Construction of Long-term Prognostic Factors and Risk Prediction Models for Patients with Metachronous Peritoneal Metastasis of Colorectal Cancer
Objective To analyze the factors affecting the long-term prognosis of patients with metachronous peritoneal metastasis of colorectal cancer and establish a risk prediction model.Methods A retrospective analysis was conducted on the clinical data of 90 patients with metachronous peritoneal metastasis of colorectal cancer who underwent tumor cell reduction sur-gery and intraperitoneal thermal perfusion chemotherapy.The data were divided into a death group(n=65)and a survival group(n=25)based on the prognosis during a 3-year follow-up period.Cox regression analysis was used to analyze the factors that af-fect the long-term prognosis of patients with metachronous peritoneal metastasis of colorectal cancer.A risk prediction model was constructed based on the results of the regression analysis,and the predictive efficacy of the risk model was evaluated by drawing a receiver operating characteristic(ROC)curve.Results The proportion of patients with age ≥60 years,T4 stage of primary fo-cus,carcinoembryonic antigen(CEA)≥5 μg/L,peritoneal cancer index ≥20 points,and low differentiation of tumor cells in the death group was higher than that in the survival group,with a statistical significant difference(P＜0.05).Cox regression analysis showed that age≥60 years old,primary lesion staging as T4 staging,CEA≥5 μg/L at discharge,peritoneal cancer index ≥20 points,and low differentiation of tumor cells were risk factors for long-term prognosis and mortality in patients with metachronous peritoneal metastasis of colorectal cancer(P＜0.05).A nomogram was drawn to construct a risk prediction model for long-term prognosis of colorectal cancer with metachronous peritoneal metastasis.The discrimination of the model showed that C-index value=0.762,with good discrimination.The standard curve showed that the calibration curve was similar to the Y-X straight line,and the model accuracy was good.The validation of the predictive performance of the model showed that the area under the curve(AUC)for long-term prognosis and mortality in patients with metachronous peritoneal metastasis of colorectal cancer evaluated by the risk model was 0.762,with a 95％CI of 0.636-0.887 and P＜0.001.Conclusion Age,CEA level at discharge,primary le-sion stage,peritoneal cancer index,and tumor cell differentiation are influencing factors for the long-term prognosis of patients with metachronous peritoneal metastasis of colorectal cancer.The risk prediction model constructed based on the above factors has cer-tain evaluation value for the long-term prognosis of patients with metachronous peritoneal metastasis of colorectal cancer.
Metachronous peritoneal metastasis of colorectal cancerLong-term prognosisInfluencing factorsRisk pre-diction model
万方数据
维普
