Multivariate Prognostic Models for Patients with Stages I and Ii Colon Carcinoma: a Strobe-Compliant Retrospective Cohort Study.

IF 1.4 4区医学 Q2 Medicine

Revista De Investigacion Clinica-Clinical and Translational Investigation Pub Date : 2023-01-01 DOI:10.24875/RIC.23000158

Luis F Oñate-Ocaña, Roberto Herrera-Goepfert, Alejandro Avilés-Salas, Carlo C Cortés, Sagrario González-Trejo, José F Carrillo, Erika Ruiz-García, Francisco J Ochoa-Carrillo, Vincenzo Aiello-Crocifoglio, Claudia M García-Cuellar

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Abstract

UNASSIGNED Background: Colorectal cancer is the most frequent gastrointestinal malignancy worldwide. The value of adjuvant treatment is controversial in Stages I and II. Objective: The aim of this study was to construct post-operative prognostic models applicable to patients with stages I-II colon carcinoma (CC). Methods: This is a retrospective cohort study of patients with Stage I-II CC treated over a 25-year period. Exposure was defined as clinical, histopathological, and immunohistochemical factors (including CDX2 and MUC2 expression). Patients were randomly allocated to either a "modeling set" or a "validation set". Factors associated with recurrence, disease-free survival (DFS), and overall survival (OS) were defined in the "modeling set". Their performances were tested in the "validation set". Results: From a total of 556 recruited patients, 339 (61%) were allocated to the "modeling set" and 217 (39%) to the "validation set". Three models explaining recurrence, DFS, and OS were described. Tumor location in the left colon (Hazards ratio [HR] = 1.57; 95% Confidence interval [CI] 0.99-2.48), lymphocyte (HR = 0.46; 96% CI 0.27-0.88) and monocyte (HR = 0.99; 95% CI 0.99-1) counts, neutrophil/platelet ratio (HR = 1.3; 95% CI 0.74-2.3, and HR = 2.3; 95% CI 1.3-4.1; for second and third category, respectively), albumin/monocyte ratio (HR = 0.43; 95% CI 0.21-0.87), and microscopic residual disease after surgery (HR = 8.7; 95% CI 3.1-24) were independently associated with OS. T classification and expression of CDX2 and/or MUC2 were not independently associated with recurrence or prognosis. Conclusion: These models are simple and readily available, and distinguish the risk and prognosis in patients with CC stages I and II; these models require cheaper processes than the use of more sophisticated molecular biology techniques. They may guide either the need for adjuvant therapy versus post-operative surveillance only, as well as aid in the design of clinical trials. (REV INVEST CLIN. 2023;75(5):259-71).

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I期和Ii期结肠癌患者的多因素预后模型：一项符合Strobe的回顾性队列研究。

背景：癌症是全球最常见的胃肠道恶性肿瘤。在第一阶段和第二阶段，辅助治疗的价值是有争议的。目的：本研究旨在构建适用于I-II期结肠癌（CC）患者的术后预后模型。方法：这是一项为期25年的I-II期CC患者的回顾性队列研究。暴露被定义为临床、组织病理学和免疫组织化学因素（包括CDX2和MUC2表达）。患者被随机分配到“建模集”或“验证集”。与复发、无病生存期（DFS）和总生存期（OS）相关的因素在“建模集”中进行了定义。他们的性能在“验证集”中进行了测试。结果：在总共556名招募的患者中，339名（61%）被分配到“建模集”，217名（39%）被分配给“验证集”。描述了解释复发、DFS和OS的三个模型。肿瘤在左结肠中的位置（危险比[HR]=1.57；95%置信区间[CI]0.99-2.48）、淋巴细胞（HR=0.46；96%CI 0.27-0.88）和单核细胞（HR=0.99；95%CI 0.99-1）计数、中性粒细胞/血小板比率（HR=1.3；95%CI 0.74-2.3和HR=2.3；95%CI 1.3-4.1；分别用于第二类和第三类）、白蛋白/单核细胞比率（HR=0.43；95%CI 0.21-0.87），术后显微镜下残余病变（HR=8.7；95%CI 3.1-24）与OS独立相关。T分类和CDX2和/或MUC2的表达与复发或预后无关。结论：这些模型简单易行，能够区分CC I期和II期患者的风险和预后；这些模型需要比使用更复杂的分子生物学技术更便宜的过程。它们可以指导辅助治疗与仅术后监测的需要，也可以帮助设计临床试验。（REV-INVEST-CLIN.2023；75（5）：259-71）。

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

Revista De Investigacion Clinica-Clinical and Translational Investigation 医学-医学：内科

CiteScore

3.00

自引率

0.00%

发文量

审稿时长

>12 weeks

期刊介绍： The Revista de Investigación Clínica – Clinical and Translational Investigation (RIC-C&TI), publishes original clinical and biomedical research of interest to physicians in internal medicine, surgery, and any of their specialties. The Revista de Investigación Clínica – Clinical and Translational Investigation is the official journal of the National Institutes of Health of Mexico, which comprises a group of Institutes and High Specialty Hospitals belonging to the Ministery of Health. The journal is published both on-line and in printed version, appears bimonthly and publishes peer-reviewed original research articles as well as brief and in-depth reviews. All articles published are open access and can be immediately and permanently free for everyone to read and download. The journal accepts clinical and molecular research articles, short reports and reviews. Types of manuscripts: – Brief Communications – Research Letters – Original Articles – Brief Reviews – In-depth Reviews – Perspectives – Letters to the Editor