Nomogram for Predicting Occurrence of Synchronous Liver Metastasis in Colorectal Cancer: A Single-center Retrospective Study Based on Pathological Factors
Abstract PurposeThe purpose of this study was to explore the risk factors for liver metastasis (LM) of colorectal cancer (CRC) and to construct a nomogram for predicting the occurrence of synchronous LM based on baseline and pathological information.MethodsThe baseline and pathological information of 3190 CRC patients from the Department of Colorectal Surgery, the Second Affiliated Hospital of Harbin Medical University between 2012 and 2020 were included. All patients were divided into development and validation cohorts with the 1:1 ratio. Univariate and multivariate logistic regression models were utilized to identify the potential predictors of LM in CRC patients. Using the R tool to create a predictive nomogram. In addition, receiver operating characteristic (ROC) curves was calculated to describe the discriminability of the nomogram. A calibration curve was plotted to compare the predicted and observed results of the nomogram. Decision-making curve analysis (DCA) was used to evaluate the clinical effect of nomogram.ResultsThe nomogram consisted of six features including tumor site, vascular invasion (VI), T stage, N stage, preoperative CEA and CA-199 level. ROC curves for the LM nomogram indicated good discrimination in the development cohort (AUC = 0.885, 95% CI 0.854-0.916) and the validation cohort (AUC = 0.857, 95% CI 0.821-0.893). The calibration curve showed that the prediction results of the nomogram was in good agreement with the actual observation results. Moreover, the DCA curves determined the clinical application value of predictive nomogram.ConclusionsThe pathologic-based nomogram could help clinicians to predict the occurrence of synchronous LM in postoperative CRC patients and provide a reference to perform appropriate metastatic screening plans and rational therapeutic options for the special population.