275
Views
56
Downloads
2
Crossref
N/A
WoS
1
Scopus
N/A
CSCD
No well‐performing nomogram has been developed specifically to predict individual‐patient cancer‐specific survival (CSS) and overall survival (OS) among patients with resectable colorectal liver metastasis (CRLM) who undergo simultaneous resection of primary and hepatic lesions without neoadjuvant chemotherapy (NAC). We aim to investigate the prognosis of patients with resectable CRLM undergoing simultaneous resection of primary and hepatic lesions without NAC.
Data of patients with CRLM in the Surveillance, Epidemiology and End Results Program (cohort, n = 225) were collected as the training set, and data of patients with CRLM treated at the National Cancer Center (cohort, n = 180) were collected as the validation set. The prognostic value of the clinicopathological parameters in the training cohort was assessed using Kaplan‒Meier curves and univariate and multivariate Cox proportional hazards models, and OS and CSS nomograms integrated with the prognostic variables were constructed. Calibration analyses, receiver operating characteristic (ROC) curves, and decision curve analyses (DCAs) were then performed to evaluate the performance of the nomograms.
There was no collinearity among the collected variables. Three factors were associated with OS and CSS: the pretreatment carcinoembryonic antigen (CEA) concentration, pathologic N (pN) stage, and adjuvant chemotherapy (each p < 0.05). OS and CSS nomograms were constructed using these three parameters. The calibration plots revealed favorable agreement between the predicted and observed outcomes. The areas under the ROC curves were approximately 0.7. The DCA plots revealed that both nomograms had satisfactory clinical benefits. The ROC curves and DCAs also confirmed that the nomogram surpassed the tumor, node, and metastasis staging system.
The herein‐described nomograms containing the pretreatment CEA concentration, pN stage, and adjuvant chemotherapy may be effective models for predicting postoperative survival in patients with CRLM.
No well‐performing nomogram has been developed specifically to predict individual‐patient cancer‐specific survival (CSS) and overall survival (OS) among patients with resectable colorectal liver metastasis (CRLM) who undergo simultaneous resection of primary and hepatic lesions without neoadjuvant chemotherapy (NAC). We aim to investigate the prognosis of patients with resectable CRLM undergoing simultaneous resection of primary and hepatic lesions without NAC.
Data of patients with CRLM in the Surveillance, Epidemiology and End Results Program (cohort, n = 225) were collected as the training set, and data of patients with CRLM treated at the National Cancer Center (cohort, n = 180) were collected as the validation set. The prognostic value of the clinicopathological parameters in the training cohort was assessed using Kaplan‒Meier curves and univariate and multivariate Cox proportional hazards models, and OS and CSS nomograms integrated with the prognostic variables were constructed. Calibration analyses, receiver operating characteristic (ROC) curves, and decision curve analyses (DCAs) were then performed to evaluate the performance of the nomograms.
There was no collinearity among the collected variables. Three factors were associated with OS and CSS: the pretreatment carcinoembryonic antigen (CEA) concentration, pathologic N (pN) stage, and adjuvant chemotherapy (each p < 0.05). OS and CSS nomograms were constructed using these three parameters. The calibration plots revealed favorable agreement between the predicted and observed outcomes. The areas under the ROC curves were approximately 0.7. The DCA plots revealed that both nomograms had satisfactory clinical benefits. The ROC curves and DCAs also confirmed that the nomogram surpassed the tumor, node, and metastasis staging system.
The herein‐described nomograms containing the pretreatment CEA concentration, pN stage, and adjuvant chemotherapy may be effective models for predicting postoperative survival in patients with CRLM.
Sung H, Ferlay J, Siegel RL, Laversanne M, Soerjomataram I, Jemal A, et al. Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2021;71(3):209–49. https://doi.org/10.3322/caac.21660
Mantke R, Schmidt U, Wolff S, Kube R, Lippert H. Incidence of synchronous liver metastases in patients with colorectal cancer in relationship to clinico‐pathologic characteristics. Results of a German prospective multicentre observational study. Eur J Surg Oncol. 2012;38(3):259–65. https://doi.org/10.1016/j.ejso.2011.12.013
Kim YI, Park IJ, Kim JE, Kim SY, Park J‐H, Lee JH, et al. Hepatic resection after neoadjuvant chemotherapy for patients with liver metastases from colorectal cancer: need for cautious planning. Ann Surg Treat Res. 2019;97(5):245–53. https://doi.org/10.4174/astr.2019.97.5.245
Guo M, Jin N, Pawlik T, Cloyd JM. Neoadjuvant chemotherapy for colorectal liver metastases: a contemporary review of the literature. World J Gastrointest Oncol. 2021;13(9):1043–61. https://doi.org/10.4251/wjgo.v13.i9.1043
Hirokawa F, Ueno M, Nakai T, Kaibori M, Nomi T, Iida H, et al. Neoadjuvant chemotherapy versus upfront surgery for resectable liver metastases from colorectal cancer: a multicenter, propensity score‐matched cohort study. J Gastrointest Surg. 2022;26(4):772–81. https://doi.org/10.1007/s11605-021-05175-y
Ono K, Abe T, Oshita A, Sumi Y, Yano T, Okuda H, et al. Efficacy of upfront hepatectomy without neoadjuvant chemotherapy for resectable colorectal liver metastasis. World J Surg Oncol. 2021;19(1):97. https://doi.org/10.1186/s12957-021-02210-9
Yoshino T, Arnold D, Taniguchi H, Pentheroudakis G, Yamazaki K, Xu R‐H, et al. Pan‐Asian adapted ESMO consensus guidelines for the management of patients with metastatic colorectal cancer: a JSMO‐ESMO initiative endorsed by CSCO, KACO, MOS, SSO and TOS. Ann Oncol. 2018;29(1):44–70. https://doi.org/10.1093/annonc/mdx738
Dennosuke J. General rules for clinical and pathological studies on cancer of the colon, rectum and anus: part. I. Clinical classification. Jpn J Surg. 1983;13: 557–73. https://doi.org/10.1007/BF02469505
Mandrekar JN. Receiver operating characteristic curve in diagnostic test assessment. J Thorac Oncol. 2010;5(9):1315–6. https://doi.org/10.1097/JTO.0b013e3181ec173d
Deng GC, Lv Y, Yan H, Sun DC, Qu TT, Pan YT, et al. Nomogram to predict survival of patients with advanced and metastatic pancreatic cancer. BMC Cancer. 2021;21(1):1227. https://doi.org/10.1186/s12885-021-08943-w
Vickers AJ, Elkin EB. Decision curve analysis: a novel method for evaluating prediction models. Med Decis Making. 2006;26(6):565–74. https://doi.org/10.1177/0272989X06295361
Liu C, Hu C, Huang J, Xiang K, Li Z, Qu J, et al. A prognostic nomogram of colon cancer with liver metastasis: a study of the US SEER database and a Chinese cohort. Front Oncol. 2021;11:591009. https://doi.org/10.3389/fonc.2021.591009
Cheng X, Li Y, Chen D, Xu X, Liu F, Zhao F. Nomogram predicting the survival of young‐onset patients with colorectal cancer liver metastases. Diagnostics. 2022;12(6):1395. https://doi.org/10.3390/diagnostics12061395
Becerra AZ, Probst CP, Tejani MA, Aquina CT, González MG, Hensley BJ, et al. Evaluating the prognostic role of elevated preoperative carcinoembryonic antigen levels in colon cancer patients: results from the National cancer database. Ann Surg Oncol. 2016;23(5):1554–61. https://doi.org/10.1245/s10434-015-5014-1
Spindler BA, Bergquist JR, Thiels CA, Habermann EB, Kelley SR, Larson DW, et al. Incorporation of CEA improves risk stratification in stage II colon cancer. J Gastrointest Surg. 2017;21(5):770–7. https://doi.org/10.1007/s11605-017-3391-4
Duffy MJ, van Dalen A, Haglund C, Hansson L, Holinski‐Feder E, Klapdor R, et al. Tumour markers in colorectal cancer: European Group on Tumour Markers (EGTM) guidelines for clinical use. Eur J Cancer. 2007;43(9):1348–60. https://doi.org/10.1016/j.ejca.2007.03.021
Locker GY, Hamilton S, Harris J, Jessup JM, Kemeny N, Macdonald JS, et al. ASCO 2006 update of recommendations for the use of tumor markers in gastrointestinal cancer. J Clin Oncol. 2006;24(33):5313–27. https://doi.org/10.1200/JCO.2006.08.2644
Derwinger K, Gustavsson B. A study of lymph node ratio in stage IV colorectal cancer. World J Surg Oncol. 2008;6:127. https://doi.org/10.1186/1477-7819-6-127
Portier G, Elias D, Bouche O, Rougier P, Bosset J‐F, Saric J, et al. Multicenter randomized trial of adjuvant fluorouracil and folinic acid compared with surgery alone after resection of colorectal liver metastases: FFCD ACHBTH AURC 9002 trial. J Clin Oncol. 2006;24(31):4976–82. https://doi.org/10.1200/JCO.2006.06.8353
Benson AB, Venook AP, Al‐Hawary MM, Arain MA, Chen Y‐J, Ciombor KK, et al. NCCN guidelines insights: rectal cancer, version 6.2020. J Natl Compr Cancer Netw. 2020;18(7):806–15. https://doi.org/10.6004/jnccn.2020.0032
Wu Q, Wang W, Huang Y, Fang S, Guan Y. Nomograms for estimating survival in patients with liver‐only colorectal metastases: a retrospective study. Int J Surg. 2018;60:1–8. https://doi.org/10.1016/j.ijsu.2018.10.032
Liang J, Lin H, Liu J, Wang D, Yuan Y, Li B, et al. A novel prognostic nomogram for colorectal cancer liver metastasis patients with recurrence after hepatectomy. Cancer Med. 2021;10(5):1535–44. https://doi.org/10.1002/cam4.3697
None.
This is an open access article under the terms of the Creative Commons Attribution‐NonCommercial‐NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.