Development and validation of a nomogram for predicting metachronous peritoneal metastasis in colorectal cancer: A retrospective study

doi:10.4251/wjgo.v15.i1.112

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World Journal of Gastrointestinal Oncology

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1948-5204

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

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Retrospective Study

World J Gastrointest Oncol. Jan 15, 2023; 15(1): 112-127
Published online Jan 15, 2023. doi: 10.4251/wjgo.v15.i1.112

Development and validation of a nomogram for predicting metachronous peritoneal metastasis in colorectal cancer: A retrospective study

Bo Ban, An Shang, Jian Shi

Bo Ban, An Shang, Jian Shi, Department of General Surgery, The Second Hospital of Jilin University, Changchun 130041, Jilin Province, China

Author contributions: Ban B designed and performed the research and wrote the paper; Shi J designed the research and supervised the report; Shang A designed the research and contributed to the analysis.

Supported by the Science and Technology Development Project of Jilin Province, No. 2020SCZT079.

Institutional review board statement: This study was reviewed and approved by the Ethics Committee of The Second Hospital of Jilin University (Approval No. 2021-003).

Informed consent statement: The informed consent was waived from the patients.

Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.

Data sharing statement: No additional data are available.

Corresponding author: Jian Shi, MD, PhD, Associate Chief Physician, Associate Professor, Department of General Surgery, The Second Hospital of Jilin University, No. 218 Ziqiang Street, Nanguan District, Changchun 130041, Jilin Province, China. 383888697@qq.com

Received: September 23, 2022
Peer-review started: September 23, 2022
First decision: November 16, 2022
Revised: November 23, 2022
Accepted: December 21, 2022
Article in press: December 21, 2022
Published online: January 15, 2023
Processing time: 109 Days and 5.4 Hours

ARTICLE HIGHLIGHTS

Research background

The prediction and early detection of metachronous peritoneal metastasis (m-PM) remain a difficult task in clinical practice. Few studies have reported the genetic alterations of m-PM.

Research motivation

To explore risk factors in patients with m-PM after curative-intent colorectal cancer (CRC) surgery.

Research objectives

To establish and validate a nomogram model for predicting the occurrence of m-PM in CRC within 3 years after surgery.

Research methods

We used the clinical data of 878 patients at the Second Hospital of Jilin University, between January 1, 2014 and January 31, 2019. The patients were randomly divided into training and validation cohorts at a ratio of 2:1. All data were analyzed using SPSS version 26.0 and R version 4.0.3.

Research results

The 3-year cumulative incidence of m-PM was 11.1% (65/586) in the training cohort and 9.9% (29/292) in the validation cohort. Least absolute shrinkage and selection operator regression analysis and multiple logistic regressions identified that right colon cancer, pT4, histological types of mucinous adenocarcinoma and signet-ring cell carcinoma, elevated carbohydrate antigen 125 (CA125), v-raf murine sarcoma viral oncogene homolog B (BRAF) mutation, and microsatellite instability-high-frequency (MSI-H) were independent risk factors for m-PM in CRC. These six predictors could be used to establish a nomogram for predicting m-PM. The nomogram model showed good discrimination accuracy, calibration, and reliability in both training and validation cohorts.

Research conclusions

The nomogram model based on six predictors (right colon cancer, pT4, and histological types of mucinous adenocarcinoma and signet-ring cell carcinoma, elevated CA125, BRAF mutation, and MSI-H) showed good discrimination and high accuracy.

Research perspectives

The nomogram requires further validation in multicenter prospective clinical studies.