A modified TNM staging system for non-metastatic colorectal cancer based on nomogram analysis of SEER database

Abstract

Background: To revise the American Joint Committee on Cancer TNM staging system for colorectal cancer (CRC) based on a nomogram analysis of Surveillance, Epidemiology, and End Results (SEER) database, and to prove the rationality of enhancing T stage's weighting in our previously proposed T-plus staging system. Methods: Total 115,377 non-metastatic CRC patients from SEER were randomly grouped as training and testing set by ratio 1:1. The Nomo-staging system was established via three nomograms based on 1-year, 2-year and 3-year disease specific survival (DSS) Logistic regression analysis of the training set. The predictive value of Nomo-staging system for the testing set was evaluated by concordance index (c-index), likelihood ratio (L.R.) and Akaike information criteria (AIC) for 1-year, 2-year, 3-year overall survival (OS) and DSS. Kaplan-Meier survival curve was used to valuate discrimination and gradient monotonicity. And an external validation was performed on database from the Second Affiliated Hospital of Zhejiang University (SAHZU).

The expression profile and clinical application potential of hsa_circ_0000711 in colorectal cancer

“…Although classification according to TNM and Union for International Cancer Control stage provides valuable prognostic information and guides therapy decisions, the response and outcome of individual patient’s therapy is not predicted enough. 41 Increasing evidence showed that the circRNAs could be prognostic markers for cancers, including CRC. 42 In our study, log-rank test showed that low expression level of hsa_circ_0000711 was significantly associated with poor OS of CRC patients, which was in accordance with our univariate Cox proportional hazards analysis results.…”

Challenges and solutions in patient treatment strategies for stage II colon cancer

“…There have been some attempts to modify this classification to improve patients’ outcomes, particularly in early-stage non-metastatic cancer, where more emphasis is placed on the importance of T category [9]. There is evidence from cancer registry analysis that enhanced weighting of T category in early-stage colon cancer patients may provide clinicians with an improved system of classifying colon tumours [10]. However, as the increasing need for personalized medicine and enhanced models of risk in cancer patients that can be adopted by the clinical community is recognized [11], further studies to validate this approach will be required.…”

A Prognostic Nomogram for Disease-Specific Survival in Patients with Pancreatic Ductal Adenocarcinoma of the Head of the Pancreas Following Pancreaticoduodenectomy

“…However, the current AJCC prognostic guidelines that use the tumor, lymph node, and metastasis (TNM) status for PDAC do not include other possible variables that affect patient prognosis following surgery. Therefore, more accurate disease-specific predictive models are still required for patients with PDAC of the head of the pancreas who undergo radical surgery with pancreaticoduodenectomy [ 2 ].…”

“…The nomogram is a simple multivariate predictive model, which can incorporate several variables that influence disease prognosis [ 3 ]. Recently, disease-specific nomograms have been increasingly used to predict prognosis for patients with a variety of malignant tumors [ 2 , 4 – 8 ]. However, there have been few studies on the use of nomograms in pancreatic ductal adenocarcinoma, and the models that have been developed have shown limited predictive ability [ 9 – 12 ].…”