A Prediction Model for Metachronous Peritoneal Carcinomatosis in Patients with Stage T4 Colon Cancer after Curative Resection
Abstract
:Simple Summary
Abstract
1. Introduction
2. Materials and Methods
2.1. Patient Selection
2.2. Systemic Treatment
2.3. Follow-Up Program and Diagnosis of mPC
2.4. Statistical Analysis
2.4.1. Developing a Prediction Model
2.4.2. Validating the Selected Prediction Model
3. Results
Developing and Validating a Prediction Model
4. Discussion
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Cumulative mPC Incidence (%) | Overall Survival (%) | ||||||
---|---|---|---|---|---|---|---|
Patients, N | One-Year | Three-Year | Five-Year | p-Value | Five-Year | p-Value | |
All patients | 2003 | 4.7 | 10.7 | 11.8 | 67.3 | ||
Gender, N (%) | 0.979 | 0.017 | |||||
Female | 961 (48.0) | 4.3 | 10.7 | 11.7 | 69.7 | ||
Male | 1042 (52.0) | 5.1 | 10.7 | 11.9 | 65.1 | ||
Age at diagnosis, N (%) | 0.002 | <0.001 | |||||
<50 years | 385 (19.2) | 6 | 15.1 | 16.6 | 75 | ||
≥50 years | 1618 (80.8) | 4.4 | 9.6 | 10.6 | 65.5 | ||
Tumor location, N (%) | <0.001 | 0.633 | |||||
Right colon | 941 (47.0) | 5.8 | 13.2 | 14.3 | 67.1 | ||
Left colon | 1062 (53.0) | 3.7 | 8.5 | 9.5 | 67.5 | ||
Preoperative CEA, N (%) | <0.001 | <0.001 | |||||
≤5 ng/mL | 1132 (56.5) | 3.5 | 8.1 | 9.3 | 74.2 | ||
>5 ng/mL | 871 (43.5) | 6.2 | 14 | 15 | 58.4 | ||
Histological grade, N (%) | <0.001 | 0.001 | |||||
Well-to-moderately differentiated | 1782 (89.0) | 4.2 | 9.7 | 10.9 | 68.4 | ||
Poorly differentiated | 221 (11.0) | 9 | 18.6 | 19 | 58.7 | ||
Histological type, N (%) | <0.001 | 0.88 | |||||
Adenocarcinoma | 1755 (87.6) | 4.3 | 9.2 | 10.3 | 67.8 | ||
Mucinous adenocarcinoma | 248 (12.4) | 7.3 | 21.4 | 22.6 | 63.8 | ||
pT stage, N (%) | <0.001 | 0.001 | |||||
4a | 1662 (83.0) | 4.3 | 9.1 | 10.2 | 70.4 | ||
4b | 341 (17.0) | 6.7 | 18.2 | 19.4 | 63.6 | ||
pN stage, N (%) | <0.001 | <0.001 | |||||
N0 | 958 (47.8) | 3.3 | 7.2 | 8.4 | 76.7 | ||
N1 | 640 (32.0) | 4.8 | 10.9 | 11.7 | 63.5 | ||
N2 | 405 (20.2) | 7.7 | 18.5 | 20 | 50.3 | ||
Adjuvant chemotherapy, N (%) | 0.28 | <0.001 | |||||
None | 1054 (52.6) | 5.3 | 11.6 | 12.8 | 61.5 | ||
5-FU-based only | 841 (42.0) | 3.9 | 9.6 | 10.7 | 73.2 | ||
Oxaliplatin-based | 108 (5.4) | 4.6 | 10.2 | 10.2 | 88 | ||
Examined lymph node, N (%) | 0.022 | <0.001 | |||||
<12 | 294 (14.7) | 3.4 | 7.1 | 8.2 | 61.9 | ||
≥12 | 1709 (85.3) | 4.9 | 11.3 | 12.4 | 68.3 |
Training Set | Testing Set | p-Value | |
---|---|---|---|
N = 1503 | N = 500 | ||
Gender, N (%) | 0.054 | ||
Female | 702 (46.71) | 259 (51.80) | |
Male | 801 (53.29) | 241 (48.20) | |
Age at diagnosis, N (%) | 0.833 | ||
<50 years | 291 (19.36) | 94 (18.80) | |
≥50 years | 1212 (80.64) | 406 (81.20) | |
Tumor location, N (%) | 1 | ||
Right colon | 706 (46.97) | 235 (47.00) | |
Left colon | 797 (53.03) | 265 (53.00) | |
Pre-operation CEA, N (%) | 0.209 | ||
≤5 ng/mL | 862 (57.35) | 270 (54.00) | |
>5 ng/mL | 641 (42.65) | 230 (46.00) | |
Histological grade, N (%) | 0.272 | ||
Well-to-moderately differentiated | 1330 (88.49) | 452 (90.40) | |
Poorly differentiated | 173 (11.51) | 48 (9.60) | |
Histological type, N (%) | 0.825 | ||
Adenocarcinoma | 1315 (87.49) | 440 (88.00) | |
Mucinous adenocarcinoma | 188 (12.51) | 60 (12.00) | |
pT stage, N (%) | 0.44 | ||
4a | 1241 (82.57) | 421 (84.20) | |
4b | 262 (17.43) | 79 (15.80) | |
pN stage, N (%) | 0.339 | ||
N0 | 729 (48.50) | 229 (45.80) | |
N1 | 467 (31.07) | 173 (34.60) | |
N2 | 307 (20.43) | 98 (19.60) |
Hazard Ratio (95% CI) | Coefficient | Points * | ||
---|---|---|---|---|
Tumor location | Left colon | 1 | - | 0 |
Right colon | 1.41 (1.05–1.89) | 0.34 | 2 | |
Histologic type | Adenocarcinoma | 1 | - | 0 |
Mucinous adenocarcinoma | 1.93 (1.36–2.75) | 0.66 | 3 | |
Preoperative CEA | ≤5 ng/mL | 1 | - | 0 |
>5 ng/mL | 1.46 (1.09–1.96) | 0.38 | 2 | |
pT stage | 4a | 1 | - | 0 |
4b | 2.04 (1.47–2.83) | 0.71 | 3 | |
pN stage | N0 | 1 | - | 0 |
N1 | 1.49 (1.04–2.12) | 0.4 | 2 | |
N2 | 2.79 (1.96–3.97) | 1.03 | 5 |
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Tsai, T.-Y.; You, J.-F.; Hsu, Y.-J.; Jhuang, J.-R.; Chern, Y.-J.; Hung, H.-Y.; Yeh, C.-Y.; Hsieh, P.-S.; Chiang, S.-F.; Lai, C.-C.; et al. A Prediction Model for Metachronous Peritoneal Carcinomatosis in Patients with Stage T4 Colon Cancer after Curative Resection. Cancers 2021, 13, 2808. https://doi.org/10.3390/cancers13112808
Tsai T-Y, You J-F, Hsu Y-J, Jhuang J-R, Chern Y-J, Hung H-Y, Yeh C-Y, Hsieh P-S, Chiang S-F, Lai C-C, et al. A Prediction Model for Metachronous Peritoneal Carcinomatosis in Patients with Stage T4 Colon Cancer after Curative Resection. Cancers. 2021; 13(11):2808. https://doi.org/10.3390/cancers13112808
Chicago/Turabian StyleTsai, Tzong-Yun, Jeng-Fu You, Yu-Jen Hsu, Jing-Rong Jhuang, Yih-Jong Chern, Hsin-Yuan Hung, Chien-Yuh Yeh, Pao-Shiu Hsieh, Sum-Fu Chiang, Cheng-Chou Lai, and et al. 2021. "A Prediction Model for Metachronous Peritoneal Carcinomatosis in Patients with Stage T4 Colon Cancer after Curative Resection" Cancers 13, no. 11: 2808. https://doi.org/10.3390/cancers13112808