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Nomogram Development for Predicting Synchronous Lung Metastasis in Patients with T1 Colorectal Cancer: An SEER-Based

Pin-Chun Chen1, Yi-Kai Kao1, Po-Wen Yang1

  • 1Division of Colon and Rectal Surgery, Department of Surgery, E-DA Hospital, I-Shou University, Kaohsiung 824, Taiwan.

Medicina (Kaunas, Lithuania)
|March 28, 2026
PubMed
Summary

This study developed two nomograms to predict synchronous lung metastasis in T1 colorectal cancer patients. Model A aids selective chest CT decisions, while Model B offers comprehensive risk profiling for prognostic counseling.

Keywords:
SEER databasecolorectal cancer (CRC)nomogramsynchronous lung metastasis (sLM)

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Area of Science:

  • Oncology
  • Radiology
  • Biostatistics

Background:

  • Colorectal cancer (CRC) poses a significant global health challenge.
  • Lung metastasis is a major cause of mortality in CRC patients.
  • Accurate risk stratification for synchronous lung metastasis (sLM) in T1 CRC is crucial for staging.

Purpose of the Study:

  • To develop and validate clinicopathological (Model A) and comprehensive (Model B) nomograms for predicting sLM in T1 CRC.
  • Model A aims to guide selective chest CT decisions.
  • Model B aims to provide comprehensive risk profiling post-staging.

Main Methods:

  • Utilized data from the Surveillance, Epidemiology, and End Results (SEER) database (2010-2020).
  • Included 41,728 patients diagnosed with T1 colorectal cancer.
  • Employed logistic regression to identify predictors and developed/validated nomograms using a split-sample approach.

Main Results:

  • Identified tumor grade, size, location, lymph node status, and other organ metastases as key predictors.
  • Model A (clinicopathologic) showed moderate discrimination (AUC=0.728), validated at 0.716.
  • Model B (comprehensive) showed good discrimination (AUC=0.856), validated at 0.849.

Conclusions:

  • Two nomograms for predicting sLM in T1 CRC were developed and internally validated.
  • Model A can assist in selective chest CT decisions during initial staging.
  • Model B aids in prognostic counseling, but external validation is needed for clinical use.