Clinical calculator based on clinicopathological characteristics predicts local recurrence and overall survival following radical resection of stage II-III colorectal cancer
PurposeThis study aimed to analyze the risk factors and survival prognosis of local recurrence in stage II-III colorectal cancer (CRC) and develop a clinical risk calculator and nomograms to predict local recurrence and survival in treated patients.MethodsPatients who underwent radical surgery betwe...
Saved in:
| Main Authors: | , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Frontiers Media S.A.
2025-02-01
|
| Series: | Frontiers in Oncology |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/fonc.2025.1494255/full |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1832540339506774016 |
|---|---|
| author | Fei Huang Ran Wei Shiwen Mei Tixian Xiao Wei Zhao Zhaoxu Zheng Qian Liu |
| author_facet | Fei Huang Ran Wei Shiwen Mei Tixian Xiao Wei Zhao Zhaoxu Zheng Qian Liu |
| author_sort | Fei Huang |
| collection | DOAJ |
| description | PurposeThis study aimed to analyze the risk factors and survival prognosis of local recurrence in stage II-III colorectal cancer (CRC) and develop a clinical risk calculator and nomograms to predict local recurrence and survival in treated patients.MethodsPatients who underwent radical surgery between January 2009 and December 2019 at the China National Cancer Center were included. Multivariate nomograms and a clinical risk calculator based on Cox regression were developed. Discrimination was measured with an area under curve (AUC) and variability in individual predictions was assessed with calibration curves. We stratified patients into different risk groups according to the established model to predict their prognosis and guide clinical practice.ResultsThe clinical risk calculator incorporated six variables: tumor thrombus, perineural invasion, tumor grade, pathology T-stage, pathology N-stage, and whether more than 12 lymph nodes were harvested. Our clinical risk calculator provided good discrimination, with AUC values of local recurrence-free survival (LRFS) (0.764) and overall survival (OS) (0.815) in the training cohort and LRFS (0.740) and OS (0.730) in the test cohort. Calibration plots illustrated excellent agreement between the clinical risk calculator predictions and actual observations for 3- and 5-year LRFS and OS. Recurrence risk-stratified analysis showed that low-risk patients were more likely to undergo salvage radical surgery when recurrent disease existed.ConclusionThe clinical calculator can better account for tumor and patient heterogeneity, providing a more individualized outcome prognostication. The model is expected to aid in treatment planning, such as resectability evaluation, and it can be used in postoperative surveillance (https://oldcoloncancer.shinyapps.io/dynnomapp/). |
| format | Article |
| id | doaj-art-a2deeccd768f44b6bf373d4ece4d08a6 |
| institution | Kabale University |
| issn | 2234-943X |
| language | English |
| publishDate | 2025-02-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Oncology |
| spelling | doaj-art-a2deeccd768f44b6bf373d4ece4d08a62025-02-05T05:17:44ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2025-02-011510.3389/fonc.2025.14942551494255Clinical calculator based on clinicopathological characteristics predicts local recurrence and overall survival following radical resection of stage II-III colorectal cancerFei Huang0Ran Wei1Shiwen Mei2Tixian Xiao3Wei Zhao4Zhaoxu Zheng5Qian Liu6Department of Colorectal Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, ChinaDepartment of Gastrointestinal Surgery, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, ChinaDepartment of Colorectal Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, ChinaDepartment of Colorectal Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, ChinaDepartment of Colorectal Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, ChinaDepartment of Colorectal Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, ChinaDepartment of Colorectal Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, ChinaPurposeThis study aimed to analyze the risk factors and survival prognosis of local recurrence in stage II-III colorectal cancer (CRC) and develop a clinical risk calculator and nomograms to predict local recurrence and survival in treated patients.MethodsPatients who underwent radical surgery between January 2009 and December 2019 at the China National Cancer Center were included. Multivariate nomograms and a clinical risk calculator based on Cox regression were developed. Discrimination was measured with an area under curve (AUC) and variability in individual predictions was assessed with calibration curves. We stratified patients into different risk groups according to the established model to predict their prognosis and guide clinical practice.ResultsThe clinical risk calculator incorporated six variables: tumor thrombus, perineural invasion, tumor grade, pathology T-stage, pathology N-stage, and whether more than 12 lymph nodes were harvested. Our clinical risk calculator provided good discrimination, with AUC values of local recurrence-free survival (LRFS) (0.764) and overall survival (OS) (0.815) in the training cohort and LRFS (0.740) and OS (0.730) in the test cohort. Calibration plots illustrated excellent agreement between the clinical risk calculator predictions and actual observations for 3- and 5-year LRFS and OS. Recurrence risk-stratified analysis showed that low-risk patients were more likely to undergo salvage radical surgery when recurrent disease existed.ConclusionThe clinical calculator can better account for tumor and patient heterogeneity, providing a more individualized outcome prognostication. The model is expected to aid in treatment planning, such as resectability evaluation, and it can be used in postoperative surveillance (https://oldcoloncancer.shinyapps.io/dynnomapp/).https://www.frontiersin.org/articles/10.3389/fonc.2025.1494255/fullcolorectal cancernomogramclinical risk factorprognosislocal recurrence |
| spellingShingle | Fei Huang Ran Wei Shiwen Mei Tixian Xiao Wei Zhao Zhaoxu Zheng Qian Liu Clinical calculator based on clinicopathological characteristics predicts local recurrence and overall survival following radical resection of stage II-III colorectal cancer Frontiers in Oncology colorectal cancer nomogram clinical risk factor prognosis local recurrence |
| title | Clinical calculator based on clinicopathological characteristics predicts local recurrence and overall survival following radical resection of stage II-III colorectal cancer |
| title_full | Clinical calculator based on clinicopathological characteristics predicts local recurrence and overall survival following radical resection of stage II-III colorectal cancer |
| title_fullStr | Clinical calculator based on clinicopathological characteristics predicts local recurrence and overall survival following radical resection of stage II-III colorectal cancer |
| title_full_unstemmed | Clinical calculator based on clinicopathological characteristics predicts local recurrence and overall survival following radical resection of stage II-III colorectal cancer |
| title_short | Clinical calculator based on clinicopathological characteristics predicts local recurrence and overall survival following radical resection of stage II-III colorectal cancer |
| title_sort | clinical calculator based on clinicopathological characteristics predicts local recurrence and overall survival following radical resection of stage ii iii colorectal cancer |
| topic | colorectal cancer nomogram clinical risk factor prognosis local recurrence |
| url | https://www.frontiersin.org/articles/10.3389/fonc.2025.1494255/full |
| work_keys_str_mv | AT feihuang clinicalcalculatorbasedonclinicopathologicalcharacteristicspredictslocalrecurrenceandoverallsurvivalfollowingradicalresectionofstageiiiiicolorectalcancer AT ranwei clinicalcalculatorbasedonclinicopathologicalcharacteristicspredictslocalrecurrenceandoverallsurvivalfollowingradicalresectionofstageiiiiicolorectalcancer AT shiwenmei clinicalcalculatorbasedonclinicopathologicalcharacteristicspredictslocalrecurrenceandoverallsurvivalfollowingradicalresectionofstageiiiiicolorectalcancer AT tixianxiao clinicalcalculatorbasedonclinicopathologicalcharacteristicspredictslocalrecurrenceandoverallsurvivalfollowingradicalresectionofstageiiiiicolorectalcancer AT weizhao clinicalcalculatorbasedonclinicopathologicalcharacteristicspredictslocalrecurrenceandoverallsurvivalfollowingradicalresectionofstageiiiiicolorectalcancer AT zhaoxuzheng clinicalcalculatorbasedonclinicopathologicalcharacteristicspredictslocalrecurrenceandoverallsurvivalfollowingradicalresectionofstageiiiiicolorectalcancer AT qianliu clinicalcalculatorbasedonclinicopathologicalcharacteristicspredictslocalrecurrenceandoverallsurvivalfollowingradicalresectionofstageiiiiicolorectalcancer |