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Development and validation of a nomogram for preoperative prediction of tumor deposits in colorectal cancer

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World Journal of Gastroenterology 2023年第39期29卷 5483-5493页

作者： Hui-Da Zheng Yun-Huang Hu Kai Ye Jian-Hua Xu Department of Gastrointestinal Surgery The Second Affiliated Hospital of Fujian Medical UniversityQuanzhou 362000Fujian ProvinceChina

BACKGROUND Based on the clinical data of colorectal cancer(CRC)patients who underwent surgery at our institution,a model for predicting the formation of tumor deposits(TDs)in this patient population was *** To establish an effective model for predicting TD formation,thus enabling clinicians to identify CRC patients at high risk for TDs and implement personalized treatment *** CRC patients(n=645)who met the inclusion criteria were randomly divided into training(n=452)and validation(n=193)cohorts using a 7:3 ratio in this retrospective *** absolute shrinkage and selection operator regression was employed to screen potential risk factors,and multivariable logistic regression analysis was used to identify independent risk ***,a predictive model for TD formation in CRC patients was constructed based on the independent risk *** discrimination ability of the model,its consistency with actual results,and its clinical applicability were evaluated using receiveroperating characteristic curves,area under the curve(AUC),calibration curves,and decision curve analysis(DCA).RESULTS Thirty-four(7.5%)patients with TDs were identified in the training cohort based on postoperative pathological *** logistic regression analysis identified female sex,preoperative intestinal obstruction,left-sided CRC,and lymph node metastasis as independent risk factors for TD *** AUCs of the nomogram models constructed using these variables were 0.839 and 0.853 in the training and validation cohorts,*** calibration curve demonstrated good consistency,and the training cohort DCA yielded a threshold probability of 7%-78%.CONCLUSION This study developed and validated a nomogram with good predictive performance for identifying TDs in CRC *** predictive model can assist surgeons in making optimal treatment decisions.

关键词： Colorectal cancer tumor deposits Nomogram

Incorporation of perigastric tumor deposits into the TNM staging system for primary gastric cancer

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World Journal of Gastrointestinal Oncology 2023年第9期15卷 1605-1615页

作者： Yang Li Shuo Li Lu Liu Li-Yu Zhang Di Wu Tian-Yu Xie Xin-Xin Wang Medical School of Chinese People's Liberation Army The First Medical CenterChinese People's Liberation Army General HospitalBeijing 100853China Department of General Surgery The First Medical CenterChinese People's Liberation Army General HospitalBeijing 100853China

BACKGROUND The current prognostic significance of perigastric tumor deposits(TDs)in gastric cancer(GC)remains *** To assess the prognostic value of perigastric TDs and put forward a new TNM staging framework involving TDs for primary *** This study retrospectively analyzed the pathological data of 6672 patients with GC who underwent gastrectomy or surgery for GC with other diseases from January 1,2012 to December 31,2017 at the Chinese PLA General *** to the presence of perigastric TDs or not,the patients were divided into TD-positive and TD-negative groups by using the method of propensity score *** differences between TD-positive and TD-negative patients were analyzed using binary logistic regression *** Kaplan-Meier method was used to plot survival *** Cox regression modeling and the log-rank test were used to analyze the *** Perigastric TDs were found to be positive in 339(5.09%)of the 6672 patients with GC,among whom 237 were men(69.91%)and 102 were women(30.09%)(2.32:1).The median age was 59 years(range,27 to 78 years).Univariate and multivariate survival analyses indicated that TD-positive GC patients had a poorer prognosis than TD-negative patients(P<0.05).The 1-,3-,and 5-year overall survival rates of GC patients with TDs were 68.3%,19.6%,and 11.2%,respectively,and these were significantly poorer than those without TDs of the same *** was significant variation in survival according to TD locations among the GC patients(P<0.05).A new TNM staging framework for GC was formulated according to TD *** TDs appear in the gastric body,the original stages T1,T2,and T3 are classified as T4a with the new framework,and the original stages T4a and T4b both are classified as *** TDs appear in the lesser curvature,the previous stages N0,N1,N2,and N3 now both are classified as *** TDs appear in the greater curvature or the distant tissue,the patient should be categorized as

关键词： tumor deposits Gastric cancer Prognosis Stage Overall survival

Risk factors predict microscopic extranodal tumor deposits in advanced stage Ⅲ colon cancer patients

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World Journal of Gastroenterology 2023年第11期29卷 1735-1744页

作者： Yi-Han Jhuang Yu-Ching Chou Yu-Chun Lin Je-Ming Hu Ta-Wei Pu Chao-Yang Chen Division of Cardiovascular Surgery Tri-Service General HospitalNational Defense Medical CenterTaipei 114TaiwanChina School of Public Health National Defense Medical CenterTaipei 114TaiwanChina Department of Pathology Tri-Service General HospitalNational Defense Medical CenterTaipei 114TaiwanChina Division of Colorectal Surgery Tri-Service General HospitalNational Defense Medical CenterTaipei 114TaiwanChina Division of Colorectal Surgery Tri-Service General Hospital Song-shan BranchNational Defense Medical CenterTaipei 114TaiwanChina

BACKGROUND Colorectal cancer is a frequent cause of cancer-related mortality in patients with lymph node or distant *** tumor deposits(TDs)are considered prognostically distinct from lymph node *** To investigate risk factors for extranodal TDs in stage III colon *** This was a retrospective cohort *** selected 155 individuals diagnosed with stage III colon cancer from the database of the Cancer Registry of the Tri-Service General *** patients were allocated into the groups with/without *** Cox regression analysis and Kaplan-Meier method were *** primary outcomes investigate the association between the covariates and extranodal TDs,and prognostic significance of the covariates regarding the *** There were 136 individuals in the non-N1c group and 19 individuals in the N1c *** with lymphovascular invasion(LVI)had a higher risk of *** survival rates of patients with and without LVI were 6.64 years and 8.61 years,respectively(P=0.027).The N1c patients without LVI had higher overall survival than those who with LVI(7.73 years vs 4.42 years,P=0.010).CONCLUSION Patients having stage III colon cancer with LVI have a higher probability of having TDs than those with stage III colon cancer without *** III colon cancer patients with TDs and LVI could have poor prognosis and outcome.

关键词： Colon cancer tumor deposits Lymphovascular invasion Risk factor

Radiomics for differentiating tumor deposits from lymph node metastasis in rectal cancer

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World Journal of Gastroenterology 2022年第29期28卷 3960-3970页

作者： Yong-Chang Zhang Mou Li Yu-Mei Jin Jing-Xu Xu Chen-Cui Huang Bin Song Department of Radiology Chengdu Seventh People’s HospitalChengdu 610213Sichuan ProvinceChina Department of Radiology West China HospitalSichuan UniversityChengdu 610041Sichuan ProvinceChina Department of Research Collaboration R&D centerBeijing Deepwise&League of PHD Technology Co.LtdBeijing 100080China

BACKGROUND tumor deposits(TDs)are not equivalent to lymph node(LN)metastasis(LNM)but have become independent adverse prognostic factors in patients with rectal cancer(RC).Although preoperatively differentiating TDs and LNMs is helpful in designing individualized treatment strategies and achieving improved prognoses,it is a challenging *** To establish a computed tomography(CT)-based radiomics model for preoperatively differentiating TDs from LNM in patients with *** This study retrospectively enrolled 219 patients with RC[TDs+LNM-(n=89);LNM+TDs-(n=115);TDs+LNM+(n=15)]from a single center between September 2016 and September ***-positive patients(i.e.,TDs+LNM-and LNM+TDs-)were classified into the training(n=163)and validation(n=41)*** extracted numerous features from the enhanced CT(region 1:The main tumor;region 2:The largest peritumoral nodule).After deleting redundant features,three feature selection methods and three machine learning methods were used to select the best-performing classifier as the radiomics model(Rad-score).After validating Rad-score,its performance was further evaluated in the field of diagnosing double-positive patients(i.e.,TDs+LNM+)by outlining all peritumoral nodules with diameter(short-axis)>3 *** Rad-score 1(radiomics signature of the main tumor)had an area under the curve(AUC)of 0.768 on the training dataset and 0.700 on the validation ***-score 2(radiomics signature of the largest peritumoral nodule)had a higher AUC(training set:0.940;validation set:0.918)than Radscore *** factors,including age,gender,location of RC,tumor markers,and radiological features of the largest peritumoral nodule,were excluded by logistic ***,the combined model was comprised of Rad-scores of 1 and *** that the combined model had similar AUCs with Rad-score 2(P=0.134 in the training set and 0.594 in the validation set),Rad-score 2 was used as the final *** the diagnosis of double-positive

关键词： Radiomics tumor deposits Lymph node metastasis Rectal cancer Computed tomography Differential diagnosis