BACKGROUND Colorectal cancer(CRC)recurrence within a year post-surgery poses significant challenges for stage II/III patients.Few models currently predict this early recu-rrence with multi-dimensional considerations f...BACKGROUND Colorectal cancer(CRC)recurrence within a year post-surgery poses significant challenges for stage II/III patients.Few models currently predict this early recu-rrence with multi-dimensional considerations for risk stratification.AIM To develop a model for predicting the risk of recurrence within one year after sur-gery in patients with stage II/III CRC.METHODS We conducted a retrospective cohort study at Zhejiang Provincial Hospital of Chinese Medicine,including 349 stage II/III CRC patients.Clinical data were collected,and the dataset was randomly divided into training(n=244)and testing(n=105)sets.Univariate and multivariate logistic regression analyses identified risk factors for postoperative recurrence.Then a nomogram model was constructed and evaluated via receiver operating characteristic curves,calibration curves and decision curve analysis.RESULTS During the one-year follow-up,10.9%(38/349)of patients experienced recurrence.Univariate analysis identified tumor size,lymph node metastasis(N2 stage),neutrophil-to-lymphocyte ratio,platelet-to-lymphocyte ratio,fatigue,and appetite loss as significant correlates of recurrence.Multivariate logistic regression con-firmed N2 stage,appetite loss,tumor size,and neutrophil-to-lymphocyte ratio as independent risk factors.The nomogram model showed excellent performance.The area under the receiver operating characteristic was 0.98(95%confidence interval:0.97-1.00)in training set and 0.91(95%confidence interval:0.84-0.97)in testing set.The decision curve analysis curves showed strong concordance between predicted and observed recurrence probabilities.CONCLUSION The model effectively predicts early postoperative recurrence in stage II/III CRC,integrating clinical,inflam-matory,and symptomatic factors.展开更多
文摘BACKGROUND Colorectal cancer(CRC)recurrence within a year post-surgery poses significant challenges for stage II/III patients.Few models currently predict this early recu-rrence with multi-dimensional considerations for risk stratification.AIM To develop a model for predicting the risk of recurrence within one year after sur-gery in patients with stage II/III CRC.METHODS We conducted a retrospective cohort study at Zhejiang Provincial Hospital of Chinese Medicine,including 349 stage II/III CRC patients.Clinical data were collected,and the dataset was randomly divided into training(n=244)and testing(n=105)sets.Univariate and multivariate logistic regression analyses identified risk factors for postoperative recurrence.Then a nomogram model was constructed and evaluated via receiver operating characteristic curves,calibration curves and decision curve analysis.RESULTS During the one-year follow-up,10.9%(38/349)of patients experienced recurrence.Univariate analysis identified tumor size,lymph node metastasis(N2 stage),neutrophil-to-lymphocyte ratio,platelet-to-lymphocyte ratio,fatigue,and appetite loss as significant correlates of recurrence.Multivariate logistic regression con-firmed N2 stage,appetite loss,tumor size,and neutrophil-to-lymphocyte ratio as independent risk factors.The nomogram model showed excellent performance.The area under the receiver operating characteristic was 0.98(95%confidence interval:0.97-1.00)in training set and 0.91(95%confidence interval:0.84-0.97)in testing set.The decision curve analysis curves showed strong concordance between predicted and observed recurrence probabilities.CONCLUSION The model effectively predicts early postoperative recurrence in stage II/III CRC,integrating clinical,inflam-matory,and symptomatic factors.
