Real-World Implications of Nonbiological Factors with Staging, Prognosis and Clinical Management in Colon Cancer
Background: The present study analyzed the nonbiological factors (NBFs) together with the American Joint Committee on Cancer (AJCC) Tumor-Node-Metastasis (TNM) staging system to generate a refined, risk-adapted stage for the clinical treatment of colon cancer. Methods: Eligible patients (N = 28,818)...
| Main Authors: | , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2018-08-01
|
| Series: | Cancers |
| Subjects: | |
| Online Access: | http://www.mdpi.com/2072-6694/10/8/263 |
| _version_ | 1797761273006391296 |
|---|---|
| author | Qi Liu Dakui Luo Sanjun Cai Qingguo Li Xinxiang Li |
| author_facet | Qi Liu Dakui Luo Sanjun Cai Qingguo Li Xinxiang Li |
| author_sort | Qi Liu |
| collection | DOAJ |
| description | Background: The present study analyzed the nonbiological factors (NBFs) together with the American Joint Committee on Cancer (AJCC) Tumor-Node-Metastasis (TNM) staging system to generate a refined, risk-adapted stage for the clinical treatment of colon cancer. Methods: Eligible patients (N = 28,818) with colon cancer between 1 January 2010 and 31 December 2014, were identified from the Surveillance, Epidemiology, and End Results (SEER) database. Kaplan-Meier curves and Cox proportional hazards regression, analyzed the probabilities of cancer-specific survival (CSS) in patients with colon cancer, with different NBF-TNM stages. Results: Insurance status, marital status, and median household income were significant prognostic NBFs in the current study (p < 0.05). The concordance index of NBF-TNM stage was 0.857 (95% confidence interval (CI) = 0.8472–0.8668). Multivariate Cox analyses, indicated that NBF1-stage was independently associated with a 50.4% increased risk of cancer-specific mortality in colon cancer (p < 0.001), which increased to 77.1% in non-metastatic colon cancer. NBF0-stage improved in CSS as compared to the NBF1-stage in the respective stages (p < 0.05). Conclusions: The new proposed NBF-stage was an independent prognostic factor in colon cancer. Effect of NBFs on the survival of colon cancer necessitates further clinical attention. Moreover, the incorporation of NBF-stage into the AJCC TNM staging system is essential for prognostic prediction, and clinical guidance of adjuvant chemotherapy in stage II and III colon cancer. |
| first_indexed | 2024-03-12T19:11:35Z |
| format | Article |
| id | doaj.art-e1ce929d927e4049a107feb6ca327946 |
| institution | Directory Open Access Journal |
| issn | 2072-6694 |
| language | English |
| last_indexed | 2024-03-12T19:11:35Z |
| publishDate | 2018-08-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Cancers |
| spelling | doaj.art-e1ce929d927e4049a107feb6ca3279462023-08-02T05:55:47ZengMDPI AGCancers2072-66942018-08-0110826310.3390/cancers10080263cancers10080263Real-World Implications of Nonbiological Factors with Staging, Prognosis and Clinical Management in Colon CancerQi Liu0Dakui Luo1Sanjun Cai2Qingguo Li3Xinxiang Li4Department of Colorectal Surgery, Fudan University Shanghai Cancer Center, Shanghai 200032, ChinaDepartment of Colorectal Surgery, Fudan University Shanghai Cancer Center, Shanghai 200032, ChinaDepartment of Colorectal Surgery, Fudan University Shanghai Cancer Center, Shanghai 200032, ChinaDepartment of Colorectal Surgery, Fudan University Shanghai Cancer Center, Shanghai 200032, ChinaDepartment of Colorectal Surgery, Fudan University Shanghai Cancer Center, Shanghai 200032, ChinaBackground: The present study analyzed the nonbiological factors (NBFs) together with the American Joint Committee on Cancer (AJCC) Tumor-Node-Metastasis (TNM) staging system to generate a refined, risk-adapted stage for the clinical treatment of colon cancer. Methods: Eligible patients (N = 28,818) with colon cancer between 1 January 2010 and 31 December 2014, were identified from the Surveillance, Epidemiology, and End Results (SEER) database. Kaplan-Meier curves and Cox proportional hazards regression, analyzed the probabilities of cancer-specific survival (CSS) in patients with colon cancer, with different NBF-TNM stages. Results: Insurance status, marital status, and median household income were significant prognostic NBFs in the current study (p < 0.05). The concordance index of NBF-TNM stage was 0.857 (95% confidence interval (CI) = 0.8472–0.8668). Multivariate Cox analyses, indicated that NBF1-stage was independently associated with a 50.4% increased risk of cancer-specific mortality in colon cancer (p < 0.001), which increased to 77.1% in non-metastatic colon cancer. NBF0-stage improved in CSS as compared to the NBF1-stage in the respective stages (p < 0.05). Conclusions: The new proposed NBF-stage was an independent prognostic factor in colon cancer. Effect of NBFs on the survival of colon cancer necessitates further clinical attention. Moreover, the incorporation of NBF-stage into the AJCC TNM staging system is essential for prognostic prediction, and clinical guidance of adjuvant chemotherapy in stage II and III colon cancer.http://www.mdpi.com/2072-6694/10/8/263non-biological factorsAJCC TNM staging systemprognosticationcolon cancerSEER |
| spellingShingle | Qi Liu Dakui Luo Sanjun Cai Qingguo Li Xinxiang Li Real-World Implications of Nonbiological Factors with Staging, Prognosis and Clinical Management in Colon Cancer Cancers non-biological factors AJCC TNM staging system prognostication colon cancer SEER |
| title | Real-World Implications of Nonbiological Factors with Staging, Prognosis and Clinical Management in Colon Cancer |
| title_full | Real-World Implications of Nonbiological Factors with Staging, Prognosis and Clinical Management in Colon Cancer |
| title_fullStr | Real-World Implications of Nonbiological Factors with Staging, Prognosis and Clinical Management in Colon Cancer |
| title_full_unstemmed | Real-World Implications of Nonbiological Factors with Staging, Prognosis and Clinical Management in Colon Cancer |
| title_short | Real-World Implications of Nonbiological Factors with Staging, Prognosis and Clinical Management in Colon Cancer |
| title_sort | real world implications of nonbiological factors with staging prognosis and clinical management in colon cancer |
| topic | non-biological factors AJCC TNM staging system prognostication colon cancer SEER |
| url | http://www.mdpi.com/2072-6694/10/8/263 |
| work_keys_str_mv | AT qiliu realworldimplicationsofnonbiologicalfactorswithstagingprognosisandclinicalmanagementincoloncancer AT dakuiluo realworldimplicationsofnonbiologicalfactorswithstagingprognosisandclinicalmanagementincoloncancer AT sanjuncai realworldimplicationsofnonbiologicalfactorswithstagingprognosisandclinicalmanagementincoloncancer AT qingguoli realworldimplicationsofnonbiologicalfactorswithstagingprognosisandclinicalmanagementincoloncancer AT xinxiangli realworldimplicationsofnonbiologicalfactorswithstagingprognosisandclinicalmanagementincoloncancer |