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. 2025 Sep;27(9):3679-3686.
doi: 10.1007/s12094-025-03903-3. Epub 2025 Apr 12.

Prediction of lymph node metastasis in stage I-III colon cancer patients younger than 40 years

Wei-Hao Zhang  1 , Meng-Di Huang  2 , Yan-Ling Tu  3 , Kun-Zhai Huang  1 , Chao-Jun Wang  4 , Zhao-Hui Liu  5 , Rui-Sheng Ke  6
Affiliations

Prediction of lymph node metastasis in stage I-III colon cancer patients younger than 40 years

Wei-Hao Zhang et al. Clin Transl Oncol. 2025 Sep.

Abstract

Aims: Developing a clinical model to predict the individual risk of lymph node metastasis (LNM) in young colon cancer (CC) patients may address an unmet clinical need.

Methods: A total of 2,360 CC patients under 40 years old were extracted from the SEER database and randomly divided into development and validation cohorts. Risk factors for LNM were identified by using a logistic regression model. A weighted scoring system was built according to beta coefficients (β) calculated by a logistic regression model. Model discrimination was evaluated by C-statistics, model calibration was evaluated by H-L test and calibration plot.

Results: Risk factors were identified as T stage, tumor site, grade and histology. The area under the receiver operating characteristic curve (AUC-ROC) was 0.66 in both cohorts, indicating acceptable discriminatory power. The H-L test showed good calibration in the development cohort (χ2=2.869, P=0.837) and validation cohort (χ2=10.103, P=0.120) which also had been proved by calibration plot. Patients with total risk score of 0-1, 2-3 and 4-6 were considered as low, medium and high risk group.

Conclusion: This clinical risk prediction model is accurate enough to identify young CC patients with high risk of LNM and can further provide individualized clinical reference.

Keywords: Colon cancer; Lymph node metastasis; Prediction model; Young patient.

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Conflict of interest statement

Declarations. Conflict of interest: The authors declare that there is no conflict of interest in the submission of this manuscript. Moreover, all authors have approved this manuscript for publication. Ethical approval and Human participants and/or animals: This retrospective study has been approved by the Institutional Review Board of the institutions of all authors. All methods were carried out in strict accordance with the Declaration of Helsinki and the approved guidelines. Informed consent: Informed consent was deemed unnecessary as no personal identification information was involved in this study. Moreover, the authors had obtained permission from the National Cancer Institute to extract the data file from the SEER database, with the reference number 10249 – Nov 2015.

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