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Development and validation of a nomogram to predict which patients with colorectal cancer liver metastases would benefit from primary tumor resection

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International Journal of Colorectal Disease Aims and scope Submit manuscript

Abstract

Purpose

The use of primary tumor resection (PTR) in the treatment of colorectal cancer liver metastases (CRLM) patients has become increasingly controversial. Our goal is to establish a nomogram to screen for the candidates that would benefit from PTR in CRLM patients.

Methods

The Surveillance, Epidemiology, and End Results (SEER) database was searched for 8366 patients with colorectal liver cancer metastases (CRLM) from 2010 to 2015. Overall survival (OS) rates were calculated using the Kaplan–Meier curve. After propensity score matching (PSM), predictors were analyzed by logistic regression analysis, and a nomogram was created to predict for survival benefit of PTR using R software.

Results

After PSM, there were 814 patients in both PTR group and non-PTR group, respectively. The median OS time in the PTR group was 26 months (95%CI = 23.33 ~ 28.67) and the median OS time in the non-PTR group was 15 months (95%CI = 13.36 ~ 16.64). The Cox regression analysis found that PTR was an independent predictive factor (HR = 0.46, 0.41 ~ 0.52) for OS. Additionally, logistic regression was used to study the factors impacting PTR benefit, and the results showed that CEA (P = 0.016), chemotherapy (P < 0.001), N stage (P < 0.001), histological grade (P < 0.001), and lung metastasis (P = 0.001) are independent predictive factors affecting the therapeutic outcome of PTR in patients with CRLM. The developed nomogram displayed good discriminative ability in predicting the beneficial probability of PTR surgery, with the area under the curve (AUC) values of 0.801 in training set and 0.739 in validation set respectively.

Conclusion

We developed a nomogram that predicts the survival benefits of PTR in CRLM patients with relatively high accuracy, and quantifies the predictive factors for PTR-related benefits.

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Data availability

The data used in this study can be obtained from the SEER*Stat software (version 8.4.0; https://seer.cancer.gov/seerstat/).

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Acknowledgements

The authors would like to thank SEER for open access to the database.

Funding

This work was supported by University Natural Science Research Project of Anhui Province (KJ2020A0171) and National Natural Science Foundation Training Program of The First Affiliated Hospital of Anhui Medical University (2019KJ04).

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Authors and Affiliations

  1. Department of General Surgery, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, 230022, China

    Mingming He & Huo Wu

  2. Department of Oncology, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China

    Zhenya Jia

  3. Department of General Surgery, Division of Life Sciences and Medicine, The First Affiliated Hospital of USTC, University of Science and Technology of China, Hefei, Anhui, 230001, China

    Lei Hu

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Contributions

(I) Conception and design: all authors; (II) administrative support: all authors; (III) collection and assembly of data: all authors; (IV) data analysis and interpretation: all authors; (V) manuscript writing: all authors; (VI) final approval of manuscript: all authors.

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Correspondence to Lei Hu or Huo Wu.

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Data used in this study were obtained from publicly available database. Therefore, this study did not require the approval of the Ethics Committee of The First Affiliated Hospital of Anhui Medical University, China.

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He, M., Jia, Z., Hu, L. et al. Development and validation of a nomogram to predict which patients with colorectal cancer liver metastases would benefit from primary tumor resection. Int J Colorectal Dis 38, 144 (2023). https://doi.org/10.1007/s00384-023-04426-5

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