Stage II–III colon cancer: a comparison of survival calculators

Abstract

Background: Individualized postoperative survival calculators for patients with cancer can be an aid for predicting prognosis and clinical decision making, such as the use of adjuvant chemotherapy. The aim of this study was to compare existing survival calculators for colon cancer and determine their performance using an independent cohort of patients. Methods: A retrospective analysis of a multi-site institutional experience was performed on patients diagnosed with stage II-III colon cancer between January 2012 and March 2013. Patient survival rates were estimated using Roswell Park Comprehensive Cancer Center (RPCCC), Memorial Sloan Kettering Cancer Center (MSKCC), and MD Anderson Cancer Center (MDACC) calculators. These calculators vary in the number and breadth of variables that are included. The agreement between selected models was obtained through a scatter plot matrix and related intra-class correlation coefficient (ICC). Calculators' performances were compared using time-dependent receiver operating characteristic (ROC) curves and corresponding area under the curve (AUC) values. Results: After the application of inclusion and exclusion criteria, a total of 97 patients were included in the analysis. Survival data were available for all patients. Median follow-up was 57.6 months, and the overall 5-year survival rate was 0.74 (95% CI: 0.64-0.82). Overall, the different calculators tended to predict survival similarly (ICC =0.017). However, there was variation among calculator performance with the RPCCC calculator showing the highest performance (AUC =0.913), followed by the MSKCC calculator (AUC =0.803), and the MDACC calculator (AUC =0.644). Conclusions: Prognostic models incorporating a more comprehensive amount of patient and tumor specific variables may provide a more accurate estimate of individual patient survival rates. These tools can be an actual aid in the clinical practice, allowing physicians to personalize treatment and follow-up for patients with colon cancer.

Neoadjuvant Chemotherapy for Locally Advanced T4 Colon Cancer: A Nationwide Propensity-Score Matched Cohort Analysis

“…An encouraging finding of this study is that despite the higher R0 resection rate, an excellent 5-year overall survival rate of 67% was demonstrated in the neoadjuvant group. This is similar to the survival in the control group (65%) and comparable to recent literature [37][38][39]. Most importantly, these results are in accordance with the first results of the randomized phase FOxTROT trial that were presented at the ASCO annual meeting 2019.…”

A Prediction Model for Tumor Recurrence in Stage II–III Colorectal Cancer Patients: From a Machine Learning Model to Genomic Profiling

“…These nomograms can be pictorial representations of complex mathematical formulas with the primary advantages of estimating individualized risk based on histopathological features and patient characteristics [ 35 ]. However, the efficacies of the current recurrence prediction nomograms for stage II–III CRC may be restrained due to their retrospective nature and other analytical limitations [ 36 ]. Weiser [ 34 ] and Valentini [ 37 ] reported on two nomograms that had significant discriminative abilities with external validation for the OS of patients with stage II–III CRC.…”

Prognostic models for stage I–III esophageal cancer: a comparison between existing calculators

“…Thus, the low performance and agreement among calculators is possibly biased by these unaccounted differences. However, the development of clinical prediction tools has been applied to a myriad of other site-specific neoplasms, as in colorectal cancer, where calculators achieved good results in predicting 5-year OS, with RPCCC model being the one that achieving the best performance (AUC =0.91) (33).…”