Discussion
tumor, death, colon cancer, AJCC T stage, AJCC N stage
TUMOR, METASTASIS, COLON CANCER, REGRESSION, LIVER METASTASIS, METASTASES
Previous studies investigated prognostic factors and constructed prediction models for colon cancer with distant organ metastases (In this study, we established prediction models for the 1-, 3-, and 5-year prognosis of CCLM based on a mass of clinical samples from the SEER database. Six parameters (i.e., tumor grade, AJCC T stage, AJCC N stage, chemotherapy, CEA, liver metastasis), significantly associated with the OS and CSS of CCLM patients, were incorporated as independent prognostic factors. The analysis showed that patients in tumor grades III–IV had a 62% increased risk of overall death (HR, 1.62) and a nearly 60% increased risk of cancer-specific death (HR, 1.59), in comparison with patients in I–II tumor grades. According to the results of LASSO regression analysis, we excluded the parameter “tumor size,” which probably has certain collinearity with “AJCC T stage.” Furthermore, lymph node metastasis was the common form of CC metastasis. Previous studies had proved that the higher N stage indicated the worse prognosis in metastatic CC patients (Based on the results of the model validation, all the C-indexes and AUCs were more than or close to 0.7 and the proximity of calibration curves for models to the diagonal was excellent, indicating that the models had excellent predictability and accuracy. All the ROC curves of single prognostic factors were under curves of the constructed prediction models, which showed that models had better predictability than any independent risk factor. Furthermore, DCA was recommended in many leading medical journals including Nomogram was used to show and apply our prediction models as a convenient form to predict various clinical outcomes, providing better guidance for CCLM-individualized medical judgement and decision-making (There were still some shortcomings in the present study. First, a mass of data with missing or unclear information were excluded, exacerbating the risk of selection bias. Surgery was a recognized protective factor, and the resection of the primary and metastatic lesions in patients with metastatic CC results in 5-year survival rates of 20%–50% (