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
ARTICLE HIGHLIGHTS
Research background

Colon cancer is one of the most common malignant tumors of the digestive system. Clinical treatment primarily includes surgery, and chemo- and radiotherapy are used as auxiliary therapies to ensure comprehensive treatment. Surgical resection is an effective radical treatment for colon cancer; however, liver metastasis still occurs in 25% of patients after surgery.

Research motivation

In the current study, several methods to predict and assess liver metastasis after colon cancer surgery were investigated. Therefore, the identification of simple and efficient predictors of liver metastasis after colon cancer surgery is clinically important.

Research objectives

This study is aimed to predict the efficacy of postoperative liver metastasis in colon cancer using nomogram models constructed from systemic inflammatory index (SII), C-reactive protein/albumin ratio (CAR), and red blood cell distribution width (RDW) to provide predictive value in the clinic.

Research methods

This study retrospectively analyzed the clinicopathological data of 242 patients who underwent radical resection for colon cancer; analyzed the risk factors affecting the development of liver metastases in these patients; assessed nomogram models constructed using the SII, CAR, and RDW; and evaluated the predictive efficacy of the models.

Research results

The SII, CAR, and RDW are risk factors for liver metastasis after colon cancer surgery. The area under the receiver operating characteristic curve of the column-line diagram model constructed based on these three risk factors to predict whether liver metastasis occurred after colon cancer surgery was 0.93 (95%CI: 0.89-0.96). The calibration curve of the column-line diagram predicting the risk of postoperative liver metastasis from colon cancer matched well with the actual risk of occurrence, and the net benefit of the model was better, indicating that the model was safer.

Research conclusions

The SII, CAR, and RDW are independent risk factors for the development of liver metastases after colon cancer surgery, and the predictive efficacy of the column-line graph model constructed using the SII, CAR, and RDW was high.

Research perspectives

To analyze the factors influencing the occurrence of liver metastases in patients with colon cancer and construct a nomogram model using the SII, CAR, and RDW to evaluate the predictive efficacy of the model.