Prognostic Nomogram for Liver Metastatic Colon Cancer Based on Histological Type, Tumor Differentiation, and Tumor Deposit: A TRIPOD Compliant Large-Scale Survival Study

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Abstract

Objective

A proportional hazard model was applied to develop a large-scale prognostic model and nomogram incorporating clinicopathological characteristics, histological type, tumor differentiation grade, and tumor deposit count to provide clinicians and patients diagnosed with colon cancer liver metastases (CLM) a more comprehensive and practical outcome measure.

Methods

Using the Transparent Reporting of multivariable prediction models for individual Prognosis or Diagnosis (TRIPOD) guidelines, this study identified 14,697 patients diagnosed with CLM from 1975 to 2017 in the Surveillance, Epidemiology, and End Results (SEER) 21 registry database. Patients were divided into a modeling group (n=9800), an internal validation group (n=4897) using computerized randomization. An independent external validation cohort (n=60) was obtained. Univariable and multivariate Cox analyses were performed to identify prognostic predictors for overall survival (OS). Subsequently, the nomogram was constructed, and the verification was undertaken by receiver operating curves (AUC) and calibration curves.

Results

Histological type, tumor differentiation grade, and tumor deposit count were independent prognostic predictors for CLM. The nomogram consisted of age, sex, primary site, T category, N category, metastasis of bone, brain or lung, surgery, and chemotherapy. The model achieved excellent prediction power on both internal (mean AUC=0.811) and external validation (mean AUC=0.727), respectively, which were significantly higher than the American Joint Committee on Cancer (AJCC) TNM system.

Conclusion

This study proposes a prognostic nomogram for predicting 1- and 2-year survival based on histopathological and population-based data of CLM patients developed using TRIPOD guidelines. Compared with the TNM stage, our nomogram has better consistency and calibration for predicting the OS of CLM patients.

Related collections

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All references

Author and article information

Contributors

Le Kuai: URI : https://loop.frontiersin.org/people/811786

Ying Zhang: URI : https://loop.frontiersin.org/people/1160856

Ying Luo: URI : https://loop.frontiersin.org/people/812072

Wei Li: URI : https://loop.frontiersin.org/people/838997

Xiao-dong Li: URI : https://loop.frontiersin.org/people/1502324

Shuang-yi Yin: URI : https://loop.frontiersin.org/people/1129309

Bin Li: URI : https://loop.frontiersin.org/people/811399

Journal

Journal ID (nlm-ta): Front Oncol

Journal ID (iso-abbrev): Front Oncol

Journal ID (publisher-id): Front. Oncol.

Title: Frontiers in Oncology

Publisher: Frontiers Media S.A.

ISSN (Electronic): 2234-943X

Publication date (Electronic): 12 October 2021

Publication date Collection: 2021

Volume: 11

Electronic Location Identifier: 604882

Affiliations

[1] ¹ Department of Dermatology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine , Shanghai, China

[2] ² Institute of Dermatology, Shanghai Academy of Traditional Chinese Medicine , Shanghai, China

[3] ³ Center for Translational Medicine, Huaihe Hospital of Henan University , Kaifeng, China

[4] ⁴ Department of Urology Surgery, Huaihe Hospital of Henan University , Kaifeng, China

[5] ⁵ Institute of Evidence-Based Medicine and Knowledge Translation, Henan University , Kaifeng, China

[6] ⁶ Research and Development Center, Shanghai Applied Protein Technology Co., Ltd. , Shanghai, China

[7] ⁷ Shanghai Skin Disease Hospital, School of Medicine, Tongji University , Shanghai, China

Author notes

Edited by: Liang Qiao, Westmead Institute for Medical Research, Australia

Reviewed by: Louise Catherine Connell, Cornell University, United States; Shuai Xiao, The First Affiliated Hospital, University of South China, China

*Correspondence: Bin Li, 18930568129@ 123456163.com ; Shuang-yi Yin, shuangyi918@ 123456foxmail.com

†These authors have contributed equally to this work

This article was submitted to Gastrointestinal Cancers, a section of the journal Frontiers in Oncology

Article

DOI: 10.3389/fonc.2021.604882

PMC ID: 8546254

PubMed ID: 34712601

SO-VID: eceeb20a-1a88-44ca-9ba7-43a3f3572638

License:

This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

History

Date received : 10 September 2020

Date accepted : 20 September 2021

Page count

Figures: 7, Tables: 4, Equations: 0, References: 36, Pages: 12, Words: 4973

Funding

Funded by: National Key Research and Development Program of China Stem Cell and Translational Research , doi 10.13039/501100013290;

Award ID: 2018YFC1705305

Funded by: National Natural Science Foundation of China , doi 10.13039/501100001809;