Diao YH, Rao SQ, Shu XP, Cheng Y, Tan C, Wang LJ, Peng D. Prognostic prediction model of colorectal cancer based on preoperative serum tumor markers. World J Gastrointest Surg 2024; 16(5): 1344-1353 [PMID: 38817280 DOI: 10.4240/wjgs.v16.i5.1344]
Corresponding Author of This Article
Dong Peng, PhD, Chief Doctor, Department of Gastrointestinal Surgery, The First Affiliated Hospital of Chongqing Medical University, No. 1 Youyi Road, Yuzhong District, Chongqing 400016, China. carry_dong@126.com
Research Domain of This Article
Oncology
Article-Type of This Article
Retrospective Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (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: http://creativecommons.org/licenses/by-nc/4.0/
Yu-Hang Diao, Si-Qi Rao, Xin-Peng Shu, Yong Cheng, Can Tan, Li-Juan Wang, Dong Peng, Department of Gastrointestinal Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China
Co-first authors: Yu-Hang Diao and Si-Qi Rao.
Author contributions: Rao SQ was thanked for her significant contribution in revising the manuscript; Diao YH and Rao SQ contributed to the data analysis; Peng D led the quality assessments, Diao YH wrote the original draft; Shu XP and Cheng Y revised the manuscript. All authors have agreed on the manuscript to be submitted, provided final approval of the version to be published, and agree to be responsible for all elements of the work. Diao YH and Rao SQ contributed equally to this work.
Supported byCQMU Program for Youth Innovation in Future Medicine, No. W0190.
Institutional review board statement: This study was reviewed and approved by the Ethics Committee of The First Affiliated Hospital of Chongqing Medical University.
Informed consent statement: This study is a retrospective study, and the patients is come from a teaching hospital of the First Affiliated Hospital of Chongqing Medical University. When we deliver the ethics application, we have also delivered application for exemption of informed consent, and This study was approved by the Medical Ethics Committee of the First Affiliated Hospital of Chongqing Medical University (2022-133-2).
Conflict-of-interest statement: The authors declare no conflicts of interest.
Data sharing statement: The datasets generated and/or analyzed during the current study are not publicly available due but are available from the corresponding author upon reasonable request.
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: Dong Peng, PhD, Chief Doctor, Department of Gastrointestinal Surgery, The First Affiliated Hospital of Chongqing Medical University, No. 1 Youyi Road, Yuzhong District, Chongqing 400016, China. carry_dong@126.com
Received: January 28, 2024 Revised: April 6, 2024 Accepted: April 15, 2024 Published online: May 27, 2024 Processing time: 116 Days and 3.5 Hours
Abstract
BACKGROUND
Preoperative serum tumor markers not only play a role in the auxiliary diagnosis and postoperative monitoring in colorectal cancer (CRC), but also have been found to have potential prognostic value.
AIM
To analyze whether preoperative serum tumor markers, including carcinoembryonic antigen (CEA) and carbohydrate antigen 19-9 (CA19-9), affect the prognosis of CRC.
METHODS
This was a retrospective study conducted in a single center. Patients with nonmetastatic CRC who underwent initial surgery between January 2011 and January 2020 were enrolled and divided into development site and validation site groups at a ratio of 7:3. The independent prognostic factors were screened by Cox regression analysis, and finally, a prognostic nomogram model was established. The newly developed model was tested by internal validation.
RESULTS
Eventually, 3526 postoperative patients with nonmetastatic CRC were included in the study. There were 2473 patients at the development site and 1056 patients at the validation site. Age (P < 0.01, HR = 1.042, 95%CI = 1.033-1.051), tumor node metastasis (TNM) classification (P < 0.01, HR = 1.938, 95%CI = 1.665-2.255), preoperative CEA (P = 0.001, HR = 1.393, 95%CI = 1.137-1.707) and CA19-9 (P < 0.01, HR = 1.948, 95%CI = 1.614-2.438) levels were considered independent prognostic factors for patients with nonmetastatic CRC and were used as variables in the nomogram model. The areas under the curve of the development and validation sites were 0.655 and 0.658, respectively. The calibration plot also showed the significant performance of the newly established nomogram.
CONCLUSION
We successfully constructed a nomogram model based on age, TNM stage, preoperative CEA, and CA19-9 levels to evaluate the overall survival of patients with nonmetastatic CRC.
Core Tip: The tumor markers carcinoembryonic antigen and carbohydrate antigen 19-9 are often used in the auxiliary diagnosis and postoperative monitoring of colorectal patients, but their role in prognosis needs to be further explored. Here, we retrospectively analyzed the clinical data and pathological characteristics of 3526 patients with nonmetastatic colorectal cancer (CRC), confirmed the negative correlation between preoperative serum tumor marker levels and prognosis, and established a nomogram model to evaluate the prognosis of CRC patients.
