Contemporary Validation of a Nomogram Predicting Colon Cancer Recurrence, Revealing All-Stage Improved Outcomes

Author:

Konishi Tsuyoshi12,Shimada Yoshifumi13,Hsu Meier4,Wei Iris H1,Pappou Emmanouil1,Smith J Joshua1,Nash Garrett M1,Guillem José G1,Paty Philip B1,Garcia-Aguilar Julio1,Cercek Andrea5,Yaeger Rona5,Stadler Zsofia K5,Segal Neil H5,Varghese Anna5,Saltz Leonard B5,Shia Jinru6,Vakiani Efsevia6,Gönen Mithat4,Weiser Martin R1

Affiliation:

1. Department of Surgery , Memorial Sloan Kettering Cancer Center, New York, NY

2. Department of Gastroenterological Surgery, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan

3. Division of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan

4. Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY

5. Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY

6. Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY

Abstract

Abstract Background The Memorial Sloan Kettering Cancer Center (MSK) colon cancer recurrence nomogram is a risk calculator that provides patients and clinicians with individualized prediction of recurrence following curative resection of colon cancer. Although validated on multiple separate cohorts, the nomogram requires periodic updating as patient care changes over time. The aim of this study was to evaluate the nomogram’s accuracy in a contemporary cohort and modify the tool to reflect improvements in outcome related to advances in colon cancer therapy. Methods A contemporary patient cohort was compiled, including consecutive colon cancer patients undergoing curative resection for stage I–III colon adenocarcinoma at MSK from 2007 to 2014. The nomogram’s predictive accuracy was assessed by concordance index and calibration plots of predicted vs actual freedom from recurrence at 5 years after surgery. Results Data from a total of 999 eligible patients with complete records were used for validation. Median follow-up among survivors was 37 months. The concordance index was 0.756 (95% confidence interval = 0.707 to 0.805), indicating continued discriminating power, but the calibration plot revealed that the nomogram overestimated recurrence risk. Recalibration of the nomogram by estimating a new baseline freedom-from-recurrence function restored the nomogram’s accuracy. Conclusion The updated nomogram retains the original nomogram’s variables but includes a lower baseline estimation of recurrence risk, reflecting improvements in outcomes for all stages of colon cancer, likely resulting from advances in imaging and integration of multiple treatment modalities.

Funder

National Institutes of Health

Publisher

Oxford University Press (OUP)

Subject

Cancer Research,Oncology

同舟云学术

1.学者识别学者识别

2.学术分析学术分析

3.人才评估人才评估

"同舟云学术"是以全球学者为主线,采集、加工和组织学术论文而形成的新型学术文献查询和分析系统,可以对全球学者进行文献检索和人才价值评估。用户可以通过关注某些学科领域的顶尖人物而持续追踪该领域的学科进展和研究前沿。经过近期的数据扩容,当前同舟云学术共收录了国内外主流学术期刊6万余种,收集的期刊论文及会议论文总量共计约1.5亿篇,并以每天添加12000余篇中外论文的速度递增。我们也可以为用户提供个性化、定制化的学者数据。欢迎来电咨询!咨询电话:010-8811{复制后删除}0370

www.globalauthorid.com

TOP

Copyright © 2019-2024 北京同舟云网络信息技术有限公司
京公网安备11010802033243号  京ICP备18003416号-3