Nomograms predicting Overall Survival and Cancer-specific Survival for Synchronous Colorectal Liver-limited Metastasis.
Nomograms predicting Overall Survival and Cancer-specific Survival for Synchronous Colorectal Liver-limited Metastasis.
复制标题
预测同步结直肠肝局限性转移的总体生存率和癌症特异性生存率的列线图
DOI：
10.7150/jca.46155
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发表时间：
2020
影响因子：
3.9
通讯作者：
Pei H
中科院分区：
文献类型：
--
作者：
Li Y;Liu W;Zhao L;Güngör C;Xu Y;Song X;Wang D;Zhou Z;Zhou Y;Li C;Pei Q;Tan F;Pei H
背景：结直肠癌（CRC）是世界上第三常见的癌症类型和第二大癌症相关死亡原因。肝脏是结直肠癌最常见的转移部位，20%-34%的患者发生同步肝转移。结直肠癌肝局限性转移患者占结直肠癌死亡人数的三分之一。此外，一些证据表明，与同步发展的转移性肝病相比，CRC合并同步肝病患者预后更差，疾病状态更弥散。方法：回顾性分析的数据来自监测、流行病学和最终结果（SEER）数据库。以多变量Cox回归分析为基础构建nomogram。采用c指数、随时间变化的受试者工作特征（ROC）曲线、决策曲线分析（DCA）和校准曲线对预后图进行验证。结果：2010-2016年，从SEER数据库中共提取9958例同步肝局限性转移的结直肠癌患者。总生存期（OS）和肿瘤特异性生存期（CSS）与年龄、婚姻状况、种族、肿瘤部位、病理分级、组织学类型、T分期、N分期、原发肿瘤手术、肝转移手术、化疗及CEA均有显著相关。所有显著变量被用来创建预测OS和CSS的nomogram。c指数值、随时间变化的ROC曲线、DCA曲线和校正曲线均证明了该方法的优越性。结论：我们的研究调查了全国近10,000名患者的队列，以创建和验证基于病理，治疗和人口学特征的nomographic，以预测同步结直肠肝局限性转移（SCLLM）的OS和CSS。该图可以作为一个很好的工具来整合临床特征，指导SCLLM患者的治疗选择。
Background: Colorectal cancer (CRC) ranks as the third most frequent cancer type and the second leading cause of cancer-related death worldwide. The liver is the most common metastatic site of CRC with 20%-34% of patients suffering synchronous liver metastasis. Patients with colorectal liver-limited metastasis account for one-third of deaths from colorectal cancer. Moreover, some evidence indicated that CRC patients with synchronous liver disease encounter a worse prognosis and more disseminated disease state comparing with metastatic liver disease that develops metachronously. Methods: Data in this retrospective analysis were extracted from the Surveillance, Epidemiology, and End Results (SEER) database. Nomograms were constructed with basis from a multivariate Cox regression analysis. The prognostic nomograms were validated by C-index, time-dependent receiver operating characteristic (ROC) curve, decision curve analysis (DCA) and calibration curves. Results: A total of 9,958 CRC patients with synchronous liver-limited metastasis were extracted from the SEER database during 2010-2016. Both overall survival (OS) and cancer-specific survival (CSS) were significantly correlated with age, marital status, race, tumor location, pathological grade, histologic type, T stage, N stage, surgery for primary tumor, surgery for liver metastasis, chemotherapy and CEA. All of the significant variables were used to create the nomograms predicting OS and CSS. C-index values, time-dependent ROC curves, DCA curves and calibration curves, proved the superiority of the nomograms. Conclusions: Our research investigated a national cohort of almost 10,000 patients to create and verify nomograms based on pathological, therapeutic and demographic features to predict OS and CSS for synchronous colorectal liver-limited metastasis (SCLLM). The nomograms may act as an excellent tool to integrate clinical characteristics to guide the therapeutic choice for SCLLM patients.