中国实用外科杂志

中国实用外科杂志

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MSKCC结肠癌生存预测模型单中心验证性研究

 崔    明1，陈东来2，刘茂兴1，姚震旦1，邢加迪1，杨    宏1，张成海1，张    楠1，陈    蕾1，谭    非1，邸佳柏1，王早早1，姜北海1，苏向前1   

  1. 1 北京大学肿瘤医院暨北京市肿瘤防治研究所胃肠肿瘤中心四病区（原胃肠肿瘤微创外科） 恶性肿瘤发病机制及转化研究教育部重点实验室，北京 100142；2 Department of Statistics，Purdue University
  • 出版日期:2016-02-01 发布日期:2016-01-29

  • Online:2016-02-01 Published:2016-01-29

摘要：

目的    验证并评估美国纪念斯隆-凯特琳癌症中心（MSKCC）生存预测模型在中国结肠癌病人中的应用价值。方法    回顾性分析北京大学肿瘤医院胃肠肿瘤微创外科2009年10月至2013年5月收治的259例行结肠癌根治术病人的临床资料，应用MSKCC生存预测模型分析病人5年存活率，通过一致性指数（C-index）和校准曲线对其进行外部验证和预测准确性评估。结果    MSKCC生存预测模型的C-index为0.713，而美国癌症联合委员会（AJCC）TNM分期的C-index为0.711，二者差异无统计学意义（P=0.794）。MSKCC模型对结肠癌根治术后5年总存活率的预测准确性同AJCC/TNM分期系统相当。MSKCC模型在验证队列中呈现良好的校准特性。对于同一AJCC/TNM分期病人，应用MSKCC模型预测的5年存活率存在差异。结论    MSKCC结肠癌生存预测模型适用于我国结肠癌病人，其不仅可以对病人进行准确的个体化生存预测，并且有助于提供临床咨询，选择治疗方案，安排随访流程。

关键词: 结肠癌, 生存预测, 总存活率

Abstract:

Validation of MSKCC nomogram in predicting overall survival for colon cancer        CUI Ming*，CHEN Dong-lai，LIU Mao-xing，et al. *Key Laboratory of Carcinogenesis and Translational Research （Ministry of Education），Department of Gastrointestinal Surgery Ⅳ，Peking University Cancer Hospital & Institute，Beijing 100142，China
Corresponding author：SU Xiang-qian，E-mail：suxiangian@bjmu.edu.cn
Abstract    Objective    To evaluate the accuracy and clinical value of MSKCC colon cancer nomogram in an independent external Chinese patients who underwent curative colectomy. Methods    The clinical data of 259 patients who underwent curative R0 surgery at Department of Minimally Invasive Gastrointestinal Surgery，Peking University Cancer Hospital & Institute between October 2009 and May 2013 were analyzed retrospectively. MSKCC nomogram was used to estimate the probability of 5-year overall survival. The performance of the MSKCC nomogram was evaluated using concordance index (C-index) and calibration plot. Results    In Chinese population, the C-index for the MSKCC predictive nomogram was 0.713，compared with 0.711 for American Joint Committee on Cancer (AJCC) staging system (P=0.794). The result indicated the discriminating value of MSKCC nomogram is similar to AJCC staging system. Calibration plot showed that the actual survival corresponded closely to the probabilities predicted by the MSKCC nomogram. In addition，the MSKCC nomogram prediction suggested the heterogeneity for survival of patients within each AJCC stage. Conclusion    MSKCC nomogram performs well for Chinese patients with colon cancer. The model is a simple and easy tool to make individualized prediction of survival，and may assist both clinician and patients in patient counseling，decision making of treatment options，and follow-up scheduling.

Key words: colon cancer, survival prediction, overall survival rate