Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Jun 4;13(11):2808.
doi: 10.3390/cancers13112808.

A Prediction Model for Metachronous Peritoneal Carcinomatosis in Patients with Stage T4 Colon Cancer after Curative Resection

Tzong-Yun Tsai  1   2 , Jeng-Fu You  1   2 , Yu-Jen Hsu  1   2 , Jing-Rong Jhuang  3 , Yih-Jong Chern  1   2 , Hsin-Yuan Hung  1   2 , Chien-Yuh Yeh  1   2 , Pao-Shiu Hsieh  1   2 , Sum-Fu Chiang  1   2 , Cheng-Chou Lai  1   2 , Jy-Ming Chiang  1   2 , Reiping Tang  1   2 , Wen-Sy Tsai  1   2
Affiliations

A Prediction Model for Metachronous Peritoneal Carcinomatosis in Patients with Stage T4 Colon Cancer after Curative Resection

Tzong-Yun Tsai et al. Cancers (Basel). .

Abstract

(1) Background: The aim of this study was to develop a prediction model for assessing individual mPC risk in patients with pT4 colon cancer. Methods: A total of 2003 patients with pT4 colon cancer undergoing R0 resection were categorized into the training or testing set. Based on the training set, 2044 Cox prediction models were developed. Next, models with the maximal C-index and minimal prediction error were selected. The final model was then validated based on the testing set using a time-dependent area under the curve and Brier score, and a scoring system was developed. Patients were stratified into the high- or low-risk group by their risk score, with the cut-off points determined by a classification and regression tree (CART). (2) Results: The five candidate predictors were tumor location, preoperative carcinoembryonic antigen value, histologic type, T stage and nodal stage. Based on the CART, patients were categorized into the low-risk or high-risk groups. The model has high predictive accuracy (prediction error ≤5%) and good discrimination ability (area under the curve >0.7). (3) Conclusions: The prediction model quantifies individual risk and is feasible for selecting patients with pT4 colon cancer who are at high risk of developing mPC.

Keywords: T4 colon cancer; metachronous peritoneal carcinomatosis; prediction model.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Long-term predictive performance of metachronous peritoneal carcinomatosis (mPC) risk prediction model in testing set. (A) Predictive error curve. mPC risk prediction model has high predictive accuracy (prediction error ≤5%) within one year of operation. After that, predictive accuracy decreases gradually but continues to be better compared to Kaplan–Meier model (no factors included). (B) Time-dependent area under the curve (AUC) of mPC risk prediction model shows acceptable discrimination ability (0.7 ≤ AUC ≤ 0.8) six months after operation.
Figure 2
Figure 2
(A) mPC recurrence-free survival and (B) overall survival were significantly higher in low-risk than high-risk group.
Figure 3
Figure 3
(A) mPC recurrence-free survival and (B) overall survival were significantly higher in low-risk than high-risk group in training and testing sets.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Franko J., Shi Q., Meyers J.P., Maughan T.S., Adams R., Seymour M.T., Saltz L., A Punt C.J., Koopman M., Tournigand C., et al. Prognosis of patients with peritoneal metastatic colorectal cancer given systemic therapy: An analysis of individual patient data from prospective randomised trials from the Analysis and Research in Cancers of the Digestive System (ARCAD) database. Lancet Oncol. 2016;17:1709–1719. doi: 10.1016/S1470-2045(16)30500-9. - DOI - PubMed
    1. Kerscher A.G., Chua T.C., Gasser M., Maeder U., Kunzmann V., Isbert C., Germer C.T., Pelz J.O.W. Impact of peritoneal carcinomatosis in the disease history of colorectal cancer management: A longitudinal experience of 2406 patients over two decades. Br. J. Cancer. 2013;108:1432–1439. doi: 10.1038/bjc.2013.82. - DOI - PMC - PubMed
    1. Elias D., Lefevre J.H., Chevalier J., Brouquet A., Marchal F., Classe J.-M., Ferron G., Guilloit J.-M., Meeus P., Goéré D., et al. Complete Cytoreductive Surgery Plus Intraperitoneal Chemohyperthermia with Oxaliplatin for Peritoneal Carcinomatosis of Colorectal Origin. J. Clin. Oncol. 2009;27:681–685. doi: 10.1200/JCO.2008.19.7160. - DOI - PubMed
    1. Verwaal V.J., Van Ruth S., de Bree E., Van Slooten G.W., Van Tinteren H., Boot H., Zoetmulder F.A. Randomized trial of cytoreduction and hyperthermic intraperitoneal chemotherapy versus systemic chemotherapy and palliative surgery in patients with peritoneal carcinomatosis of colorectal cancer. J. Clin. Oncol. 2003;21:3737–3743. doi: 10.1200/JCO.2003.04.187. - DOI - PubMed
    1. Sugarbaker P.H., Schellinx M.E., Chang D., Koslowe P., von Meyerfeldt M. Peritoneal carcinomatosis from adenocarcinoma of the colon. World J. Surg. 1996;20:585–591. doi: 10.1007/s002689900091. - DOI - PubMed

LinkOut - more resources