Development of a nomogram predicting perineural invasion risk and assessment of the prognostic value of perineural invasion in colon cancer: a population study based on the Surveillance, Epidemiology, and End Results database.

IF 1.5 4区 医学 Q4 ONCOLOGY
Translational cancer research Pub Date : 2025-01-31 Epub Date: 2025-01-23 DOI:10.21037/tcr-24-1030
Zhongqiang Zheng, Xuanzi Sun
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引用次数: 0

Abstract

Background: Perineural invasion (PNI) in colon cancer (CC) is widely associated with poor prognosis. In this study, we aimed to develop a predictive model for PNI and to assess its prognostic value in CC patients.

Methods: Data for CC patients with or without PNI were obtained from the Surveillance, Epidemiology, and End Results (SEER) database from 2010 to 2015. Potential features were selected by stepwise logistic regression, and multivariate logistic regression was used to develop the nomogram. Nomogram performance was assessed based on its calibration curve, discrimination ability and clinical utility. The prognostic value of PNI was assessed using Kaplan-Meier analysis, a competing risk model, and a Fine-Gray multivariable regression model.

Results: A total of 51,826 subjects were included in the study. The nomogram consisted of 11 features was constructed, which provided good calibration and discrimination with area under the curve values of 0.787 vs. 0.781 (development cohort vs. validation cohort). Patients with PNI had worse CC-specific survival (P<0.001) and a higher CC-specific death rate (Gray's test, P<0.001) than patients without PNI. Fine-Gray multivariable regression analysis showed that patients with PNI had a higher CC-specific death rate than patients without PNI [hazard ratio (HR) =1.243; 95% confidence interval (CI): 1.183-1.305; P<0.001]. Pathologic stage T4 (pT4) CC patients without PNI treated with chemotherapy (ChemT) plus radiotherapy (RT) had a lower CC-specific death rate than ChemT-treated or non-therapy patients.

Conclusions: The nomogram developed herein has certain clinical application value for predicting PNI risk in CC patients. PNI is a survival predictor for CC patients. pT4 patients without PNI might benefit from combined ChemT and RT.

预测神经周围浸润风险的nomogram发展和结肠癌神经周围浸润预后价值的评估:基于监测、流行病学和最终结果数据库的人群研究。
背景:结肠癌(CC)的周围神经侵犯(PNI)与不良预后广泛相关。在本研究中,我们旨在建立PNI的预测模型,并评估其在CC患者中的预后价值。方法:从2010年至2015年的监测、流行病学和最终结果(SEER)数据库中获取伴有或不伴有PNI的CC患者的数据。采用逐步逻辑回归选择潜在特征,并采用多元逻辑回归建立正态图。根据其校准曲线、鉴别能力和临床应用评估Nomogram性能。使用Kaplan-Meier分析、竞争风险模型和Fine-Gray多变量回归模型评估PNI的预后价值。结果:共纳入51826名受试者。构建了包含11个特征的nomogram,曲线下面积分别为0.787和0.781(开发队列和验证队列),具有良好的定标和判别能力。结论:本文建立的nomogram PNI在预测CC患者PNI风险方面具有一定的临床应用价值。PNI是CC患者的生存预测指标。没有PNI的pT4患者可能从联合化疗和放疗中获益。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
2.10
自引率
0.00%
发文量
252
期刊介绍: Translational Cancer Research (Transl Cancer Res TCR; Print ISSN: 2218-676X; Online ISSN 2219-6803; http://tcr.amegroups.com/) is an Open Access, peer-reviewed journal, indexed in Science Citation Index Expanded (SCIE). TCR publishes laboratory studies of novel therapeutic interventions as well as clinical trials which evaluate new treatment paradigms for cancer; results of novel research investigations which bridge the laboratory and clinical settings including risk assessment, cellular and molecular characterization, prevention, detection, diagnosis and treatment of human cancers with the overall goal of improving the clinical care of cancer patients. The focus of TCR is original, peer-reviewed, science-based research that successfully advances clinical medicine toward the goal of improving patients'' quality of life. The editors and an international advisory group of scientists and clinician-scientists as well as other experts will hold TCR articles to the high-quality standards. We accept Original Articles as well as Review Articles, Editorials and Brief Articles.
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