探索可切除结直肠癌患者的最佳随访时间:一个多中心的五年纵向队列研究
Boyu Kang1,2, Yihuan Qiao1,2, Yiqian Wang3,4
1Department of Digestive Surgery, The First Affiliated Hospital of Digestive Diseases, Air Force Medical University, Xi'an, China.
Scientific reports
|March 1, 2026
概括
通过CCC-DISPO模型优化结直肠癌的随访,改善了患者的生存率. 这种动态预测工具指导基于癌症阶段的个性化随访计划,以获得更好的结果.
科学领域:
- 在瘤学瘤学.
- 生物统计学 生物统计学
- 临床医学 临床医学
背景情况:
- 手术后的随访对于早期检测结直肠癌复发和转移至关重要.
- 目前的随访策略可能不是最佳的,以改善患者的生存率和经济效益.
研究的目的:
- 开发一个全面的混合效应模型,使用多维临床数据来确定结直肠癌患者的最佳术后随访时间.
- 通过个性化后续策略,提高患者的生存率和经济效益.
主要方法:
- 一项队列研究,涉及2011-2023年期间来自三家医院 (西京,解放军总医院,西省人民医院) 的5848名患者.
- 使用常规和动态临床数据开发和验证多变量混合效应模型 (CCC-DISPO).
- 模型性能使用AUC,F1得分,Brier得分和校准曲线进行评估.
主要成果:
- 多变量考克斯回归确定了许多风险因素,包括年龄,BMI,TNM阶段和特定的生物标志物.
- CCC-DISPO模型显示出高预测性能,AUC值为0.87 (外部验证).
- 小组分析表明,最佳的随访时间因阶段而异:第一阶段为12个月,第二,第三和第四阶段为3个月.
结论:
- CCC-DISPO模型提供了对结直肠癌结果的动态和准确预测.
- 根据CCC-DISPO模型指导的基于癌症阶段的个性化随访计划至关重要.
- 推的随访时间:所有患者6个月,II-IV阶段3个月,I阶段12个月.
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