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Clin Colorectal Cancer. 2018 Sep;17(3):e513-e518. doi: 10.1016/j.clcc.2018.03.011. Epub 2018 Mar 29.

Predictive Nomogram for Recurrence of Stage I Colorectal Cancer After Curative Resection.

Author information

1
Department of Medical Oncology, CHA Bundang Medical Center, CHA University, Seongnam, Korea.
2
Department of Surgery, CHA Bundang Medical Center, CHA University, Seongnam, Korea.
3
Dental Education Research Center, Brain Korea 21 Project, Yonsei University College of Dentistry, Seoul, Korea.
4
Division of Medical Oncology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.
5
Department of Surgery, Yonsei University College of Medicine, Seoul, Korea.
6
Division of Medical Oncology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea. Electronic address: vvswm513@yuhs.ac.

Abstract

BACKGROUND:

Patients with stage I colorectal cancer (CRC) have excellent prognosis after curative surgery. However, approximately 5% to 10% of patients experience recurrence and have a poor prognosis. Because the incidence of stage I CRC is increasing with active screening programs worldwide, a more accurate and easy-to-use predictive tool for recurrence is becoming more important. This study aimed to develop a predictive nomogram for recurrence in stage I CRC.

PATIENTS AND METHODS:

A total of 1538 patients who underwent curative surgery for stage I CRC were enrolled. Predictive factors for recurrence were determined by multivariate Cox regression model and were used to develop a predictive nomogram. This model was internally validated, and performance was evaluated through calibration plots.

RESULTS:

The cumulative recurrence rate at 5 years after surgery for stage I CRC was 5.3%. In multivariate Cox analysis, independent predictors of recurrence were tumor location at rectum, pT2 stage, and presence of lymphovascular invasion. The 5-year recurrence rate was significantly different depending on the number of risk factors (0.7% for 0, 5.8% for 1, and 9.7% for ≥ 2 risk factors). On this basis, a nomogram for recurrence-free survival was developed and internally validated. The concordance index of the nomogram was 0.71, and the performance was acceptable.

CONCLUSION:

We developed and internally validated a nomogram that can predict postoperative recurrence in stage I CRC patients. This nomogram may be used to more accurately stratify the risk of recurrence and to perform personalized postoperative surveillance in stage I CRC patients.

KEYWORDS:

Colorectal Cancer; Nomogram; Prognosis; Recurrence; Stage I

PMID:
29661621
DOI:
10.1016/j.clcc.2018.03.011
[Indexed for MEDLINE]

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