Independent prognostic factors and prediction models construction of patients with stage ⅡA colorectal cancer
Objective To analyze the independent prognostic factors of postoperative patients with stage ⅡA colorectal cancer and construct a prediction model.Methods A total of 4847 patients with a diagnosis of stage ⅡA colorectal cancer with concomitant surgical treatment registered at the American Cancer Center from January 1,2010 to December 31,2015 were collected according to the SEER database,and the Kaplan-Meier method was applied to draw the survival curves,and the COX proportional risk model was applied to analyze the factors affecting the prognosis of postoperative patients with stage ⅡA colorectal cancer and to construct a prediction model.Results Univariate COX regression analysis suggested that six factors,including patient age,tumor site,nerve invasion,number of lymph nodes cleared,carcinoembryonic antigen level and adjuvant chemotherapy,were the influencing factors of patients'overall survival(P＜0.001).Multifactorial analysis identified five independent risk factors associated with overall survival,which were age,nerve invasion,number of lymph nodes cleared,carcinoembryonic antigen level and adjuvant chemotherapy(P＜0.001).Accordingly,survival curves were plotted and stratified for patients with different neuroinvasive status,and both patients with PNI(+)and PNI(-)showed improved prognosis after adjuvant chemotherapy,but the difference between the two groups was not statistically significant(P=0.652).Based on the results of the multifactorial COX analysis,a column-line diagram was constructed,and the ROC curve showed that the column-line diagram could accurately predict the survival rates of patients with stage ⅡA colorectal cancer after surgery at 1 year(AUC=0.727),3 years(AUC=0.697),and 5 years(AUC=0.692).AUCs of the 1-,3-,and 5-year survival rates in the test set were 0.760,0.722,0.704,respectively.Conclusion The column-line graphical model can provide a basis for prognostic and therapeutic decision-making in postoperative patients with stage ⅡA colorectal cancer.
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