Nomogram as a novel predictive tool for lymph node metastasis in T1 colorectal cancer treated with endoscopic resection: a nationwide, multicenter study - 17/05/23
, Shiro Oka, MD, PhD 2, Shinji Tanaka, MD, PhD 2, Takahiro Nakamura, MD, PhD 3, Shoichi Saito, MD, PhD 4, Yosuke Fukunaga, MD, PhD 5, Manabu Takamatsu, MD, PhD 6, Hiroshi Kawachi, MD, PhD 6, Kinichi Hotta, MD, PhD 7, Hiroaki Ikematsu, MD, PhD 8, Motohiro Kojima, MD, PhD 9, Yutaka Saito, MD, PhD 10, Masayoshi Yamada, MD, PhD 10, Yukihide Kanemitsu, MD, PhD 11, Shigeki Sekine, MD, PhD 12, Shinji Nagata, MD, PhD 13, Kazutaka Yamada, MD, PhD 14, Nozomu Kobayashi, MD, PhD 15, Soichiro Ishihara, MD, PhD 16, Yusuke Saitoh, MD, PhD 17, Kenji Matsuda, MD, PhD 18, Kazutomo Togashi, MD, PhD 19, Koji Komori, MD, PhD 20, Megumi Ishiguro, MD, PhD 21, Toshio Kuwai, MD, PhD 22, Takashi Okuyama, MD, PhD 23, Akihiro Ohuchi, MD, PhD 24, Shinobu Ohnuma, MD, PhD 25, Kazuhiro Sakamoto, MD, PhD 26, Tamotsu Sugai, MD, PhD 27, Kenji Katsumata, MD, PhD 28, Hiro-o Matsushita, MD, PhD 29, Hiro-o Yamano, MD, PhD 30, Hirotsugu Eda, MD, PhD 31, Toshio Uraoka, MD, PhD 32, Naohiko Akimoto, MD, PhD 33, Hirotoshi Kobayashi, MD, PhD 34, Yoichi Ajioka, MD, PhD 35, Kenichi Sugihara, MD, PhD 36, Hideki Ueno, MD, PhD 1Abstract |
Background and Aims |
Since 2009, the Japanese Society for Cancer of the Colon and Rectum guidelines have recommended that tumor budding and submucosal invasion depth, in addition to lymphovascular invasion and tumor grade, be included as risk factors for lymph node metastasis (LNM) in patients with T1 colorectal cancer (CRC). In this study, a novel nomogram was developed and validated by usirge-scale, real-world data, including the Japanese Society for Cancer of the Colon and Rectum risk factors, to accurately evaluate the risk of LNM in T1 CRC.
Methods |
Data from 4673 patients with T1 CRC treated at 27 high-volume institutions between 2009 and 2016 were analyzed for LNM risk. To prepare a nonrandom split sample, the total cohort was divided into development and validation cohorts. Pathologic findings were extracted from the medical records of each participating institution. The discrimination ability was measured by using the concordance index, and the variability in each prediction was evaluated by using calibration curves.
Results |
Six independent risk factors for LNM, including submucosal invasion depth and tumor budding, were identified in the development cohort and entered into a nomogram. The concordance index was .784 for the clinical calculator in the development cohort and .790 in the validation cohort. The calibration curve approached the 45-degree diagonal in the validation cohort.
Conclusions |
This is the first nomogram to include submucosal invasion depth and tumor budding for use in routine pathologic diagnosis based on data from a nationwide multi-institutional study. This nomogram, developed with real-world data, should improve decision-making for an appropriate treatment strategy for T1 CRC.
Il testo completo di questo articolo è disponibile in PDF.Graphical abstract |
Abbreviations : CRC, JSCCR, LNM, NCCN
Mappa
| DISCLOSURE: All authors disclosed no financial relationships . |
Vol 97 - N° 6
P. 1119 - giugno 2023 Ritorno al numero
Articolo precedente
- Polyp characteristics at screening colonoscopy and post-colonoscopy colorectal cancer mortality: a retrospective cohort study
- Jasmin Zessner-Spitzenberg, Lena Jiricka, Elisabeth Waldmann, Lisa-Maria Rockenbauer, Jeremy Cook, Anna Hinterberger, Barbara Majcher, Aleksandra Szymanska, Arno Asaturi, Michael Trauner, Monika Ferlitsch
- Risk of post-sphincterotomy bleeding with antiplatelet and anticoagulant use: a propensity-matched analysis of the U.S. Collaborative Network
- Saurabh Chandan, Aakash Desai, Dushyant S. Dahiya, Daryl Ramai, Babu P. Mohan, Antonio Facciorusso, Douglas G. Adler, Gursimran S. Kochhar
Benvenuto su EM|consulte, il riferimento dei professionisti della salute.
L'accesso al testo integrale di questo articolo richiede un abbonamento.
Già abbonato a @@106933@@ rivista ?