A nomogram for predicting disease-specific survival after hepatic resection for metastatic colorectal cancer Journal Article
| Authors: | Kattan, M. W.; Gonen, M.; Jarnagin, W. R.; DeMatteo, R.; D'Angelica, M.; Weiser, M.; Blumgart, L. H.; Fong, Y. |
| Article Title: | A nomogram for predicting disease-specific survival after hepatic resection for metastatic colorectal cancer |
| Abstract: | PURPOSE: To develop a tool for predicting survival after liver resection for patients with stage IV colorectal cancer. By using a nomogram we are trying to improve on the current practice of using prognostic scores for evaluating risks of therapeutic failure. PATIENTS AND METHODS: All patients admitted to Memorial Sloan-Kettering Cancer Center (MSKCC) for curative intent for treatment of metastatic disease from colorectal cancer between January 1986 and December 1999 were included. A nomogram was developed as a graphical representation of a Cox proportional hazards regression model. The nomogram was verified for discrimination and calibration, both employing bootstrapping to obtain relatively unbiased estimates. RESULTS: Using nodal status of the primary tumor, disease-free interval, size of the largest metastatic tumor, preoperative carcinoembryonic antigen, bilateral resection, extensive resection (lobectomy or more), gender, number of hepatic tumors, primary cancer site (colon vs. rectum), and age, the nomogram achieved a concordance index of 0.61, statistically significantly greater than chance. The nomogram also had very good calibration. CONCLUSION: This nomogram is a predictive tool, upon external validation, that can routinely be used to counsel patients in making treatment decisions. The discriminatory ability of the nomogram indicates that this population should not be considered homogeneous with respect to risk of death. © 2008 Lippincott Williams & Wilkins, Inc. |
| Keywords: | adult; cancer survival; aged; aged, 80 and over; middle aged; survival rate; retrospective studies; major clinical study; cancer localization; postoperative period; liver neoplasms; united states; cancer patient; cancer staging; follow-up studies; lymph node metastasis; neoplasm staging; preoperative evaluation; colorectal cancer; reproducibility of results; proportional hazards models; carcinoembryonic antigen; calibration; surgical approach; prediction; time factors; risk assessment; colorectal neoplasms; survival time; proportional hazards model; statistical significance; nomograms; cancer size; surgical risk; liver resection; hepatectomy; hospital admission; nomogram; bootstrapping |
| Journal Title: | Annals of Surgery |
| Volume: | 247 |
| Issue: | 2 |
| ISSN: | 0003-4932 |
| Publisher: | Lippincott Williams & Wilkins |
| Date Published: | 2008-02-01 |
| Start Page: | 282 |
| End Page: | 287 |
| Language: | English |
| DOI: | 10.1097/SLA.0b013e31815ed67b |
| PUBMED: | 18216534 |
| PROVIDER: | scopus |
| DOI/URL: | |
| Notes: | --- - "Cited By (since 1996): 27" - "Export Date: 17 November 2011" - "CODEN: ANSUA" - "Source: Scopus" |
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