Establishment of prognostic nomogram for elderly colorectal cancer patients: a SEER database analysis
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RESEARCH ARTICLE
Open Access
Establishment of prognostic nomogram for elderly colorectal cancer patients: a SEER database analysis Chaoran Yu1,2*†
and Yujie Zhang3†
Abstract Background: This study aimed to establish nomogram models of overall survival (OS) and cancer-specific survival (CSS) in elderly colorectal cancer (ECRC) patients (Age ≥ 70). Methods: The clinical variables of patients confirmed as ECRC between 2004 and 2016 were retrieved from the Surveillance, Epidemiology, and End Results (SEER) database. Univariate and multivariate analysis were performed, followed by the construction of nomograms in OS and CSS. Results: A total of 44,761 cases were finally included in this study. Both C-index and calibration plots indicated noticeable performance of newly established nomograms. Moreover, nomograms also showed higher outcomes of decision curve analysis (DCA) and the area under the curve (AUC) compared to American Joint Committee on Cancer (AJCC) tumor-node-metastasis (TNM) stage and SEER stage. Conclusions: This study established nomograms of elderly colorectal cancer patients with distinct clinical values compared to AJCC TNM and SEER stages regarding both OS and CSS. Keywords: Elderly colon cancer, Nomogram, Overall survival, Cancer-specific survival, SEER
Background Colorectal cancer has been ranked as the second most common malignancy in women and third in men across the world. Annual global incidence is approximately 1.4 million with nearly 700,000 deaths [1, 2]. There are more than 50,000 death reports and over 130,000 newly occurred cases in the United States [2]. In European Union, 215,000 cases have been reported with colorectal cancer being listed as the second common cause of death [3]. In China, colorectal cancer is listed as one of
* Correspondence: [email protected]; [email protected] † Chaoran Yu and Yujie Zhang contributed equally to this work. 1 Fudan University Shanghai Cancer Center, Fudan University, Dongan Road 270, Shanghai 200025, P. R. China 2 Department of Oncology, Shanghai Medical College, Fudan University, Dongan Road 270, Shanghai 200025, P. R. China Full list of author information is available at the end of the article
the five most commonly malignancies both in men and women [4]. Genomic characterization of colorectal cancer has been well elucidated and the role of immunology is increasingly valued [5–7]. Therapeutically, surgical intervention and chemotherapy-based strategies have been widely accepted for colorectal cancer [8, 9]. Noteworthy, the impact of colorectal cancer surgery on the elder group, regarding long term survival, is similar to that of younger group [10]. Generally, elderly colorectal cancer patients (ECRC), defined by age surpass 70 years old, may naturally associate with increased mortality as age increased. However, no study did fully cover nor depict the quantified association of age and risks for prognosis of ECRC [11, 12]. Previously, tumor-node-metastasis (TNM) stage system of American Joint Committee on
© The Author(s). 2020 Open Access
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