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Development and Validation of a Prediction Model for Postoperative Peritoneal Metastasis After Curative Resection of Colon Cancer

  • Colorectal Cancer
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

Detection of peritoneal metastasis remains challenging due to the limited sensitivity of current examination methods. This study aimed to establish a prediction model for estimating the individual risk of postoperative peritoneal metastasis from colon cancer to facilitate early interventions for high-risk patients.

Methods

This study investigated 1720 patients with stages 1–3 colon cancer who underwent curative resection at the University of Tokyo Hospital between 1997 and 2015. The data for the patients were retrospectively retrieved from their medical records. The risk score was developed using the elastic net techniques in a derivation cohort (973 patients treated in 1997–2009) and validated in a validation cohort (747 patients treated in 2010–2015).

Results

The factors selected using the elastic net approaches included the T stage, N stage, number of examined lymph nodes, preoperative carcinoembryonic antigen level, large bowel obstruction, and anastomotic leakage. The model had good discrimination (c-index, 0.85) and was well-calibrated after application of the bootstrap resampling method. Discrimination and calibration were favorable in external validation (c-index, 0.83). The model presented a clear stratification of patients’ risk for postoperative peritoneal recurrence, and decision curve analysis showed its net benefit across a wide range of threshold probabilities.

Conclusions

This study established and validated a prediction model that can aid clinicians in optimizing postoperative surveillance and therapeutic strategies according to the individual patient risk of peritoneal recurrence.

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Acknowledgments

This study was supported by the Japan Society for the Promotion of Science (Grant Nos. 16H02672, 16K07143, 16K07161, 17K10620, 17K10621, and 17K10623) and the Japan Agency for Medical Research and Development (Grant No. JP17cm0106502).

Disclosure

There are no conflicts of interest.

Author information

Authors and Affiliations

  1. Department of Surgical Oncology, Faculty of Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan

    Hiroshi Nagata MD, Toshiaki Tanaka MD, PhD, Keisuke Hata MD, PhD, Kazushige Kawai MD, PhD & Hiroaki Nozawa MD, PhD

  2. Surgery Department, Sanno Hospital, International University of Health and Welfare, Tokyo, Japan

    Soichiro Ishihara MD, PhD

  3. Department of Biostatistics, School of Public Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan

    Koji Oba PhD

  4. Interfaculty Initiative in Information Studies, The University of Tokyo, Tokyo, Japan

    Koji Oba PhD

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  1. Hiroshi Nagata MD
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  2. Soichiro Ishihara MD, PhD
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  3. Koji Oba PhD
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  4. Toshiaki Tanaka MD, PhD
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  5. Keisuke Hata MD, PhD
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  6. Kazushige Kawai MD, PhD
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  7. Hiroaki Nozawa MD, PhD
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Corresponding author

Correspondence to Hiroshi Nagata MD.

Electronic supplementary material

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10434_2018_6403_MOESM1_ESM.tif

Supplementary material 1 (TIFF 593 kb). Calibration plots of the prediction model in the derivation data sets. The black line shows the probability calculated by the prediction model, and the blue curve corresponds to 1000 bootstrap-corrected estimates.

Supplementary material 2 (DOCX 30 kb)

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Nagata, H., Ishihara, S., Oba, K. et al. Development and Validation of a Prediction Model for Postoperative Peritoneal Metastasis After Curative Resection of Colon Cancer. Ann Surg Oncol 25, 1366–1373 (2018). https://doi.org/10.1245/s10434-018-6403-z

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  • DOI: https://doi.org/10.1245/s10434-018-6403-z

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