{"title":"Prognostic Value of Tumor Deposit Counts in Patients with Stage III Colorectal Cancer: A Population-Based Study","authors":"Quanhe Long, Ya Xu, G. Ma, Weizheng Mao","doi":"10.1080/08941939.2022.2069306","DOIUrl":null,"url":null,"abstract":"Abstract Objective To investigate the prognostic value of tumor deposits (TDs) counts in stage III colorectal cancer (CRC) patients and develop a prognostic nomogram. Methods Data on stage III CRC patients from 2010 to 2015 were collected from the Surveillance, Epidemiology, and End Results (SEER) database. The Kaplan–Meier analysis was used to assess differences in survival outcomes among patients. The Cox regression analysis was performed to establish the independent prognostic factors for cancer-specific survival and to establish a nomogram. The nomograms’ performance was evaluated by calibration plots and concordance index (C-index). Decision curve analysis (DCA) was used to assess the clinical utility of the prediction model. Results A total of 23,345 CRC patients were included in this study, and 3,578 (15.3%) had TDs. Cox multivariate regression analyses revealed that age, race, histological tumor grade, the administered chemotherapy, pathological type, T-stage, CEA, N-stage, peripheral nerve invasion, and TDs were independent prognostic factors. Patients with many TDs (=0/1–4, HR: 1.325,/≥5 HR: 2.223) had poorer cancer-specific survival. The prognostic value of the number of TDs was comparable to that of lymph node metastasis. The C-indices of the nomogram were superior to TNM staging in training (0.730 vs 0.646) and validation (0.714 vs 0.636) groups. DCA revealed that the nomogram had a higher clinical net benefit compared to TNM staging. Conclusions TDs count is an adverse prognostic factor for stage III CRC patients. Furthermore, the TDs-based nomogram can accurately predict the prognostic outcomes for stage III CRC.","PeriodicalId":16200,"journal":{"name":"Journal of Investigative Surgery","volume":"35 1","pages":"1502 - 1509"},"PeriodicalIF":2.1000,"publicationDate":"2022-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"2","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Investigative Surgery","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1080/08941939.2022.2069306","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"SURGERY","Score":null,"Total":0}
引用次数: 2
Abstract
Abstract Objective To investigate the prognostic value of tumor deposits (TDs) counts in stage III colorectal cancer (CRC) patients and develop a prognostic nomogram. Methods Data on stage III CRC patients from 2010 to 2015 were collected from the Surveillance, Epidemiology, and End Results (SEER) database. The Kaplan–Meier analysis was used to assess differences in survival outcomes among patients. The Cox regression analysis was performed to establish the independent prognostic factors for cancer-specific survival and to establish a nomogram. The nomograms’ performance was evaluated by calibration plots and concordance index (C-index). Decision curve analysis (DCA) was used to assess the clinical utility of the prediction model. Results A total of 23,345 CRC patients were included in this study, and 3,578 (15.3%) had TDs. Cox multivariate regression analyses revealed that age, race, histological tumor grade, the administered chemotherapy, pathological type, T-stage, CEA, N-stage, peripheral nerve invasion, and TDs were independent prognostic factors. Patients with many TDs (=0/1–4, HR: 1.325,/≥5 HR: 2.223) had poorer cancer-specific survival. The prognostic value of the number of TDs was comparable to that of lymph node metastasis. The C-indices of the nomogram were superior to TNM staging in training (0.730 vs 0.646) and validation (0.714 vs 0.636) groups. DCA revealed that the nomogram had a higher clinical net benefit compared to TNM staging. Conclusions TDs count is an adverse prognostic factor for stage III CRC patients. Furthermore, the TDs-based nomogram can accurately predict the prognostic outcomes for stage III CRC.
摘要目的探讨肿瘤沉积物(TDs)计数对Ⅲ期癌症(CRC)患者的预后价值,并建立预后列线图。方法从监测、流行病学和最终结果(SEER)数据库中收集2010年至2015年III期CRC患者的数据。Kaplan–Meier分析用于评估患者之间生存结果的差异。进行Cox回归分析以确定癌症特异性存活的独立预后因素并建立列线图。列线图的性能通过校准图和一致性指数(C指数)进行评估。决策曲线分析(DCA)用于评估预测模型的临床效用。结果本研究共纳入23345例CRC患者,其中3578例(15.3%)有TDs。Cox多元回归分析显示,年龄、种族、组织学肿瘤分级、化疗方案、病理类型、T分期、CEA、N分期、外周神经侵犯和TDs是独立的预后因素。有许多TDs的患者(=0/1-4,HR:1.325,/≥5 HR:2.23)具有较差的癌症特异性存活率。TDs数量的预后价值与淋巴结转移的预后价值相当。列线图的C指数优于训练组(0.730 vs 0.646)和验证组(0.714 vs 0.636)的TNM分期。DCA显示,与TNM分期相比,列线图具有更高的临床净效益。结论TDs计数是III期CRC患者的不良预后因素。此外,基于TDs的列线图可以准确预测III期CRC的预后结果。
期刊介绍:
Journal of Investigative Surgery publishes peer-reviewed scientific articles for the advancement of surgery, to the ultimate benefit of patient care and rehabilitation. It is the only journal that encompasses the individual and collaborative efforts of scientists in human and veterinary medicine, dentistry, basic and applied sciences, engineering, and law and ethics. The journal is dedicated to the publication of outstanding articles of interest to the surgical research community.