Xia HB, Chen C, Jia ZX, Li L, Xu AM. Advantage of log odds of positive lymph nodes in prognostic evaluation of patients with early-onset colon cancer. World J Gastrointest Surg 2023; 15(11): 2430-2444 [PMID: 38111780 DOI: 10.4240/wjgs.v15.i11.2430]
Corresponding Author of This Article
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
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Retrospective Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (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: http://creativecommons.org/licenses/by-nc/4.0/
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 Processing time: 143 Days and 7.7 Hours
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.
