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Predictive Nomogram for Recurrence of Stage I Colorectal Cancer After Curative Resection

Authors
 Chan Kim  ;  Woo Ram Kim  ;  Ki-Yeol Kim  ;  Hong Jae Chon  ;  Seung Hoon Beom  ;  Hyojoong Kim  ;  Minkyu Jung  ;  Sang Joon Shin  ;  Nam Kyu Kim  ;  Joong Bae Ahn 
Citation
 Clinical Colorectal Cancer, Vol.17(3) : e513-e518, 2018 
Journal Title
 Clinical Colorectal Cancer 
Issue Date
2018
Keywords
Colorectal Cancer ; Nomogram ; Prognosis ; Recurrence ; Stage I
Abstract
BACKGROUND: Patients with stage I colorectal cancer (CRC) have excellent prognosis after curative surgery. However, approximately 5% to 10% of patients experience recurrence and have a poor prognosis. Because the incidence of stage I CRC is increasing with active screening programs worldwide, a more accurate and easy-to-use predictive tool for recurrence is becoming more important. This study aimed to develop a predictive nomogram for recurrence in stage I CRC. PATIENTS AND METHODS: A total of 1538 patients who underwent curative surgery for stage I CRC were enrolled. Predictive factors for recurrence were determined by multivariate Cox regression model and were used to develop a predictive nomogram. This model was internally validated, and performance was evaluated through calibration plots. RESULTS: The cumulative recurrence rate at 5 years after surgery for stage I CRC was 5.3%. In multivariate Cox analysis, independent predictors of recurrence were tumor location at rectum, pT2 stage, and presence of lymphovascular invasion. The 5-year recurrence rate was significantly different depending on the number of risk factors (0.7% for 0, 5.8% for 1, and 9.7% for ≥ 2 risk factors). On this basis, a nomogram for recurrence-free survival was developed and internally validated. The concordance index of the nomogram was 0.71, and the performance was acceptable. CONCLUSION: We developed and internally validated a nomogram that can predict postoperative recurrence in stage I CRC patients. This nomogram may be used to more accurately stratify the risk of recurrence and to perform personalized postoperative surveillance in stage I CRC patients.
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/163451
DOI
10.1016/j.clcc.2018.03.011
Appears in Collections:
1. Journal Papers (연구논문) > 2. College of Dentistry (치과대학) > Others (기타)
1. Journal Papers (연구논문) > 1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실)
1. Journal Papers (연구논문) > 1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실)
Yonsei Authors
김기열(Kim, Ki Yeol)
김남규(Kim, Nam Kyu) ORCID logo https://orcid.org/0000-0003-0639-5632
범승훈(Beum, Seung Hoon)
신상준(Shin, Sang Joon)
안중배(Ahn, Joong Bae)
정민규(Jung, Min Kyu) ORCID logo https://orcid.org/0000-0001-8281-3387
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