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Predictive Nomograms for Synchronous Distant Metastasis in Rectal Cancer

  • Original Article
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Journal of Gastrointestinal Surgery Aims and scope

Abstract

Background

Nomograms may be used to quantitatively assess the probability of synchronous distant metastasis. The purpose of this study is to develop predictive nomograms for the presence of synchronous distant metastasis in patients with rectal cancer.

Methods

A retrospective analysis of the Surveillance Epidemiology and End Results database was performed for cases diagnosed between 2010 and 2014.

Results

Overall, 46,785 patients with rectal cancer (27,773 [59.4%] males, mean age 63.9 ± 13.7 years) were identified, of which 6192 (13.2%) had liver metastasis, 2767 (5.9%) had lung metastasis, and 601 (1.3%) had bone metastasis. Age, sex, race, tumor location, tumor grade, primary tumor size, CEA levels, perineural invasion, T stage, N stage, and liver and lung metastasis were found to be associated with the presence of synchronous distant metastasis and were included in the predictive models. The c-indexes of these models were 0.99 for liver metastasis, 0.99 for lung metastasis, and 1 for bone metastasis.

Conclusions

Predictive nomograms for the presence of synchronous liver, lung, and bone metastasis were developed and may be used to predict the probability of distant disease in rectal cancer patients.

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Funding

This study was supported by the General Secretariat for Research and Technology (GSRT) and the Hellenic Foundation for Research and Innovation (HFRI).

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Authors and Affiliations

  1. Second Department of Surgery, University General Hospital of Alexandroupoli, Democritus University of Thrace Medical School, 681 00, Alexandroupoli, Greece

    Apostolos Gaitanidis, Alexandra Tsaroucha, Christos Tsalikidis & Michail Pitiakoudis

  2. Department of Medicine, University of Pittsburgh Medical Center, Pittsburgh, PA, USA

    Michail Alevizakos

Authors
  1. Apostolos Gaitanidis
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  2. Michail Alevizakos
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  3. Alexandra Tsaroucha
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  4. Christos Tsalikidis
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  5. Michail Pitiakoudis
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Contributions

Conception/Design: Gaitanidis, Alevizakos, Pitiakoudis.

Provision of study material or patients: Gaitanidis, Alevizakos.

Collection and/or assembly of data: Gaitanidis, Alevizakos, Tsaroucha, Tsalikidis.

Data analysis and interpretation: All authors.

Manuscript drafting: Gaitanidis, Alevizakos, Tsalikidis.

Final approval of manuscript: Pitiakoudis.

All authors agree to be accountable for all aspects of this work.

Corresponding author

Correspondence to Apostolos Gaitanidis.

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The authors declare that they have no conflict of interest.

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Gaitanidis, A., Alevizakos, M., Tsaroucha, A. et al. Predictive Nomograms for Synchronous Distant Metastasis in Rectal Cancer. J Gastrointest Surg 22, 1268–1276 (2018). https://doi.org/10.1007/s11605-018-3767-0

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  • DOI: https://doi.org/10.1007/s11605-018-3767-0

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