• Cancer medicine · Mar 2021

    A novel prognostic nomogram for colorectal cancer liver metastasis patients with recurrence after hepatectomy.

    • Jie-Ying Liang, Hao-Cheng Lin, Jingwen Liu, De-Shen Wang, Yun-Fei Yuan, Bin-Kui Li, Yun Zheng, Xiao-Jun Wu, Gong Chen, Feng-Hua Wang, Zhi-Qiang Wang, Zhi-Zhong Pan, De-Sen Wan, Rui-Hua Xu, and Yu-Hong Li.
    • State Key Laboratory of Oncology in South China, Sun Yat-sen University Cancer Center, Collaborative Innovation Center for Cancer Medicine, Guangzhou, People's Republic of China.
    • Cancer Med. 2021 Mar 1; 10 (5): 1535-1544.

    PurposeWe aimed to construct a nomogram to predict personalized post-recurrence survival (PRS) among colorectal cancer liver metastasis (CRLM) patients with post-hepatectomy recurrence.MethodsColorectal cancer liver metastasis patients who received initial hepatectomy and had subsequent recurrence between 2001 and 2019 in Sun Yat-sen University Cancer Center from China were included in the study. Patients were randomly assigned to a training cohort and a validation cohort on a ratio of 2:1. Univariable analysis was first employed to select potential predictive factors for PRS. Then, the multivariable Cox regression model was applied to recognize independent prognostic factors. According to the model, a nomogram to predict PRS was established. The nomogram's predictive capacity was further assessed utilizing concordance index (C-index) values, calibration plots, and Kaplan-Meier curves.ResultsAbout 376 patients were finally enrolled, with a 3-year PRS rate of 37.3% and a 5-year PRS rate of 24.6%. The following five independent predictors for PRS were determined to construct the nomogram: the largest size of liver metastases at initial hepatectomy, relapse-free survival, CEA level at recurrence, recurrent sites, and treatment for recurrence. The nomogram displayed fairly good discrimination and calibration. The C-index value was 0.742 for the training cohort and 0.773 for the validation cohort. Patients were grouped into three risk groups very well by the nomogram, with 5-year PRS rates of 45.2%, 23.3%, and 9.0%, respectively (p < 0.001) in the training cohort and 36.0%, 9.2%, and 4.6%, respectively (p < 0.001) in the validation cohort.ConclusionA novel nomogram was built and validated to enable the prediction of personal PRS in CRLM patients with post-hepatectomy recurrence. The nomogram may help physicians in decision making.© 2021 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.

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