Retrospective Study
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Surg. Apr 27, 2024; 16(4): 1055-1065
Published online Apr 27, 2024. doi: 10.4240/wjgs.v16.i4.1055
Prognostic value of a nomogram model for postoperative liver metastasis of colon cancer
De-Xin Cheng, Kang-Di Xu, Han-Bo Liu, Yi Liu
De-Xin Cheng, Han-Bo Liu, Cancer Center, Department of Interventional Medicine, Zhejiang Provincial People’s Hospital (Affiliated People’s Hospital, Hangzhou Medical College), Hangzhou 310014, Zhejiang Province, China
Kang-Di Xu, Yi Liu, General Surgery, Cancer Center, Department of Vascular Surgery, Zhejiang Provincial People’s Hospital (Affiliated People’s Hospital, Hangzhou Medical College), Hangzhou 310014, Zhejiang Province, China
Author contributions: Cheng DX wrote the manuscript; Liu Y reviewed the manuscript; Xu KD and Liu HB collected the data; and all authors annotated the manuscript.
Institutional review board statement: This study was reviewed and approved by the Institutional Review Board of Zhejiang Provincial People’s Hospital (Approval No. 2023-338).
Informed consent statement: The Institutional Review Board waived the requirement for informed consent.
Conflict-of-interest statement: The authors declare no conflicts of interest.
Data sharing statement: Data used in this study are available from the corresponding author.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Yi Liu, MM, Attending Doctor, General Surgery, Cancer Center, Department of Vascular Surgery, Zhejiang Provincial People’s Hospital (Affiliated People’s Hospital, Hangzhou Medical College), No. 158 Shangtang Road, Hangzhou 310014, Zhejiang Province, China. liuyi4917@126.com
Received: December 19, 2023
Peer-review started: December 19, 2023
First decision: January 9, 2024
Revised: January 18, 2024
Accepted: March 7, 2024
Article in press: March 7, 2024
Published online: April 27, 2024
Processing time: 125 Days and 9.7 Hours
Abstract
BACKGROUND

Colon cancer is one of the most common malignant tumors of the digestive system. Liver metastasis after colon cancer surgery is the primary cause of death in patients with colon cancer.

AIM

To construct a novel nomogram model including various factors to predict liver metastasis after colon cancer surgery.

METHODS

We retrospectively analyzed 242 patients with colon cancer who were admitted and underwent radical resection for colon cancer in Zhejiang Provincial People’s Hospital from December 2019 to December 2022. Patients were divided into liver metastasis and non-liver metastasis groups. Sex, age, and other general and clinicopathological data (preoperative blood routine and biochemical test indexes) were compared. The risk factors for liver metastasis were analyzed using single-factor and multifactorial logistic regression. A predictive model was then constructed and evaluated for efficacy.

RESULTS

Systemic inflammatory index (SII), C-reactive protein/albumin ratio (CAR), red blood cell distribution width (RDW), alanine aminotransferase, preoperative carcinoembryonic antigen level, and lymphatic metastasis were different between groups (P < 0.05). SII, CAR, and RDW were risk factors for liver metastasis after colon cancer surgery (P < 0.05). The area under the curve was 0.93 for the column-line diagram prediction model constructed based on these risk factors to distinguish whether liver metastasis occurred postoperatively. The actual curve of the column-line diagram predicting the risk of postoperative liver metastasis was close to the ideal curve, with good agreement. The prediction model curves in the decision curve analysis showed higher net benefits for a larger threshold range than those in extreme cases, indicating that the model is safer.

CONCLUSION

Liver metastases after colorectal cancer surgery could be well predicted by a nomogram based on the SII, CAR, and RDW.

Keywords: Systemic immunoinflammatory index; C-reactive protein/albumin ratio; Erythrocyte distribution width; Colon cancer; Liver metastasis; Novel nomogram model

Core Tip: Colon cancer is a highly aggressive and migratory malignant tumor for which the liver is the most common target organ for postoperative metastasis. Herein, we analyzed the general and clinicopathological data of 242 patients with colon cancer who underwent radical resection for colon cancer. The results showed that the systemic inflammatory index, C-reactive protein/albumin ratio, and red blood cell distribution width were risk factors for postoperative liver metastasis in patients with colon cancer. A columnar graph prediction model was subsequently developed based on these three factors, and its predictive efficacy was evaluated.