Clinical and Translational Research
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Surg. Jun 27, 2024; 16(6): 1791-1802
Published online Jun 27, 2024. doi: 10.4240/wjgs.v16.i6.1791
Analysis of cancer-specific survival in patients with metastatic colorectal cancer: A evidence-based medicine study
Yin-Jie Zhou, Zhi-E Tan, Wei-Da Zhuang, Xin-Hua Xu
Yin-Jie Zhou, Xin-Hua Xu, Department of Oncology, The First College of Clinical Medical Science, China Three Gorges University & Yichang Central People's Hospital, Yichang 443000, Hubei Province, China
Zhi-E Tan, Department of Nuclear Medicine, The First College of Clinical Medical Science, China Three Gorges University & Yichang Central People's Hospital, Yichang 443000, Hubei Province, China
Wei-Da Zhuang, Department of Athe and Intestinal Surgery, Cancer Hospital of The Chinese Academy of Medical Sciences, Beijing 100021, China
Author contributions: Zhou YJ wrote the manuscript; Tan ZE and Zhuang WD collected the data; and Xu XH guided the study; All authors reviewed, edited, and approved the final manuscript and revised it critically for important intellectual content, gave final approval of the version to be published, and agreed to be accountable for all aspects of the work.
Conflict-of-interest statement: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as potential conflicts of interest.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Xin-Hua Xu, MM, Doctor, Department of Oncology, The First College of Clinical Medical Science, China Three Gorges University & Yichang Central People's Hospital, No. 183 Yi Ling Road, Yichang 443000, Hubei Province, China. 2732774352@qq.com
Received: March 8, 2024
Revised: April 29, 2024
Accepted: May 16, 2024
Published online: June 27, 2024
Processing time: 113 Days and 23.2 Hours
Abstract
BACKGROUND

Metastatic colorectal cancer (mCRC) is a common malignancy whose treatment has been a clinical challenge. Cancer-specific survival (CSS) plays a crucial role in assessing patient prognosis and treatment outcomes. However, there is still limited research on the factors affecting CSS in mCRC patients and their correlation.

AIM

To predict CSS, we developed a new nomogram model and risk grading system to classify risk levels in patients with mCRC.

METHODS

Data were extracted from the United States Surveillance, Epidemiology, and End Results database from 2018 to 2023. All eligible patients were randomly divided into a training cohort and a validation cohort. The Cox proportional hazards model was used to investigate the independent risk factors for CSS. A new nomogram model was developed to predict CSS and was evaluated through internal and external validation.

RESULTS

A multivariate Cox proportional risk model was used to identify independent risk factors for CSS. Then, new CSS columns were developed based on these factors. The consistency index (C-index) of the histogram was 0.718 (95%CI: 0.712-0.725), and that of the validation cohort was 0.722 (95%CI: 0.711-0.732), indicating good discrimination ability and better performance than tumor-node-metastasis staging (C-index: 0.712-0.732). For the training set, 0.533, 95%CI: 0.525-0.540; for the verification set, 0.524, 95%CI: 0.513-0.535. The calibration map and clinical decision curve showed good agreement and good potential clinical validity. The risk grading system divided all patients into three groups, and the Kaplan-Meier curve showed good stratification and differentiation of CSS between different groups. The median CSS times in the low-risk, medium-risk, and high-risk groups were 36 months (95%CI: 34.987-37.013), 18 months (95%CI: 17.273-18.727), and 5 months (95%CI: 4.503-5.497), respectively.

CONCLUSION

Our study developed a new nomogram model to predict CSS in patients with synchronous mCRC. In addition, the risk-grading system helps to accurately assess patient prognosis and guide treatment.

Keywords: Colorectal tumor, Surveillance epidemiology and end results database, Nomogram analysis, Survival prognosis, Retrospective study

Core Tip: This study utilized an evidence-based approach to analyze cancer-specific survival (CSS) in patients with metastatic colorectal cancer (mCRC). By systematically collecting, integrating, and analyzing relevant data, we explored CSS in mCRC patients and its influencing factors to provide clinicians with more accurate prognostic assessments and treatment decision support. The importance of this study is that it can provide a basis for individualized treatment of mCRC patients and promote the maximization of treatment effects, thereby improving the quality of life and survival rate of patients.