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The incidence, associated factors, and predictive nomogram for early death in stage IV colorectal cancer

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International Journal of Colorectal Disease Aims and scope Submit manuscript

Abstract

Purpose

The purpose of the present study was to investigate the incidence and associated factors for early death in stage IV colorectal cancer (CRC) and to construct the predictive nomogram.

Methods

Patients with stage IV CRC, who had been diagnosed between 2010 and 2014 in the Surveillance, Epidemiology, and End Results datasets, were eligible for this retrospective cohort study. The univariable and multivariable logistic regression models were conducted to determine the associated factors for early death (survival time ≤ 3 months). The predictive nomogram was constructed and the internal validation was performed.

Results

Ten thousand two hundred sixty-three out of 36,461 (28.1%) eligible patients resulted in all causes of early death (25.8% for cancer-specific early death and 2.3% for non-cancer early death). Advanced age, marital status, right colon, poor differentiation, higher N stage, and bone metastasis were positively associated with all causes of early death, cancer-specific early death, and non-cancer early death, while higher T stage, positive carcinoembryonic antigen, and distant metastases (bone, lung, liver, and brain) were only positively associated with all causes of early death and cancer-specific early death. The calibration curve for all causes of early death, cancer-specific early death, and non-cancer early death showed the prediction curve closely approximated at the 45° line and the areas under the curve were 75.7% (95% CI, 74.9–76.4%), 75.9% (95% CI, 75.1–76.6%), and 76.9% (95% CI, 76.3–77.6%), respectively.

Conclusions

The nomogram was calibrated to predict all causes of early death development, cancer-specific early death development, and non-cancer early death development. These findings can be utilized in early screening and to tailor targeted treatment regimens for stage IV CRC patients.

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Funding

Natural Science Foundation of China (81702161, 81801781, and 81802508); Natural Science Foundation of the Tianjin Science and Technology Committee of China (17JCQNJC11000); Natural Science Foundation of Tianjin Medical University (2016KYZQ10); Doctor Start-up Grant of Tianjin Medical University Cancer Institute and Hospital (B1711); Top talent training program of the first affiliated hospital of PLA Army Medical University (SWH2018BJKJ-12).

Author information

Author notes

  1. Xin Wang, Min Mao and Guijun Xu contributed equally to this work.

Authors and Affiliations

  1. Department of Epidemiology and Biostatistics, First Affiliated Hospital, Army Medical University, Chongqing, China

    Xin Wang

  2. Department of Pathology and Southwest Cancer Center, First Affiliated Hospital, Army Medical University, Chongqing, China

    Min Mao

  3. Department of Bone and Soft Tissue Tumors, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin’s Clinical Research Center for Cancer, Tianjin Medical University Cancer Institute and Hospital, Huanhu Xi Road, Tianjin, 300060, China

    Guijun Xu, Feng Lin, Jin Zhang & Chao Zhang

  4. Department of General Surgery, The Second Affiliated Hospital of Harbin Medical University, Harbin, China

    Peng Sun

  5. Department of Colorectal Surgery, National Cancer Center, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China

    Peng Sun

  6. Federal Research and Clinical Center of Specialized Medical Care and Medical Technologies, Federal Biomedical Agency of the Russian Federation, Moscow, Russian Federation

    Vladimir P. Baklaushev

  7. Department of Basic and Applied Neurobiology, Federal Medical Research Center for Psychiatry and Narcology, Moscow, Russian Federation

    Vladimir P. Chekhonin

  8. Department of Research and Innovation, University of Limpopo, Turfloop, Mankweng, South Africa

    Karl Peltzer

Authors
  1. Xin Wang
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  2. Min Mao
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  3. Guijun Xu
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  4. Feng Lin
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  5. Peng Sun
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  6. Vladimir P. Baklaushev
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  7. Vladimir P. Chekhonin
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  8. Karl Peltzer
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  9. Jin Zhang
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  10. Chao Zhang
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Corresponding authors

Correspondence to Jin Zhang or Chao Zhang.

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The present study was complied with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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The authors declare that they have no conflict of interest.

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Wang, X., Mao, M., Xu, G. et al. The incidence, associated factors, and predictive nomogram for early death in stage IV colorectal cancer. Int J Colorectal Dis 34, 1189–1201 (2019). https://doi.org/10.1007/s00384-019-03306-1

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  • DOI: https://doi.org/10.1007/s00384-019-03306-1

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