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Pulmonary metastasis in newly diagnosed colon-rectal cancer: a population-based nomogram study

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International Journal of Colorectal Disease Aims and scope Submit manuscript

Abstract

Background

Colorectal cancer (CRC) has a high worldwide incidence with a tendency to metastasize to the lungs. We aimed to identify clinical factors related to lung metastasis (LM) and analyze the prognosis of patients after LM.

Methods

Multivariate logistic regression analysis was used to identify risk factors for LM from CRC. Univariate and multivariate Cox proportional hazard models were performed to identify potentially important prognostic factors for patients with LM.

Results

Age (p = 0.010), tumor size (p < 0.001), T stage (p < 0.001), N stage (p < 0.001), race (p < 0.001), tumor site (p < 0.001), liver metastasis (p < 0.001), brain metastasis (p < 0.001), bone metastasis (p < 0.001), serum levels of carcinoembryonic antigen (CEA) (p < 0.001), and circumferential resection margin (CRM) (p < 0.001) were associated with a risk of LM from CRC. All factors (all, p < 0.001) except tumor size (p = 0.095) and race (p = 0.650) were related to the overall survival of patients. Two nomograms were formulated to visually predict lung metastasis risk and 1-, 3-, and 5- year overall survivals for patients with LM. The concordance indices were 0.754 and 0.749, respectively.

Conclusions

Age, tumor size, histological grade, serum levels of CEA, tumor site, surgery modalities of CRC, CRM, number of positive lymph nodes, and chemotherapy were independent risk factors for LM from CRC. The nomograms we developed can be effectively used to forecast the risk of LM and predict the survival for LM from CRC.

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Acknowledgements

We thank the International Science Editing Co. for editing the language.

Funding

This work was supported by the National Natural Science Foundation of China (Grant Number 81672268) [www.nsfc.gov.cn/]).

Author information

Author notes

  1. Yiwei Huang, Mengnan Zhao and Jiacheng Yin contributed equally to this work.

Authors and Affiliations

  1. Department of Thoracic Surgery, Zhongshan Hospital, Fudan University, No. 180, Fenglin Road, Shanghai, 200032, China

    Yiwei Huang, Mengnan Zhao, Jiacheng Yin, Tao Lu, Xiaodong Yang, Yu Liu, Cheng Zhan & Qun Wang

  2. Department of Thoracic Surgery, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou, Jiangsu, China

    Guangda Yuan

  3. Eight-year Program Clinical Medicine, Shanghai Medical College, Fudan University, Shanghai, 200032, China

    Ming Li

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  1. Yiwei Huang
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  4. Tao Lu
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Correspondence to Cheng Zhan or Qun Wang.

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Survival analyses for all patients and patients with lung metastasis. (PNG 134 kb)

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Huang, Y., Zhao, M., Yin, J. et al. Pulmonary metastasis in newly diagnosed colon-rectal cancer: a population-based nomogram study. Int J Colorectal Dis 34, 867–878 (2019). https://doi.org/10.1007/s00384-019-03270-w

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