Validation of a clinical calculator predicting freedom from colon cancer recurrence after surgery on the basis of molecular and clinical variables Journal Article
| Authors: | Khan, A.; Thompson, H. M.; Hsu, M.; Widmar, M.; Wei, I. H.; Pappou, E.; Smith, J. J.; Nash, G. M.; Paty, P. B.; Garcia-Aguilar, J.; Shia, J.; Gönen, M.; Weiser, M. |
| Article Title: | Validation of a clinical calculator predicting freedom from colon cancer recurrence after surgery on the basis of molecular and clinical variables |
| Abstract: | BACKGROUND: The Memorial Sloan Kettering clinical calculator for estimating the likelihood of freedom from colon cancer recurrence on the basis of clinical and molecular variables was developed at a time when testing for microsatellite instability was performed selectively, based on patient age, family history, and histologic features. Microsatellite stability was assumed if no testing was done. OBJECTIVE: This study aimed to validate the calculator in a cohort of patients who had all been tested for microsatellite instability. DESIGN: Retrospective cohort analysis. SETTINGS: Comprehensive cancer center. PATIENTS: This study included consecutive patients who underwent curative resection for stage I, II, or III colon cancer between 2017 and 2019. INTERVENTION: Universal testing of mircrosatellite phenotype in all cases. MAIN OUTCOME MEASURES: The calculator’s predictive accuracy was assessed using the concordance index and a calibration plot of predicted versus actual freedom from recurrence at 3 years after surgery. For a secondary sensitivity analysis, the presence of a tumor deposit(s) (disease category N1c) was considered equivalent to one positive lymph node (category N1a). RESULTS: With a median follow-up of 32 months among survivors, the concordance index for the 745 patients in the cohort was 0.748 (95% CI, 0.693–0.801), and a plot of predicted versus observed recurrences approached the 45° diagonal, indicating good discrimination and calibration. In the secondary sensitivity analysis for tumor deposits, the concordance index was 0.755 (95% CI, 0.700–0.806). LIMITATIONS: This study was limited by its retrospective, single-institution design. CONCLUSIONS: These results, based on inclusion of actual rather than imputed microsatellite stability status and presence of tumor deposits, confirm the predictive accuracy and reliability of the calculator. See Video Abstract. © The ASCRS 2023. |
| Keywords: | adult; cancer survival; controlled study; aged; middle aged; cancer surgery; retrospective studies; major clinical study; genetics; clinical feature; cancer recurrence; postoperative period; cancer staging; follow up; lymph node metastasis; neoplasm staging; prospective study; sensitivity analysis; reproducibility; reproducibility of results; phenotype; clinical assessment; calibration; colonic neoplasms; cohort analysis; pathology; validation study; retrospective study; molecular mechanics; nomograms; colon cancer; colon tumor; microsatellite instability; kaplan meier method; nomogram; predictive value; clinical outcome; extranodal extension; humans; prognosis; human; male; female; article |
| Journal Title: | Diseases of the Colon and Rectum |
| Volume: | 67 |
| Issue: | 2 |
| ISSN: | 0012-3706 |
| Publisher: | Lippincott Williams & Wilkins |
| Date Published: | 2024-02-01 |
| Start Page: | 240 |
| End Page: | 245 |
| Language: | English |
| DOI: | 10.1097/dcr.0000000000002896 |
| PUBMED: | 37815326 |
| PROVIDER: | scopus |
| PMCID: | PMC10843082 |
| DOI/URL: | |
| Notes: | The MSK Cancer Center Support Grant (P30 CA008748) is acknowledged in the PDF -- Corresponding author is MSK author: Martin R. Weiser -- Source: Scopus |
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