods A total of 52,859 patients during 2010-2015 were collected from Surveillance, Epidemiology, and End Results (SEER) database. After propensity score matching (PSM), cancer-specific survival (CCS) and overall survival (OS) with BM were adopted to assess survival probability difference. Logistic regression was used to identify risk factors for BM; COX proportion hazard regression was applied to explore prognosticators for OS in patients with BM. Subsequently, nomograms were constructed and receiver operating curves (ROCs) were used to confirm the validation of nomogram. Results Three hundred and forty-two (0.65%) patients were diagnosed with synchronous BM. After PSM, 16 variables were balanced. Tumor site, histology, grade, T stage, N stage, CEA, radiochemotherapy, surgery, and liver/lung/brain metastases were associated with BM, and histology, grade, T stage, N stage, CEA, chemotherapy, surgery, and liver/lung metastases were prognosticators for BM survival. Nomograms were applied and the ROC curve proved the predictive effects. Conclusion CRC patients with BM have worse real-world survival. Nomogram can predict incidence of BM in CRC patients and survival among patients with BM.