scholarly journals Establishment and validation of a novel nomogram incorporating clinicopathological parameters into the TNM staging system to predict prognosis for stage II colorectal cancer

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Shaobo Mo ◽  
Zheng Zhou ◽  
Yaqi Li ◽  
Xiang Hu ◽  
Xiaoji Ma ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Staging System ◽  
Tnm Staging ◽  
Stage Ii ◽  
Clinicopathological Parameters ◽  
Tnm Staging System ◽  
Stage Ii Colorectal Cancer

Construction and validation of a simple-to-use nomogram incorporating clinicopathological parameters into the TNM staging system to predict prognosis for stage II colorectal cancer.

2020 ◽  
Vol 38 (4_suppl) ◽  
pp. 31-31
Author(s):  
Shaobo Mo ◽  
Yaqi Li ◽  
Junjie Peng ◽  
SanJun Cai
Keyword(s):  
Colorectal Cancer ◽  
Large Population ◽  
Disease Free Survival ◽  
Staging System ◽  
Tnm Staging ◽  
Stage Ii ◽  
Clinicopathological Parameters ◽  
Tnm Staging System ◽  
Stage Ii Colorectal Cancer ◽  
Validation Set

31 Background: Survival outcomes are significant different in stage II colorectal cancer (CRC) patients with diverse clinicopathological features. Objective of this study is to establish a credible prognostic nomogram incorporating easily obtained parameters for stage II CRC patients. Methods: A total of 1708 stage II CRC patients at Fudan University Shanghai Cancer Center (FUSCC) during 2008 to 2013 were retrospectively analyzed in this study. Cases were randomly separated into training set (n = 1084) and validation set (n = 624). Univariate and multivariate Cox regression analyses were used to identify independent prognostic factors which were subsequently incorporated into a nomogram. The performance of the nomogram was evaluated by C-index and ROC curve to calculate the area under the curve (AUC). The clinical utility of the nomogram was evaluated using decision curve analysis (DCA). Results: In univariate and multivariate analyses, eight parameters were correlated with disease free survival (DFS), which were subsequently selected to draw prognostic nomogram based on DFS. For DFS predictions, the predicted concordance index (C-index) of the nomogram was 0.842 (95% confidence interval (CI), 0.710-0.980), and 0.701 (95% CI, 0.610-0.770) for training and validation set, respectively. The AUC values of ROC predicted 1, 3 and 5-year survival of nomogram in the training and validation groups were 0.869, 0.858, 0.777 and 0.673, 0.714, 0.706, respectively. The recurrence probability calibration curve showed good consistency between actual observations and nomogram-based predictions. DCA showed better clinical application value for the nomogram compared with TNM staging system. Conclusions: A novel nomogram based on a large population study was established and validated, which is a simple-to-use tool for physicians to facilitate the postoperative personalized prognostic evaluation and determine therapeutic strategies for stage II CRC patients.

scholarly journals Prognostic value of lymphovascular invasion in stage II colorectal cancer patients with an inadequate examination of lymph nodes

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Zhenyan Gao ◽  
Huihua Cao ◽  
Xiang Xu ◽  
Qing Wang ◽  
Yugang Wu ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Prognostic Value ◽  
Lymphovascular Invasion ◽  
Multivariate Analyses ◽  
Staging System ◽  
Tnm Staging ◽  
Stage Ii ◽  
Tnm Staging System ◽  
Serum Cea ◽  
Stage Ii Colorectal Cancer

Abstract Background Lymphovascular invasion (LVI) is defined as the presence of cancer cells in lymphatics or blood vessels. This study aimed to evaluate the prognostic value of LVI in stage II colorectal cancer (CRC) patients with inadequate examination of lymph nodes (ELNs) and further combined LVI with the TNM staging system to determine the predictive efficacy for CRC prognosis. Adjuvant chemotherapy (ACT) was then evaluated for stage II CRC patients with LVI positivity (LVI+). Methods In order to avoid the effects of different ACT regimens, among 409 stage II patients, we chose 121 patients who received FOLFOX regimen and the 144 patients who did not receive ACT as the object of study. LVI was examined by hematoxylin-eosin (HE) staining. Kaplan-Meier analysis followed by a log-rank test was used to analyze survival rates. Univariate and multivariate analyses were performed using a Cox proportional hazards model. Harrell’s concordance index (C-index) was used to evaluate the accuracy of different systems in predicting prognosis. Results The LVI+ status was significantly associated with pT stage, degree of differentiation, tumor stage, serum CEA and CA19-9 levels, perineural invasion (PNI), tumor budding (TB), and KRAS status. The 5-year overall survival (OS) rate of stage II patients with < 12 ELNs and LVI+ was less than stage IIIA. Multivariate analyses showed that LVI, pT-stage, serum CEA and CA19-9 levels, PNI, TB, and KRAS status were significant prognostic factors for stage II patients with < 12 ELNs. The 8th TNM staging system combined with LVI showed a higher C-index than the 8th TNM staging system alone (C-index, 0.895 vs. 0.833). Among patients with LVI+, the ACT group had a significantly higher 5-year OS and 5-year disease-free survival (DFS) than the surgery alone (SA) group (5-year OS, 66.7% vs. 40.9%, P = 0.004; 5-year DFS, 64.1% vs. 36.3%, P = 0.002). Conclusions LVI is an independent prognostic risk factor for stage II CRC patients. Combining LVI with the 8th TNM staging system improved the predictive accuracy for CRC prognosis. ACT in stage II CRC patients with LVI+ is beneficial for survival.

Verification of T-plus staging system for colorectal cancer based on nomogram analysis of single center’s 25-year follow-up.

2016 ◽  
Vol 34 (4_suppl) ◽  
pp. 516-516
Author(s):  
Ke-Feng Ding ◽  
Jun Li ◽  
Xiang-Xing Kong ◽  
Ke-Jun Tang ◽  
Di-Kai Bei ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Lymph Node ◽  
Staging System ◽  
Tnm Staging ◽  
Information Criteria ◽  
Stage Ii ◽  
Lymph Node Status ◽  
T Stage ◽  
Node Status ◽  
Tnm Staging System

516 Background: We proposed T-plus staging system which abandon the criterion to discriminate stage II/III by lymph node status and strengthens weighting of the T stage according to cluster analysis of the summary survival data of SEER. In this study, this principle of the T-plus staging system was verified with single center data by nomogram analysis. Methods: The 1,099 patients with colorectal cancer diagnosed before 2005 were analyzed to build a novel staging system based on nomogram (nomo-staging system). The remaining 981 patients diagnosed after 2005 were used to test the performance of nomo-staging system, T-plus staging system and the 7th edition TNM staging system by Akaike information criteria (AIC), Harrell’s c-index and the area under the curve (AUC) of Receiver Operating Characteristic to predict 5-year overall survival. A smaller AIC, higher c-index and higher AUC indicated a better staging system. Results: The nomo-staging system and T-plus staging system were listed in Table 1. The validation found that the 7th edition TNM staging system showed the weakest performance. For AIC, both nomo-staging system and T-plus staging system showed smaller value than the 7th edition TNM staging system (3214.912 vs. 3224.643 vs. 3229.810). For Harrell’s c-index, both the T-plus staging system and nomo-staging system showed higher value than the 7th edition TNM staging system (0.6814 vs. 0.6787 vs. 0.6778). For AUC to predict 5-year OS, the T-plus staging system and nomo-staging system showed slightly higher value than the 7th edition TNM staging system (0.6944 vs. 0.6924 vs. 0.6913). Conclusions: We propose replacement of lymph node status as the criterion to discriminate colorectal cancer stage II/III with greater weighting of the T stage. [Table: see text]

scholarly journals A modified TNM staging system for non-metastatic colorectal cancer based on nomogram analysis of SEER database

BMC Cancer ◽  
2018 ◽  
Vol 18 (1) ◽  
Author(s):  
Xiangxing Kong ◽  
Jun Li ◽  
Yibo Cai ◽  
Yu Tian ◽  
Shengqiang Chi ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Metastatic Colorectal Cancer ◽  
Staging System ◽  
Tnm Staging ◽  
Seer Database ◽  
Tnm Staging System

Is the Seventh Edition of the UICC/AJCC TNM Staging System Reasonable for Patients With Tumor Deposits in Colorectal Cancer?

2012 ◽  
Vol 255 (2) ◽  
pp. 208-213 ◽  
Author(s):  
Lin-lin Tong ◽  
Peng Gao ◽  
Zhen-ning Wang ◽  
Yong-xi Song ◽  
Ying-ying Xu ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Staging System ◽  
Tnm Staging ◽  
Seventh Edition ◽  
Tnm Staging System

scholarly journals Prognostic nomogram to predict the overall survival of patients with early-onset colorectal cancer: a population-based analysis

2021 ◽  
Author(s):  
Junxian Wu ◽  
Linbin Lu ◽  
Hong Chen ◽  
Yihong Lin ◽  
Huanlin Zhang ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Overall Survival ◽  
Prognostic Factors ◽  
Early Onset ◽  
Clinical Decision Making ◽  
Staging System ◽  
Tnm Staging ◽  
Discriminative Ability ◽  
Tnm Staging System ◽  
Early Onset Colorectal Cancer

Abstract Purpose The present study aimed to identify independent clinicopathological and socio-economic prognostic factors associated with overall survival of early-onset colorectal cancer (EO-CRC) patients and then establish and validate a prognostic nomogram for patients with EO-CRC. Methods Eligible patients with EO-CRC diagnosed from 2010 to 2017 were extracted from the Surveillance, Epidemiology, and End Results (SEER) database. Patients were randomly divided into a training cohort and a testing cohort. Independent prognostic factors were obtained using univariate and multivariate Cox analyses and were used to establish a nomogram for predicting 3- and 5-year overall survival (OS). The discriminative ability and calibration of the nomogram were assessed using C-index values, AUC values, and calibration plots. Results In total, 5585 patients with EO-CRC were involved in the study. Based on the univariate and multivariate analyses, 15 independent prognostic factors were assembled into the nomogram to predict 3- and 5-year OS. The nomogram showed favorable discriminatory ability as indicated by the C-index (0.840, 95% CI 0.827–0.850), and the 3- and 5-year AUC values (0.868 and 0.84869 respectively). Calibration plots indicated optimal agreement between the nomogram-predicted survival and the actual observed survival. The results remained reproducible in the testing cohort. The C-index of the nomogram was higher than that of the TNM staging system (0.840 vs 0.804, P < 0.001). Conclusion A novel prognostic nomogram for EO-CRC patients based on independent clinicopathological and socio-economic factors was developed, which was superior to the TNM staging system. The nomogram could facilitate postoperative individual prognosis prediction and clinical decision-making.

Key Issues in Reporting Common Cancer Specimens: Problems in Pathologic Staging of Colon Cancer

2006 ◽  
Vol 130 (3) ◽  
pp. 318-324 ◽  
Author(s):  
Carolyn C. Compton
Keyword(s):  
Colorectal Cancer ◽  
Prognostic Factor ◽  
Staging System ◽  
Tnm Staging ◽  
International Union ◽  
Cancer Resection ◽  
American Joint Committee ◽  
Colorectal Cancer Resection ◽  
Tnm Staging System ◽  
Pathologic Staging

Abstract Context.—Standardized pathologic assessment is a quality measure for cancer care. Objective.—Pathologic staging parameters and the clinically important stage-independent pathologic factors that pathologists find most problematic to evaluate in colorectal cancer resection specimens are reviewed. The objective of this review is to provide practical guidance for the practicing surgical pathologist. Data Sources.—Published literature related to the TNM staging system for colorectal cancer of the American Joint Committee on Cancer and the International Union Against Cancer and to stage-independent tissue-based prognostic factor evaluation was included in the review. Study Selection, Data Extraction, and Synthesis.—Published guidelines from authoritative sources and published peer-reviewed data related to colorectal cancer staging and pathologic prognostic factor assessment were included for consideration. The general and site-specific rules of application of the American Joint Committee on Cancer and International Union Against Cancer TNM staging system for the colorectum and the protocol for evaluation of colorectal cancer resection specimens of the Cancer Committee of the College of American Pathologists served as the basis for discussion and amplified with practical advice on specific application. Conclusions.—Standardization of pathologic evaluation of colorectal cancer resection specimens is essential for optimal patient care and is aided by the use of data-driven guidelines that are easily understood and consistently applied.

scholarly journals Masaoka-Koga and TNM Staging System in Thymic Epithelial Tumors: Prognostic Comparison and the Role of the Number of Involved Structures

Cancers ◽  
2021 ◽  
Vol 13 (21) ◽  
pp. 5254
Author(s):  
Marco Chiappetta ◽  
Filippo Lococo ◽  
Luca Pogliani ◽  
Isabella Sperduti ◽  
Diomira Tabacco ◽  
...  
Keyword(s):  
Staging System ◽  
Tnm Staging ◽  
Multiple Organ ◽  
Stage I ◽  
Stage Ii ◽  
Stage Iii ◽  
Thymic Epithelial Tumors ◽  
Epithelial Tumors ◽  
Tnm Staging System ◽  
Staging Systems

Background: The aim of this study was to evaluate the Masaoka–Koga and the tumor node metastases (TNM) staging system in thymic epithelial tumors (TET) considering possible improvements. Methods: We reviewed the data of 379 patients who underwent surgical resection for TET from 1 January 1985 to 1 January 2018, collecting and classifying the pathological report according to the Masaoka–Koga and the TMN system. The number of involved organs was also considered as a possible prognostic factor and integrated in the two staging systems to verify its impact. Results: Considering the Masaoka–Koga system, 5- and 10-year overall survival (5–10YOS) was 96.4% and 88.9% in stage I, 95% and 89.5% in stage II and 85.4% and 72.8% in stage III (p = 0.01), with overlapping in stage I and stage II curves. Considering the TNM system, 5–10YOS was 95.5% and 88.8% in T1, 84.8% and 70.7% in T2 and 88% and 76.3% in T3 (p = 0.02), with overlapping T2–T3 curves. Including the number of involved structures, in Masaoka–Koga stage III, patients with singular involved organs had a 100% and 76.6% vs. 87.7% 5–10YOS, which was 76.6% in patients with multiple organ infiltration. Considering the TNM, T3 patients with singular involved structures presented a 5–10YOS of 100% vs. 62.5% and 37.5% in patients with multiple organ involvement (p = 0.07). Conclusion: The two staging systems present limitations due to overlapping curves in early Masaoka–Koga stages and in advanced T stages for TNM. The addition of the number of involved organs seems to be a promising factor for the prognosis stratification in these patients.

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