Nomogram for predicting the overall survival of underweight patients with colorectal cancer: a clinical study
Abstract Background An underweight individual is defined as one whose Body Mass Index (BMI) is < 18.5 kg/m2. Currently, the prognosis in patients with colorectal cancer (CRC) who are also underweight is unclear. Methods Information on South Korean patients who underwent curative resection for CRC...
| Main Authors: | , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2023-02-01
|
| Series: | BMC Gastroenterology |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12876-023-02669-8 |
| _version_ | 1797864549217468416 |
|---|---|
| author | Jun Woo Bong Younghyun Na Yeonuk Ju Chinock Cheong Sanghee Kang Sun Il Lee Byung Wook Min |
| author_facet | Jun Woo Bong Younghyun Na Yeonuk Ju Chinock Cheong Sanghee Kang Sun Il Lee Byung Wook Min |
| author_sort | Jun Woo Bong |
| collection | DOAJ |
| description | Abstract Background An underweight individual is defined as one whose Body Mass Index (BMI) is < 18.5 kg/m2. Currently, the prognosis in patients with colorectal cancer (CRC) who are also underweight is unclear. Methods Information on South Korean patients who underwent curative resection for CRC without distant metastasis was collected from health insurance registry data between January 2014 and December 2016. We compared the overall survival (OS) of underweight and non-underweight (BMI ≥ 18.5 kg/m2) patients after adjusting for confounders using propensity score matching. A nomogram to predict OS in the underweight group was constructed using the significant risk factors identified in multivariate analysis. The predictive and discriminative capabilities of the nomogram for predicting 3- and 5-year OS in the underweight group were validated and compared with those of the tumor, node, and metastasis (TNM) staging system in the training and validation sets. Results A total of 23,803 (93.6%) and 1,644 (6.4%) patients were assigned to the non-underweight and underweight groups, respectively. OS was significantly worse in the underweight group than in the non-underweight group for each pathological stage (non-underweight vs. underweight: stage I, 90.1% vs. 77.1%; stage IIA, 85.3% vs. 67.3%; stage IIB/C, 74.9% vs. 52.1%; and stage III, 73.2% vs. 59.4%, P < 0.001). The calibration plots demonstrated that the nomogram exhibited satisfactory consistency with the actual results. The concordance index (C-index) and area under the receiver operating characteristic curve (AUC) of the nomogram exhibited better discriminatory capability than those of the TNM staging system (C-index, nomogram versus TNM staging system: training set, 0.713 versus 0.564, P < 0.001; validation set, 0.691 versus 0.548, P < 0.001; AUC for 3- and 5- year OS, nomogram versus TNM staging system: training set, 0.748 and 0.741 versus 0.610 and 0.601; validation set, 0.715 and 0.753 versus 0.586 and 0.579, respectively). Conclusions Underweight patients had worse OS than non-underweight patients for all stages of CRC. Our nomogram can guide prognostic predictions and the treatment plan for underweight patients with CRC. |
| first_indexed | 2024-04-09T22:53:42Z |
| format | Article |
| id | doaj.art-36b600e9209b4795b3d58d0d02d00392 |
| institution | Directory Open Access Journal |
| issn | 1471-230X |
| language | English |
| last_indexed | 2024-04-09T22:53:42Z |
| publishDate | 2023-02-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Gastroenterology |
| spelling | doaj.art-36b600e9209b4795b3d58d0d02d003922023-03-22T11:23:18ZengBMCBMC Gastroenterology1471-230X2023-02-0123111110.1186/s12876-023-02669-8Nomogram for predicting the overall survival of underweight patients with colorectal cancer: a clinical studyJun Woo Bong0Younghyun Na1Yeonuk Ju2Chinock Cheong3Sanghee Kang4Sun Il Lee5Byung Wook Min6Department of Surgery, Korea University Guro Hospital, Korea University College of MedicineDepartment of Surgery, Korea University Guro Hospital, Korea University College of MedicineDepartment of Surgery, Korea University Guro Hospital, Korea University College of MedicineDepartment of Surgery, Korea University Guro Hospital, Korea University College of MedicineDepartment of Surgery, Korea University Guro Hospital, Korea University College of MedicineDepartment of Surgery, Korea University Guro Hospital, Korea University College of MedicineDepartment of Surgery, Korea University Guro Hospital, Korea University College of MedicineAbstract Background An underweight individual is defined as one whose Body Mass Index (BMI) is < 18.5 kg/m2. Currently, the prognosis in patients with colorectal cancer (CRC) who are also underweight is unclear. Methods Information on South Korean patients who underwent curative resection for CRC without distant metastasis was collected from health insurance registry data between January 2014 and December 2016. We compared the overall survival (OS) of underweight and non-underweight (BMI ≥ 18.5 kg/m2) patients after adjusting for confounders using propensity score matching. A nomogram to predict OS in the underweight group was constructed using the significant risk factors identified in multivariate analysis. The predictive and discriminative capabilities of the nomogram for predicting 3- and 5-year OS in the underweight group were validated and compared with those of the tumor, node, and metastasis (TNM) staging system in the training and validation sets. Results A total of 23,803 (93.6%) and 1,644 (6.4%) patients were assigned to the non-underweight and underweight groups, respectively. OS was significantly worse in the underweight group than in the non-underweight group for each pathological stage (non-underweight vs. underweight: stage I, 90.1% vs. 77.1%; stage IIA, 85.3% vs. 67.3%; stage IIB/C, 74.9% vs. 52.1%; and stage III, 73.2% vs. 59.4%, P < 0.001). The calibration plots demonstrated that the nomogram exhibited satisfactory consistency with the actual results. The concordance index (C-index) and area under the receiver operating characteristic curve (AUC) of the nomogram exhibited better discriminatory capability than those of the TNM staging system (C-index, nomogram versus TNM staging system: training set, 0.713 versus 0.564, P < 0.001; validation set, 0.691 versus 0.548, P < 0.001; AUC for 3- and 5- year OS, nomogram versus TNM staging system: training set, 0.748 and 0.741 versus 0.610 and 0.601; validation set, 0.715 and 0.753 versus 0.586 and 0.579, respectively). Conclusions Underweight patients had worse OS than non-underweight patients for all stages of CRC. Our nomogram can guide prognostic predictions and the treatment plan for underweight patients with CRC.https://doi.org/10.1186/s12876-023-02669-8Colorectal cancerUnderweightOverall survivalNomogramBody mass index |
| spellingShingle | Jun Woo Bong Younghyun Na Yeonuk Ju Chinock Cheong Sanghee Kang Sun Il Lee Byung Wook Min Nomogram for predicting the overall survival of underweight patients with colorectal cancer: a clinical study BMC Gastroenterology Colorectal cancer Underweight Overall survival Nomogram Body mass index |
| title | Nomogram for predicting the overall survival of underweight patients with colorectal cancer: a clinical study |
| title_full | Nomogram for predicting the overall survival of underweight patients with colorectal cancer: a clinical study |
| title_fullStr | Nomogram for predicting the overall survival of underweight patients with colorectal cancer: a clinical study |
| title_full_unstemmed | Nomogram for predicting the overall survival of underweight patients with colorectal cancer: a clinical study |
| title_short | Nomogram for predicting the overall survival of underweight patients with colorectal cancer: a clinical study |
| title_sort | nomogram for predicting the overall survival of underweight patients with colorectal cancer a clinical study |
| topic | Colorectal cancer Underweight Overall survival Nomogram Body mass index |
| url | https://doi.org/10.1186/s12876-023-02669-8 |
| work_keys_str_mv | AT junwoobong nomogramforpredictingtheoverallsurvivalofunderweightpatientswithcolorectalcanceraclinicalstudy AT younghyunna nomogramforpredictingtheoverallsurvivalofunderweightpatientswithcolorectalcanceraclinicalstudy AT yeonukju nomogramforpredictingtheoverallsurvivalofunderweightpatientswithcolorectalcanceraclinicalstudy AT chinockcheong nomogramforpredictingtheoverallsurvivalofunderweightpatientswithcolorectalcanceraclinicalstudy AT sangheekang nomogramforpredictingtheoverallsurvivalofunderweightpatientswithcolorectalcanceraclinicalstudy AT sunillee nomogramforpredictingtheoverallsurvivalofunderweightpatientswithcolorectalcanceraclinicalstudy AT byungwookmin nomogramforpredictingtheoverallsurvivalofunderweightpatientswithcolorectalcanceraclinicalstudy |