Predictive Nomogram for Recurrence of Stage I Colorectal Cancer After Curative Resection

被引：28

作者：

Kim, Chan ^{[1
]}

Kim, Woo Ram ^{[2
]}

Kim, Ki-Yeol ^{[3
]}

Chon, Hong Jae ^{[1
]}

Beom, Seung Hoon ^{[4
]}

Kim, Hyojoong ^{[1
]}

Jung, Minkyu ^{[4
]}

Shin, Sang Joon ^{[4
]}

Kim, Nam Kyu ^{[5
]}

Ahn, Joong Bae ^{[4
]}

机构：

[1] CHA Univ, CHA Bundang Med Ctr, Dept Med Oncol, Seongnam, South Korea

[2] CHA Univ, CHA Bundang Med Ctr, Dept Surg, Seongnam, South Africa

[3] Yonsei Univ, Coll Dent, Dent Educ Res Ctr, Brain Korea Project 21, Seoul, South Korea

[4] Yonsei Univ, Coll Med, Dept Internal Med, Div Med Oncol, 50 Yonsei Ro, Seoul 120752, South Korea

[5] Yonsei Univ, Coll Med, Dept Surg, Seoul, South Korea

来源：

CLINICAL COLORECTAL CANCER | 2018年 / 17卷 / 03期

基金：

新加坡国家研究基金会;

关键词：

Colorectal Cancer; Nomogram; Prognosis; Recurrence; Stage I; RECTAL-CANCER; SURVIVAL;

D O I：

10.1016/j.clcc.2018.03.011

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

In a study that aimed to develop a predictive nomogram for postoperative recurrence in stage I colorectal cancer (CRC), a predictive nomogram was developed with a total of 1538 stage I CRC patients and internally validated. This nomogram will assist physicians to more accurately identify high-risk patients who need more active surveillance and will help ensure more efficient disease management. Background: Patients with stage I colorectal cancer (CRC) have excellent prognosis after curative surgery. However, approximately 5% to 10% of patients experience recurrence and have a poor prognosis. Because the incidence of stage I CRC is increasing with active screening programs worldwide, a more accurate and easy-to-use predictive tool for recurrence is becoming more important. This study aimed to develop a predictive nomogram for recurrence in stage I CRC. Patients and Methods: A total of 1538 patients who underwent curative surgery for stage I CRC were enrolled. Predictive factors for recurrence were determined by multivariate Cox regression model and were used to develop a predictive nomogram. This model was internally validated, and performance was evaluated through calibration plots. Results: The cumulative recurrence rate at 5 years after surgery for stage I CRC was 5.3%. In multivariate Cox analysis, independent predictors of recurrence were tumor location at rectum, pT2 stage, and presence of lymphovascular invasion. The 5-year recurrence rate was significantly different depending on the number of risk factors (0.7% for 0, 5.8% for 1, and 9.7% for >= 2 risk factors). On this basis, a nomogram for recurrence-free survival was developed and internally validated. The concordance index of the nomogram was 0.71, and the performance was acceptable. Conclusion: We developed and internally validated a nomogram that can predict postoperative recurrence in stage I CRC patients. This nomogram may be used to more accurately stratify the risk of recurrence and to perform personalized postoperative surveillance in stage I CRC patients. (C) 2018 Elsevier Inc. All rights reserved.

引用

页码：E513 / E518

页数：6