The Influencing Factors and Risk Prediction Model Construction of Conversion Therapy Outcomes in Patients with Initial Unresectable Colorectal Cancer Liver Metastasis
Objective To explore the influencing factors of conversion therapy outcomes in patients with initial unresect-able colorectal cancer liver metastasis,and construct a risk prediction model.Methods A retrospective study was conducted,se-lecting 50 patients with initial unresectable colorectal cancer liver metastasis who failed conversion therapy as the conversion fail-ure group,and 81 patients who successfully converted treatment during the same period as the conversion success group.The base-line data and related clinical indicators of the 2 groups of patients were collected.Logistic regression analysis was used to test the influencing factors affecting the outcome of conversion therapy in patients with initial unresectable colorectal cancer liver metasta-sis.Based on the regression results,a risk prediction model was constructed,and then the receiver operating curve(ROC)was drawn to analyze the efficacy of the risk prediction model.Results There was a statistical significant difference between the 2 groups of patients in terms of tumor primary site,number of liver metastases,invasion of portal vein,serum albumin,and anemia(P＜0.05).Logistic regression analysis showed that the tumor was located in the right colon,with≥5 metastatic lesions,invasion of the portal vein,serum albumin＜36 g/L,and anemia as influencing factors for the outcome of conversion therapy in patients with initial unresectable colorectal cancer liver metastasis(P＜0.05).The risk prediction model was constructed.The ROC internal validation showed that the area under the curve(AUC)was 0.784,the 95％CI of AUC was 0.703～0.864,P＜0.001,the speci-ficity was 0.654,the sensitivity was 0.880,and the Youden's J statistic index was 0.534.External validation:AUC was 0.793,95％CI of AUC was 0.714～0.873,P＜0.001,specificity:0.654,sensitivity:0.880,Youdens J statistic index:0.534.Conclu-sion The primary site of the tumor,invasion of the portal vein,serum albumin,anemia,and the number of liver metastases are factors that affect the outcome of conversion therapy in patients with initial unresectable colorectal cancer liver metastasis.The risk prediction model constructed based on these factors has moderate predictive value for the effectiveness of conversion therapy.
Initial unresectable colorectal cancer liver metastasisConversion therapyInfluencing factorsRisk predic-tion model
万方数据
维普
