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Real-World Implications of Nonbiological Factors with Staging, Prognosis and Clinical Management in Colon Cancer

Background: The present study analyzed the nonbiological factors (NBFs) together with the American Joint Committee on Cancer (AJCC) Tumor-Node-Metastasis (TNM) staging system to generate a refined, risk-adapted stage for the clinical treatment of colon cancer. Methods: Eligible patients (N = 28,818)...

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Autores principales: Liu, Qi, Luo, Dakui, Cai, Sanjun, Li, Qingguo, Li, Xinxiang
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6115817/
https://www.ncbi.nlm.nih.gov/pubmed/30096811
http://dx.doi.org/10.3390/cancers10080263
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author Liu, Qi
Luo, Dakui
Cai, Sanjun
Li, Qingguo
Li, Xinxiang
author_facet Liu, Qi
Luo, Dakui
Cai, Sanjun
Li, Qingguo
Li, Xinxiang
author_sort Liu, Qi
collection PubMed
description Background: The present study analyzed the nonbiological factors (NBFs) together with the American Joint Committee on Cancer (AJCC) Tumor-Node-Metastasis (TNM) staging system to generate a refined, risk-adapted stage for the clinical treatment of colon cancer. Methods: Eligible patients (N = 28,818) with colon cancer between 1 January 2010 and 31 December 2014, were identified from the Surveillance, Epidemiology, and End Results (SEER) database. Kaplan-Meier curves and Cox proportional hazards regression, analyzed the probabilities of cancer-specific survival (CSS) in patients with colon cancer, with different NBF-TNM stages. Results: Insurance status, marital status, and median household income were significant prognostic NBFs in the current study (p < 0.05). The concordance index of NBF-TNM stage was 0.857 (95% confidence interval (CI) = 0.8472–0.8668). Multivariate Cox analyses, indicated that NBF1-stage was independently associated with a 50.4% increased risk of cancer-specific mortality in colon cancer (p < 0.001), which increased to 77.1% in non-metastatic colon cancer. NBF0-stage improved in CSS as compared to the NBF1-stage in the respective stages (p < 0.05). Conclusions: The new proposed NBF-stage was an independent prognostic factor in colon cancer. Effect of NBFs on the survival of colon cancer necessitates further clinical attention. Moreover, the incorporation of NBF-stage into the AJCC TNM staging system is essential for prognostic prediction, and clinical guidance of adjuvant chemotherapy in stage II and III colon cancer.
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spelling pubmed-61158172018-08-31 Real-World Implications of Nonbiological Factors with Staging, Prognosis and Clinical Management in Colon Cancer Liu, Qi Luo, Dakui Cai, Sanjun Li, Qingguo Li, Xinxiang Cancers (Basel) Article Background: The present study analyzed the nonbiological factors (NBFs) together with the American Joint Committee on Cancer (AJCC) Tumor-Node-Metastasis (TNM) staging system to generate a refined, risk-adapted stage for the clinical treatment of colon cancer. Methods: Eligible patients (N = 28,818) with colon cancer between 1 January 2010 and 31 December 2014, were identified from the Surveillance, Epidemiology, and End Results (SEER) database. Kaplan-Meier curves and Cox proportional hazards regression, analyzed the probabilities of cancer-specific survival (CSS) in patients with colon cancer, with different NBF-TNM stages. Results: Insurance status, marital status, and median household income were significant prognostic NBFs in the current study (p < 0.05). The concordance index of NBF-TNM stage was 0.857 (95% confidence interval (CI) = 0.8472–0.8668). Multivariate Cox analyses, indicated that NBF1-stage was independently associated with a 50.4% increased risk of cancer-specific mortality in colon cancer (p < 0.001), which increased to 77.1% in non-metastatic colon cancer. NBF0-stage improved in CSS as compared to the NBF1-stage in the respective stages (p < 0.05). Conclusions: The new proposed NBF-stage was an independent prognostic factor in colon cancer. Effect of NBFs on the survival of colon cancer necessitates further clinical attention. Moreover, the incorporation of NBF-stage into the AJCC TNM staging system is essential for prognostic prediction, and clinical guidance of adjuvant chemotherapy in stage II and III colon cancer. MDPI 2018-08-08 /pmc/articles/PMC6115817/ /pubmed/30096811 http://dx.doi.org/10.3390/cancers10080263 Text en © 2018 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Liu, Qi
Luo, Dakui
Cai, Sanjun
Li, Qingguo
Li, Xinxiang
Real-World Implications of Nonbiological Factors with Staging, Prognosis and Clinical Management in Colon Cancer
title Real-World Implications of Nonbiological Factors with Staging, Prognosis and Clinical Management in Colon Cancer
title_full Real-World Implications of Nonbiological Factors with Staging, Prognosis and Clinical Management in Colon Cancer
title_fullStr Real-World Implications of Nonbiological Factors with Staging, Prognosis and Clinical Management in Colon Cancer
title_full_unstemmed Real-World Implications of Nonbiological Factors with Staging, Prognosis and Clinical Management in Colon Cancer
title_short Real-World Implications of Nonbiological Factors with Staging, Prognosis and Clinical Management in Colon Cancer
title_sort real-world implications of nonbiological factors with staging, prognosis and clinical management in colon cancer
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6115817/
https://www.ncbi.nlm.nih.gov/pubmed/30096811
http://dx.doi.org/10.3390/cancers10080263
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