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
APA StyleTsai, 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., Chiang, J.-M., Tang, R., & Tsai, W.-S. (2021). A Prediction Model for Metachronous Peritoneal Carcinomatosis in Patients with Stage T4 Colon Cancer after Curative Resection. Cancers, 13(11), 2808. https://doi.org/10.3390/cancers13112808