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开发和验证早期直肠癌患者的生存预测名录:一个基于人口的研究

Sirui Zhu¹, Yuncan Xing¹, Jiawei Tu¹

¹Department of Colorectal Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.

Translational cancer research

|May 19, 2025

概括

这项研究开发了用于预测早期直肠癌 (ESRC) 患者的存活率的诺姆图. 诺米图识别了关键的风险因素,并显示了比现有的分期系统更好的准确性,指导了ESRC的个性化处理.

科学领域:

在瘤学瘤学.
癌症研究癌症研究
临床预后临床预后

背景情况:

结直肠癌 (CRC) 的发病率不断上升,特别是早期结直肠癌 (ESRC).
需要改进预后工具,以指导ESRC的临床决策.
现有的分期系统可能无法完全捕捉ESRC的预后变化.

研究的目的:

研究ESRC患者的整体存活率 (OS) 和癌症特异性存活率 (CSS) 的独立风险因素.
在ESRC中开发和验证OS和CSS的预测名ograms.
评估与AJCC第七阶段分级系统相比,开发的诺姆图的临床实用性.

主要方法:

从监测,流行病学和最终结果 (SEER) 数据库中分析数据.
使用考克斯回归,一致性指数和ROC分析开发和验证名ograms.
倾向性得分匹配 (PSM) 用于亚组治疗的益处评估.

主要成果:

T阶段,瘤等级,年龄,CEA水平,瘤大小和手术选择被确定为OS的独立风险因素.
瘤等级,年龄,CEA水平升高和手术选择被确定为CSS的独立风险因素.
开发的诺姆图表显示出比AJCC第7个分期系统更高的预测准确度 (C指数0.69/0.65),具有强大的校准和临床实用性.

结论:

诺米图为预测ESRC患者的OS和CSS提供了一个强大的工具.
小组分析表明,局部切除可能有利于更年轻,低风险的ESRC患者.
放射和化疗在分析的ESRC子组中没有显著的益处.

关键词:

早期直肠癌 (ESRC) 是一种疾病.化学疗法化疗化疗局部切除局部切除预后预后预后辐射辐射辐射辐射的辐射

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