Survival nomograms for simultaneous resection of primary and hepatic lesions without neoadjuvant chemotherapy in patients with resectable colorectal liver metastasis  

作　　者：Yu-Juan Jiang Si-Cheng Zhou Zi-Xing Zhu Jing-Hua Chen Jian-Wei Liang 

机构地区：[1]Department of Colorectal Surgery,National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital,Chinese Academy of Medical Sciences and Peking Union Medical College,17 Panjiayuan Nanli,Chaoyang,Beijing 100021,China [2]Department of Hepatobiliary Surgery,National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital,Chinese Academy of Medical Sciences and Peking Union Medical College,Beijing,China

出　　处：《Cancer Innovation》2023年第4期240-252,共13页肿瘤创新（英文）

基　　金：National Natural Science Foundation of China,Grant/Award Number:81441070。

摘　　要：Background 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.Methods 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.Results 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.Conclusion 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.

关 键 词：NOMOGRAM SEER colorectallivermetastasis cancer-specific survival overallsurvival 

分 类 号：R735.34[医药卫生—肿瘤]