Retrospective Study
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Surg. Nov 27, 2023; 15(11): 2430-2444
Published online Nov 27, 2023. doi: 10.4240/wjgs.v15.i11.2430
Advantage of log odds of positive lymph nodes in prognostic evaluation of patients with early-onset colon cancer
Heng-Bo Xia, Chen Chen, Zhi-Xing Jia, Liang Li, A-Man Xu
Heng-Bo Xia, Chen Chen, A-Man Xu, Department of General Surgery, The First Affiliated Hospital of Anhui Medical University, Hefei 230032, Anhui Province, China
Heng-Bo Xia, Chen Chen, A-Man Xu, Department of General Surgery, Anhui Public Health Clinical Center, Hefei 230032, Anhui Province, China
Zhi-Xing Jia, Liang Li, Department of Surgery, The Second People’s Hospital of Hefei, Hefei 230011, Anhui Province, China
Co-first authors: Heng-Bo Xia and Chen Chen.
Co-corresponding authors: Liang Li and A-Man Xu.
Author contributions: Xia HB, Chen C, and Jia ZX wrote the manuscript and revised the main work, and they contributed equally to this work; Li L and Xu AM designed this study, and they are all the correspondence and contributed equally to this work; Xu AM provided the idea for the article and Li L provided guidance in writing and revising; and all authors contributed to the article and approved the submitted version.
Institutional review board statement: This study was approved by the ethics committee of the First Affiliated Hospital of Anhui Medical University.
Informed consent statement: All the subjects involved have been informed of the purpose and significance of this study, signed the informed consent. This study was performed in line with the principles of the Declaration of Helsinki.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: The datasets generated during and/or analyzed during the current study are available from the corresponding author upon reasonable request.
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: A-Man Xu, MD, Doctor, Department of General Surgery, The First Affiliated Hospital of Anhui Medical University, Jixi Road, Hefei 230032, Anhui Province, China. xuaman@ahmu.edu.cn
Received: July 7, 2023
Peer-review started: July 7, 2023
First decision: September 18, 2023
Revised: September 28, 2023
Accepted: November 2, 2023
Article in press: November 2, 2023
Published online: November 27, 2023
ARTICLE HIGHLIGHTS
Research background

Colon cancer (CC) is one of the most common cancers of the digestive tract, the third most common cancer worldwide, and the second most common cause of cancer-related deaths. A higher risk of lymph node metastasis (LNM) in young patients with CC. It might be reasonable to treat patients with early-onset locally advanced CC with extended lymph node dissection. However, few studies have focused on early-onset CC (ECC) patients with LNM.

Research motivation

To compare the predictive values of different LN indicators in ECC patients.

Research objectives

The prognostic values of four lymph node staging indices were compared. And the best nomogram for patients with ECC was established.

Research methods

The patients obtained from the Surveillance, Epidemiology, and End Results database were randomly divided into a training group and a testing group. The model was constructed by the training group and verified by the testing group. Using multiple Cox regression models to compare the prediction efficiency of LNM indicators, nomograms were built based on the best model selected for overall survival (OS) and cause-specific survival (CSS). In the two groups, the performance of the nomogram was evaluated by constructing a calibration plot, time-dependent area under the curve (AUC), and decision curve analysis. Finally, the patients were grouped based on the risk score predicted by the prognosis model, and the survival curve was constructed after comparing the survival status of the high and low-risk groups.

Research results

Log odds of PLN (LODDS) were considered to be independent predictors of OS and CSS. The prediction model including LODDS is composed of minimal Akaike information criterion, maximal concordance indexes, and AUCs. The nomograms of OS and CSS were constructed, which representing both cohorts had been successfully verified in terms of prediction accuracy and clinical practicability.

Research conclusions

LODDS is superior to N-stage, PLN, and LNR of ECC. The nomogram based on LODDS might be helpful in tumor evaluation and clinical decision-making, since it provides an appropriate prediction of ECC.

Research perspectives

The nomogram containing LODDS may be helpful in tumor evaluation and clinical decision-making.