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Yin W, Pei W, Yu T, Zhang Q, Zhang S, Zhang M, Liu G. Construction and validation of a nomogram for predicting overall survival of patients with stage III/IV early-onset colorectal cancer. Front Oncol 2024; 14:1332499. [PMID: 38660128 PMCID: PMC11040690 DOI: 10.3389/fonc.2024.1332499] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Accepted: 03/26/2024] [Indexed: 04/26/2024] Open
Abstract
Purpose This study aimed to identify prognostic factors and develop a nomogram for predicting overall survival (OS) in stage III/IV early-onset colorectal cancer (EO-CRC). Methods Stage III/IV EO-CRC patients were identified from the Surveillance, Epidemiology, and End Results (SEER) database between 2010 and 2015. The datasets were randomly divided (2:1) into training and validation sets. A nomogram predicting OS was developed based on the prognostic factors identified by Cox regression analysis in the training cohort. Moreover, the predictive performance of the nomogram was assessed using the receiver operating characteristic (ROC) curves, calibration plots, and decision curve analysis (DCA). Subsequently, the internal validation was performed using the validation cohort. Finally, a risk stratification system was established based on the constructed nomogram. Results Of the 10,387 patients diagnosed with stage III/IV EO-CRC between 2010 and 2015 in the SEER database, 8,130 patients were included. In the training cohort (n=3,071), sex, marital status, race/ethnicity, primary site, histologic subtypes, grade, T stage, and N stage were identified as independent prognostic variables for OS. The 1-, 3-, and 5-year area under the curve (AUC) values of the nomogram were robust in both the training (0.751, 0.739, and 0.723) and validation cohorts (0.748, 0.733, and 0.720). ROC, calibration plots, and DCA indicated good predictive performance of the nomogram in both the training and validation sets. Furthermore, patients were categorized into low-, middle-, and high-risk groups based on the nomogram risk score. Kaplan-Meier curve showed significant survival differences between the three groups. Conclusion We developed a prognostic nomogram and risk stratification system for stage III/IV EO-CRC, which may facilitate clinical decision-making and individual prognosis prediction.
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Affiliation(s)
- Wanbin Yin
- Department of General Surgery, Tianjin Medical University General Hospital, Tianjin, China
- Department of Anorectal Surgery, Affiliated Hospital of Jining Medical University, Jining, China
| | - Wenju Pei
- Department of General Surgery, Tianjin Medical University General Hospital, Tianjin, China
- Department of Anorectal Surgery, Affiliated Hospital of Jining Medical University, Jining, China
| | - Tao Yu
- Department of Oncology, Tianjin Medical University General Hospital, Tianjin, China
| | - Qi Zhang
- Department of General Surgery, Tianjin Medical University General Hospital, Tianjin, China
| | - Shiyao Zhang
- Department of General Surgery, Tianjin Medical University General Hospital, Tianjin, China
| | - Maorun Zhang
- Department of General Surgery, Tianjin Medical University General Hospital, Tianjin, China
| | - Gang Liu
- Department of General Surgery, Tianjin Medical University General Hospital, Tianjin, China
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Kuang T, Ma W, Zhang J, Yu J, Deng W, Dong K, Wang W. Construction of a Nomogram to Predict Overall Survival in Patients with Early-Onset Hepatocellular Carcinoma: A Retrospective Cohort Study. Cancers (Basel) 2023; 15:5310. [PMID: 38001570 PMCID: PMC10670167 DOI: 10.3390/cancers15225310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Revised: 10/31/2023] [Accepted: 11/03/2023] [Indexed: 11/26/2023] Open
Abstract
Hepatocellular carcinoma (HCC) is a widespread and impactful cancer which has pertinent implications worldwide. Although most cases of HCC are typically diagnosed in individuals aged ≥60 years, there has been a notable rise in the occurrence of HCC among younger patients. However, there is a scarcity of precise prognostic models available for predicting outcomes in these younger patients. A retrospective analysis was conducted to investigate early-onset hepatocellular carcinoma (EO-LIHC) using data from the Surveillance, Epidemiology, and End Results (SEER) database from 2004 to 2018. The analysis included 1392 patients from the SEER database and our hospital. Among them, 1287 patients from the SEER database were assigned to the training cohort (n = 899) and validation cohort 1 (n = 388), while 105 patients from our hospital were assigned to validation cohort 2. A Cox regression analysis showed that age, sex, AFP, grade, stage, tumor size, surgery, and chemotherapy were independent risk factors. The nomogram developed in this study demonstrated its discriminatory ability to predict the 1-, 3-, and 5-year overall survival (OS) rates in EO-LIHC patients based on individual characteristics. Additionally, a web-based OS prediction model specifically tailored for EO-LIHC patients was created and validated. Overall, these advancements contribute to improved decision-making and personalized care for individuals with EO-LIHC.
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Affiliation(s)
- Tianrui Kuang
- Department of General Surgery, Renmin Hospital of Wuhan University, Wuhan 430060, China
- Central Laboratory, Renmin Hospital of Wuhan University, Wuhan 430060, China
| | - Wangbin Ma
- Department of General Surgery, Renmin Hospital of Wuhan University, Wuhan 430060, China
- Central Laboratory, Renmin Hospital of Wuhan University, Wuhan 430060, China
| | - Jiacheng Zhang
- Department of General Surgery, Renmin Hospital of Wuhan University, Wuhan 430060, China
- Central Laboratory, Renmin Hospital of Wuhan University, Wuhan 430060, China
| | - Jia Yu
- Department of General Surgery, Renmin Hospital of Wuhan University, Wuhan 430060, China
- Central Laboratory, Renmin Hospital of Wuhan University, Wuhan 430060, China
| | - Wenhong Deng
- Department of General Surgery, Renmin Hospital of Wuhan University, Wuhan 430060, China
- Central Laboratory, Renmin Hospital of Wuhan University, Wuhan 430060, China
| | - Keshuai Dong
- Department of General Surgery, Renmin Hospital of Wuhan University, Wuhan 430060, China
- Central Laboratory, Renmin Hospital of Wuhan University, Wuhan 430060, China
| | - Weixing Wang
- Department of General Surgery, Renmin Hospital of Wuhan University, Wuhan 430060, China
- Central Laboratory, Renmin Hospital of Wuhan University, Wuhan 430060, China
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Chen M, Chen T. Individualized conditional survival nomograms for stage I-III early onset colorectal cancer patients. Jpn J Clin Oncol 2023; 53:115-121. [PMID: 36385679 DOI: 10.1093/jjco/hyac169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Accepted: 10/18/2022] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVE Conditional survival accounts for the time already survived after surgery and provides additional survival information. The aim was to assess conditional survival in stages I-III early onset colorectal cancer patients and to create nomograms predicting the conditional overall survival and cancer-specific survival after surgery. METHODS A total of 7058 patients who underwent surgical resection of early onset colorectal cancer were identified from surveillance, epidemiology and end results database. The formula used for conditional survival calculation was conditional survival(x|y) = S(x + y)/S(x), where S(x) represents the survival at x years. Conditional survival nomograms were then developed to predict the 5-year conditional overall survival and cancer-specific survival. RESULTS The 5-year overall survival and cancer-specific survival after surgery increases gradually with additional survival time. Race, tumour site, grade, histology, T stage, N stage, lymph node ratio, preoperative carcinoma embryonic antigen level and perineural invasion status were independent predictors of cancer-specific survival, while age and sex were another two independent risk factors for overall survival. The nomograms based on these factors were successfully developed to predict 5-year overall survival and cancer-specific survival given 1-4 years already survived. CONCLUSION The probability of achieving postoperative 5-year overall survival and cancer-specific survival for early onset colorectal cancer increases gradually with additional time survived. The developed nomograms are fairly valuable and informative in facilitating clinical treatment and follow-up schemes.
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Affiliation(s)
- Min Chen
- Department of General Surgery, Changshu Hospital Affiliated to Nanjing University of Chinese Medicine, Changshu, China
| | - Ting Chen
- Department of General Surgery, Changshu Hospital Affiliated to Nanjing University of Chinese Medicine, Changshu, China
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Zhang L, Yang L, Jiang S, Yu M. Nerve Dependence in Colorectal Cancer. Front Cell Dev Biol 2022; 10:766653. [PMID: 35223829 PMCID: PMC8866866 DOI: 10.3389/fcell.2022.766653] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2021] [Accepted: 01/13/2022] [Indexed: 12/28/2022] Open
Abstract
Cancerous invasion of nerves has been reported in a list of malignant tumors as a high-risk pathological feature and marker of poor disease outcome especially in neurotrophic cancers (such as in pancreas and prostate), indicating that although once neglected, nerves could have played a pivotal role in tumorigenesis and cancer progression. In colorectal cancer, perineural invasion, a specific form of tumor-nerve interaction referring to the identification of tumor cells in proximity to the nerve, has been recognized as a strong and independent prognosis predictor; denervation of autonomic nerves and enteric nerves have shown that the existence of these nerves in the gut are accompanied by promoted cancer proliferation, further supporting that nerve is a potential accomplice to shield and nurture tumor cells. However, the precise role of nerve in CRC and the pattern of interaction between CRC cells and nerve has not been unveiled yet. Here we aim to review some basic knowledge of the importance of nerves in CRC and attempt to depict a mechanistic view of tumor-nerve interaction during CRC development.
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Affiliation(s)
- Lincheng Zhang
- Department of Gastrointestinal Surgery, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Ludi Yang
- Department of Ophthalmology, Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Shuheng Jiang
- State Key Laboratory of Oncogenes and Related Genes, Shanghai Cancer Institute, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- *Correspondence: Minhao Yu, ; Shuheng Jiang,
| | - Minhao Yu
- Department of Gastrointestinal Surgery, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
- *Correspondence: Minhao Yu, ; Shuheng Jiang,
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Tang CT, Guo ZX, Wang P, Chen YX, Zeng CY. Higher LNM rate and poorer prognosis of early-onset compared to late-onset T1 stage colorectal cancer: a large-population based study. Am J Cancer Res 2021; 11:3176-3188. [PMID: 34249453 PMCID: PMC8263633] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Accepted: 03/17/2021] [Indexed: 06/13/2023] Open
Abstract
As for T1 stage CRC, there is little knowledge of differences in lymph node metastasis (LNM) and prognosis between early-onset and late-onset CRC. To know that, we included 13,084 patients from the SEER database and 476 patients in T1 stage from our hospital to analyze difference of LNM and prognosis. Univariate and multivariate logistic analyses revealed that early-onset CRC was more likely than late-onset CRC to be positive for LNM. In addition, we found that T1b stage, poor differentiation and lymphatic invasion were risk factors for LNM. Specifically, we found that black race was a risk factor. Before propensity-score matching (PSM), we also found that early-onset CRC patients had better survival, as demonstrated by SEER data. After adjusting for confounding factors by PSM, we found that early onset remained a risk factor for LNM. Moreover, we found that patients diagnosed with early-onset CRC had a poorer prognosis than those diagnosed with late-onset CRC, which was demonstrated by analysis of SEER data and our own data. In conclusion, our study was the first to find that early-onset T1 stage CRC more frequently developed LNM, suggesting that endoscopic submucosal resection should be performed more carefully in these patients. Moreover, early-onset patients in the T1 stage also had poorer survival, suggesting that clinical doctors should pay more attention to early-onset patients.
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Affiliation(s)
- Chao-Tao Tang
- Department of Gastroenterology, The First Affiliated Hospital of Nanchang University Nanchang, China
| | - Zi-Xiang Guo
- Department of Gastroenterology, The First Affiliated Hospital of Nanchang University Nanchang, China
| | - Peng Wang
- Department of Gastroenterology, The First Affiliated Hospital of Nanchang University Nanchang, China
| | - You-Xiang Chen
- Department of Gastroenterology, The First Affiliated Hospital of Nanchang University Nanchang, China
| | - Chun-Yan Zeng
- Department of Gastroenterology, The First Affiliated Hospital of Nanchang University Nanchang, China
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Shi M, Zhou B. Clinical Characteristics and Prognostic Factors of Early-Onset Pancreatic Neuroendocrine Tumors. Cancer Control 2021; 28:1073274820986827. [PMID: 33491476 PMCID: PMC8482713 DOI: 10.1177/1073274820986827] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
BACKGROUND The incidence of pancreatic neuroendocrine tumors (PNETs) has increased significantly. The purpose of this study was to analyze the clinical characteristics and prognosis of patients under 50 years old. METHODS Patients with PNETs recorded in the Surveillance, Epidemiology, and End Results (SEER) database from 2004 to 2015 were analyzed. The clinical characteristics were analyzed by Chi-square test. The Kaplan-Meier method was used to estimate overall survival (OS). Multivariate Cox proportional risk regression analysis was used to determine independent prognostic factors. RESULTS 2,303 patients included, of which 547 (23.8%) patients were younger than 50 years old. The number of younger patients has increased steadily, while the proportion in total PNETs decreased recently. Compared with older group, the proportion of the Black, grade I/II, and surgery were higher in early-onset PNETs. Liver was the most frequent metastatic site. There was no significant difference in the incidence of different metastatic sites between younger and older PNETs patients, while younger patients had better OS (P < 0.05). Grade, N stage, M stage, and surgery were independent prognostic factors for OS in early-onset PNETs. CONCLUSIONS Younger patients have unique clinicopathological characteristics compared with older patients in PNETs. Better OS was observed in younger patients which might due to the higher proportion of well-differentiated tumor and surgery than older patients.
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Affiliation(s)
- Min Shi
- Department of Gastroenterology, Liyang People's Hospital, Liyang City, Jiangsu, China
| | - Biao Zhou
- Department of Gastroenterology, Liyang People's Hospital, Liyang City, Jiangsu, China
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