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A modified TNM staging system for non-metastatic colorectal cancer based on nomogram analysis of SEER database
BACKGROUND: To revise the American Joint Committee on Cancer TNM staging system for colorectal cancer (CRC) based on a nomogram analysis of Surveillance, Epidemiology, and End Results (SEER) database, and to prove the rationality of enhancing T stage’s weighting in our previously proposed T-plus sta...
Autores principales: | , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2018
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5759792/ https://www.ncbi.nlm.nih.gov/pubmed/29310604 http://dx.doi.org/10.1186/s12885-017-3796-1 |
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author | Kong, Xiangxing Li, Jun Cai, Yibo Tian, Yu Chi, Shengqiang Tong, Danyang Hu, Yeting Yang, Qi Li, Jingsong Poston, Graeme Yuan, Ying Ding, Kefeng |
author_facet | Kong, Xiangxing Li, Jun Cai, Yibo Tian, Yu Chi, Shengqiang Tong, Danyang Hu, Yeting Yang, Qi Li, Jingsong Poston, Graeme Yuan, Ying Ding, Kefeng |
author_sort | Kong, Xiangxing |
collection | PubMed |
description | BACKGROUND: To revise the American Joint Committee on Cancer TNM staging system for colorectal cancer (CRC) based on a nomogram analysis of Surveillance, Epidemiology, and End Results (SEER) database, and to prove the rationality of enhancing T stage’s weighting in our previously proposed T-plus staging system. METHODS: Total 115,377 non-metastatic CRC patients from SEER were randomly grouped as training and testing set by ratio 1:1. The Nomo-staging system was established via three nomograms based on 1-year, 2-year and 3-year disease specific survival (DSS) Logistic regression analysis of the training set. The predictive value of Nomo-staging system for the testing set was evaluated by concordance index (c-index), likelihood ratio (L.R.) and Akaike information criteria (AIC) for 1-year, 2-year, 3-year overall survival (OS) and DSS. Kaplan–Meier survival curve was used to valuate discrimination and gradient monotonicity. And an external validation was performed on database from the Second Affiliated Hospital of Zhejiang University (SAHZU). RESULTS: Patients with T1-2 N1 and T1N2a were classified into stage II while T4 N0 patients were classified into stage III in Nomo-staging system. Kaplan–Meier survival curves of OS and DSS in testing set showed Nomo-staging system performed better in discrimination and gradient monotonicity, and the external validation in SAHZU database also showed distinctly better discrimination. The Nomo-staging system showed higher value in L.R. and c-index, and lower value in AIC when predicting OS and DSS in testing set. CONCLUSION: The Nomo-staging system showed better performance in prognosis prediction and the weight of lymph nodes status in prognosis prediction should be cautiously reconsidered. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1186/s12885-017-3796-1) contains supplementary material, which is available to authorized users. |
format | Online Article Text |
id | pubmed-5759792 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-57597922018-01-16 A modified TNM staging system for non-metastatic colorectal cancer based on nomogram analysis of SEER database Kong, Xiangxing Li, Jun Cai, Yibo Tian, Yu Chi, Shengqiang Tong, Danyang Hu, Yeting Yang, Qi Li, Jingsong Poston, Graeme Yuan, Ying Ding, Kefeng BMC Cancer Research Article BACKGROUND: To revise the American Joint Committee on Cancer TNM staging system for colorectal cancer (CRC) based on a nomogram analysis of Surveillance, Epidemiology, and End Results (SEER) database, and to prove the rationality of enhancing T stage’s weighting in our previously proposed T-plus staging system. METHODS: Total 115,377 non-metastatic CRC patients from SEER were randomly grouped as training and testing set by ratio 1:1. The Nomo-staging system was established via three nomograms based on 1-year, 2-year and 3-year disease specific survival (DSS) Logistic regression analysis of the training set. The predictive value of Nomo-staging system for the testing set was evaluated by concordance index (c-index), likelihood ratio (L.R.) and Akaike information criteria (AIC) for 1-year, 2-year, 3-year overall survival (OS) and DSS. Kaplan–Meier survival curve was used to valuate discrimination and gradient monotonicity. And an external validation was performed on database from the Second Affiliated Hospital of Zhejiang University (SAHZU). RESULTS: Patients with T1-2 N1 and T1N2a were classified into stage II while T4 N0 patients were classified into stage III in Nomo-staging system. Kaplan–Meier survival curves of OS and DSS in testing set showed Nomo-staging system performed better in discrimination and gradient monotonicity, and the external validation in SAHZU database also showed distinctly better discrimination. The Nomo-staging system showed higher value in L.R. and c-index, and lower value in AIC when predicting OS and DSS in testing set. CONCLUSION: The Nomo-staging system showed better performance in prognosis prediction and the weight of lymph nodes status in prognosis prediction should be cautiously reconsidered. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1186/s12885-017-3796-1) contains supplementary material, which is available to authorized users. BioMed Central 2018-01-08 /pmc/articles/PMC5759792/ /pubmed/29310604 http://dx.doi.org/10.1186/s12885-017-3796-1 Text en © The Author(s). 2018 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. |
spellingShingle | Research Article Kong, Xiangxing Li, Jun Cai, Yibo Tian, Yu Chi, Shengqiang Tong, Danyang Hu, Yeting Yang, Qi Li, Jingsong Poston, Graeme Yuan, Ying Ding, Kefeng A modified TNM staging system for non-metastatic colorectal cancer based on nomogram analysis of SEER database |
title | A modified TNM staging system for non-metastatic colorectal cancer based on nomogram analysis of SEER database |
title_full | A modified TNM staging system for non-metastatic colorectal cancer based on nomogram analysis of SEER database |
title_fullStr | A modified TNM staging system for non-metastatic colorectal cancer based on nomogram analysis of SEER database |
title_full_unstemmed | A modified TNM staging system for non-metastatic colorectal cancer based on nomogram analysis of SEER database |
title_short | A modified TNM staging system for non-metastatic colorectal cancer based on nomogram analysis of SEER database |
title_sort | modified tnm staging system for non-metastatic colorectal cancer based on nomogram analysis of seer database |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5759792/ https://www.ncbi.nlm.nih.gov/pubmed/29310604 http://dx.doi.org/10.1186/s12885-017-3796-1 |
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