Background
Methods
Study population
Data collection
Statistical analysis
Results
Clinical characteristics of patients in the training and testing sets
Characteristics | Category | Training set (n = 2409) | Testing set (n = 1605) | P value |
---|---|---|---|---|
Age (year) a,b | / | 59.4 (11.69) | 59.0 (11.55) | 0.368 |
< 60 | 1219 (50.6) | 826 (51.5) | 0.615 | |
≥ 60 | 1190 (49.4) | 779 (48.5) | ||
Gender b | Male | 1436 (59.6) | 945 (58.9) | 0.668 |
Female | 973 (40.4) | 660 (41.1) | ||
BMI (kg/m2) b | < 24 | 1401 (58.2) | 915 (57.0) | 0.517 |
≥ 24 | 1008 (41.8) | 690 (43.0) | ||
Tumor location b | Colon | 1140 (47.3) | 751 (46.8) | 0.766 |
Rectum | 1269 (52.7) | 854 (53.2) | ||
Tumor diameter b | < 50 mm | 968 (40.2) | 681 (42.4) | 0.152 |
≥ 50 mm | 1441 (59.8) | 924 (57.6) | ||
Pathological classification b | Prominence | 1570 (65.2) | 1080 (67.3) | 0.379 |
Infiltration or ulceration | 253 (10.5) | 160 (10.0) | ||
Infiltration and ulceration | 586 (24.3) | 365 (22.7) | ||
Differentiation degree b | Well | 189 (7.8) | 130 (8.1) | 0.630 |
Moderate | 1861 (77.3) | 1253 (78.1) | ||
Poor | 359 (14.9) | 222 (13.8) | ||
Histologic classification b | Adenocarcinoma | 1819 (75.5) | 1213 (75.6) | 0.991 |
Mucinous adenocarcinoma + signet ring cell carcinoma | 590 (24.5) | 392 (24.4) | ||
TNM staging b | II | 1384 (57.5) | 922 (57.4) | 1.000 |
III | 1025 (42.5) | 683 (42.6) | ||
AJCC staging II b | IIA | 567 (41.0) | 379 (41.1) | 0.357 |
IIB | 94 (6.8) | 78 (8.5) | ||
IIC | 723 (52.2) | 465 (50.4) | ||
AJCC staging III b | IIIA | 70 (6.8) | 52 (7.6) | 0.354 |
IIIB | 423 (41.3) | 306 (44.8) | ||
IIIC | 532 (51.9) | 325 (47.6) | ||
Tumor invasion b | T1-T3 | 1061 (44.0) | 733 (45.7) | 0.326 |
T4 | 1348 (56.0) | 872 (54.3) | ||
Lymph nodes involved b | N0 | 1384 (57.5) | 922 (57.4) | 1.000 |
N1-N2 | 1025 (42.5) | 683 (42.6) | ||
Tumor deposits b | No | 2250 (93.4) | 1482 (92.3) | 0.219 |
Yes | 159 (6.6) | 123 (7.7) | ||
CEA b | < 5 ng/mL | 1417 (58.8) | 936 (58.3) | 0.830 |
≥ 5 ng/mL | 992 (41.2) | 669 (41.7) | ||
CA19-9 b | < 37U/mL | 2020 (83.9) | 1347 (83.9) | 0.872 |
≥ 37U/mL | 389 (16.1) | 258 (16.1) | ||
Postoperative chemotherapy b | No | 1416 (58.8) | 908 (56.6) | 0.176 |
Yes | 993 (41.2) | 697 (43.4) | ||
Postoperative radiotherapy b | No | 2296 (95.3) | 1541 (96.0) | 0.325 |
Yes | 113 (4.7) | 64 (4.0) | ||
HBs-Ag b | Negative | 2294 (95.2) | 1519 (94.6) | 0.449 |
Positive | 115 (4.8) | 86 (5.4) | ||
HCV-Ab b | Negative | 2383 (98.9) | 1590 (99.1) | 0.775 |
Positive | 26 (1.1) | 15 (0.9) | ||
Lactate dehydrogenase (U/L) c | / | 145.20 (127.00–167.00) | 145.00 (126.25–166.00) | 0.504 |
Alkaline phosphatase (U/L) c | / | 85.00 (71.10–100.05) | 85.00 (71.00–100.30) | 0.729 |
De Ritis ratio c | / | 0.74 (0.56–1.13) | 0.80 (0.56–1.16) | 0.073 |
APRI c | / | 0.07 (0.05–0.10) | 0.07 (0.05–0.10) | 0.318 |
ALRI c | / | 9.57 (7.11–13.45) | 9.42 (6.96–13.25) | 0.400 |
ANRI c | / | 4.77 (3.41–6.98) | 4.82 (3.39–6.90) | 0.996 |
APPRI c | / | 0.34 (0.26–0.44) | 0.34 (0.27–0.43) | 0.806 |
Determination of the optimal cut-off value
Identification of independent predictors associated with the prognosis of patients with stage II/III CRC
Training set | Testing set | |||||||
---|---|---|---|---|---|---|---|---|
Univariate analysis | Multivariate analysis | Univariate analysis | Multivariate analysis | |||||
HR (95% CI) | P value | HR (95% CI) | P value | HR (95% CI) | P value | HR (95% CI) | P value | |
Age (≥ 60 vs < 60) | 1.702 (1.470–1.971) | < 0.001 | 1.510 (1.296–1.758) | < 0.001 | 1.540 (1.284–1.847) | < 0.001 | 1.477 (1.224–1.783) | < 0.001 |
Male (vs Female) | 1.109 (0.957–1.285) | 0.170 | 1.229 (1.057–1.427) | 0.007 | 1.295 (1.074–1.563) | 0.007 | 1.412 (1.167–1.709) | < 0.001 |
Rectum (vs Colon) | 1.289 (1.115–1.490) | 0.001 | 1.275 (1.092–1.487) | 0.002 | 1.336 (1.113–1.604) | 0.002 | 1.200 (0.991–1.452) | 0.061 |
Tumor diameter (≥ 50 mm vs < 50 mm) | 1.309 (1.122–1.528) | 0.001 | 1.279 (1.090–1.501) | 0.003 | 1.197 (0.994–1.443) | 0.059 | 1.067 (0.879–1.295) | 0.514 |
Pathological classification | ||||||||
Infiltration or Ulceration (vs Prominence) | 1.878 (1.507–2.342) | < 0.001 | 1.746 (1.396–2.184) | < 0.001 | 1.168 (0.869–1.571) | 0.304 | 1.017 (0.754–1.372) | 0.913 |
Infiltration and Ulceration (vs Prominence) | 1.963 (1.677–2.298) | < 0.001 | 1.729 (1.473–2.029) | < 0.001 | 1.125 (0.907–1.395) | 0.284 | 1.020 (0.818–1.271) | 0.863 |
Differentiation degree | ||||||||
Moderate (vs Well) | 2.436 (1.720–3.449) | 0.023 | 1.274 (0.923–1.759) | 0.141 | 1.963 (1.237–3.116) | 0.004 | 1.799 (1.131–2.861) | 0.013 |
Poor (vs Well) | 1.453 (1.054–2.003) | < 0.001 | 1.931 (1.359–2.745) | < 0.001 | 3.637 (2.226–5.943) | < 0.001 | 2.828 (1.723–4.641) | < 0.001 |
Mucinous adenocarcinoma or signet ring cell carcinoma (vs Adenocarcinoma) | 1.162 (0.987–1.368) | 0.072 | 1.197 (1.013–1.415) | 0.034 | 1.191 (0.973–1.459) | 0.091 | 1.112 (0.901–1.371) | 0.323 |
TNM stage III (vs stage II) | 2.335 (2.018–2.703) | < 0.001 | 2.201 (1.890–2.564) | < 0.001 | 2.640 (2.193–3.177) | < 0.001 | 2.442 (2.007–2.972) | < 0.001 |
CEA (≥ 5 ng/mL vs < 5 ng/mL) | 1.528 (1.323–1.765) | < 0.001 | 1.231 (1.056–1.435) | 0.008 | 2.006 (1.659–2.426) | < 0.001 | 1.537 (1.253–1.886) | < 0.001 |
CA19-9 (≥ 37U/mL vs < 37U/mL) | 2.001 (1.686–2.374) | < 0.001 | 1.541 (1.283–1.849) | < 0.001 | 2.519 (2.049–3.097) | < 0.001 | 1.896 (1.512–2.377) | < 0.001 |
Postoperative chemotherapy (Yes vs No) | 0.640 (0.549–0.745) | < 0.001 | 0.582 (0.495–0.685) | < 0.001 | 0.774 (0.644–0.931) | 0.006 | 0.630 (0.517–0.768) | < 0.001 |
Postoperative radiotherapy (Yes vs No) | 1.675 (1.260–2.227) | < 0.001 | 1.686 (1.254–2.268) | 0.001 | 2.310 (1.636–3.261) | < 0.001 | 2.208 (1.542–3.162) | < 0.001 |
HBs-Ag (Positive vs Negative) | 0.793 (0.550–1.143) | 0.213 | - | - | 1.184 (0.818–1.714) | 0.371 | - | - |
HCV-Ab (Positive vs Negative) | 1.521 (0.860–2.691) | 0.150 | - | - | 0.645 (0.207–2.006) | 0.448 | - | - |
Lactate dehydrogenase (> 191 vs ≤ 191) | 1.203 (0.956–1.513) | 0.115 | 1.189 (0.942–1.501) | 0.145 | 1.506 (1.142–1.987) | 0.004 | 1.526 (1.154–2.019) | 0.003 |
Alkaline phosphatase (> 102 vs ≤ 102) | 1.210 (1.026–1.426) | 0.023 | 1.215 (1.029–1.435) | 0.022 | 1.244 (1.014–1.527) | 0.036 | 1.139 (0.923–1.405) | 0.227 |
De Ritis ratio (> 1.52 vs ≤ 1.52) | 1.326 (1.072–1.640) | 0.009 | 1.269 (1.020–1.579) | 0.033 | 1.370 (1.057–1.774) | 0.017 | 1.513 (1.160–1.973) | 0.002 |
APRI (> 0.12 vs ≤ 0.12) | 1.049 (0.860–1.278) | 0.639 | 1.090 (0.890–1.335) | 0.403 | 1.142 (0.903–1.446) | 0.268 | 1.089 (0.858–1.381) | 0.485 |
ALRI (> 7.50 vs ≤ 7.50) | 1.306 (1.104–1.544) | 0.002 | 1.314 (1.109–1.555) | 0.002 | 1.083 (0.889–1.318) | 0.428 | 1.114 (0.913–1.359) | 0.286 |
ANRI (> 3.18 vs ≤ 3.18) | 0.880 (0.741–1.044) | 0.143 | 0.897 (0.753–1.069) | 0.226 | 0.886 (0.716–1.097) | 0.268 | 0.918 (0.737–1.142) | 0.442 |
APPRI (> 0.46 vs ≤ 0.46) | 1.075 (0.905–1.278) | 0.409 | 1.027 (0.861–1.224) | 0.769 | 1.162 (0.934–1.447) | 0.178 | 1.015 (0.812–1.269) | 0.898 |
Training set | Testing set | |||||||
---|---|---|---|---|---|---|---|---|
Univariate analysis | Multivariate analysis | Univariate analysis | Multivariate analysis | |||||
HR (95% CI) | P value | HR (95% CI) | P value | HR (95% CI) | P value | HR (95% CI) | P value | |
Age (≥ 60 vs < 60) | 1.238 (1.053–1.456) | 0.010 | 1.291 (1.090–1.528) | 0.003 | 1.059 (0.870–1.290) | 0.567 | 1.197 (0.974–1.472) | 0.088 |
Male (vs Female) | 1.083 (0.917–1.279) | 0.344 | 1.152 (0.975–1.362) | 0.098 | 1.274 (1.037–1.565) | 0.021 | 1.328 (1.076–1.639) | 0.008 |
Rectum (vs Colon) | 1.517 (1.284–1.792) | < 0.001 | 1.477 (1.236–1.763) | < 0.001 | 1.852 (1.503–2.281) | < 0.001 | 1.642 (1.317–2.047) | < 0.001 |
Tumor diameter (≥ 50 mm vs < 50 mm) | 1.265 (1.066–1.502) | 0.007 | 1.272 (1.067–1.517) | 0.007 | 1.173 (0.954–1.441) | 0.129 | 1.129 (0.911–1.400) | 0.268 |
Pathological classification | ||||||||
Infiltration or Ulceration (vs Prominence) | 1.781 (1.390–2.281) | < 0.001 | 1.719 (1.337–2.211) | < 0.001 | 1.299 (0.949–1.779) | 0.102 | 1.171 (0.852–1.610) | 0.330 |
Infiltration and Ulceration (vs Prominence) | 1.779 (1.486–2.130) | < 0.001 | 1.611 (1.341–1.935) | < 0.001 | 1.214 (0.961–1.535) | 0.104 | 1.079 (0.850–1.371) | 0.532 |
Differentiation degree | ||||||||
Moderate (vs Well) | 0.568 (0.396–0.816) | 0.002 | 1.017 (0.734–1.409) | 0.919 | 0.308 (0.185–0.515) | < 0.001 | 1.661 (1.029–2.681) | 0.038 |
Poor (vs Well) | 0.654 (0.531–0.805) | < 0.001 | 1.379 (0.956–1.990) | 0.086 | 0.560 (0.437–0.718) | < 0.001 | 2.322 (1.386–3.890) | 0.001 |
Mucinous adenocarcinoma or signet ring cell carcinoma (vs Adenocarcinoma) | 1.149 (0.956–1.381) | 0.140 | 1.157 (0.958–1.397) | 0.129 | 1.036 (0.824–1.302) | 0.764 | 1.018 (0.803–1.291) | 0.880 |
TNM stage III (vs stage II) | 2.457 (2.083–2.898) | < 0.001 | 2.034 (1.713–2.415) | < 0.001 | 3.133 (2.548–3.852) | < 0.001 | 2.461 (1.978–3.061) | < 0.001 |
CEA (≥ 5 ng/mL vs < 5 ng/mL) | 1.343 (1.141–1.581) | < 0.001 | 1.107 (0.929–1.319) | 0.257 | 1.903 (1.534–2.361) | < 0.001 | 1.554 (1.238–1.950) | < 0.001 |
CA19-9 (≥ 37U/mL vs < 37U/mL) | 1.901 (1.565–2.310) | < 0.001 | 1.553 (1.258–1.919) | < 0.001 | 2.227 (1.762–2.815) | < 0.001 | 1.820 (1.413–2.343) | < 0.001 |
Postoperative chemotherapy (Yes vs No) | 1.234 (1.049–1.451) | 0.011 | 1.094 (0.920–1.302) | 0.310 | 1.364 (1.120–1.662) | 0.002 | 1.103 (0.892–1.365) | 0.366 |
Postoperative radiotherapy (Yes vs No) | 2.776 (2.121–3.635) | < 0.001 | 2.123 (1.595–2.824) | < 0.001 | 4.256 (3.088–5.867) | < 0.001 | 3.008 (2.131–4.246) | < 0.001 |
HBs-Ag (Positive vs Negative) | 1.006 (0.692–1.461) | 0.976 | - | - | 1.272 (0.860–1.880) | 0.228 | - | - |
HCV-Ab (Positive vs Negative) | 0.933 (0.417–2.085) | 0.866 | - | - | 1.266 (0.524–3.059) | 0.600 | - | - |
Lactate dehydrogenase (> 191 vs ≤ 191) | 1.172 (0.904–1.519) | 0.231 | 1.118 (0.859–1.455) | 0.408 | 1.343 (0.982–1.838) | 0.065 | 1.395 (1.016–1.915) | 0.039 |
Alkaline phosphatase (> 102 vs ≤ 102) | 1.275 (1.061–1.532) | 0.009 | 1.282 (1.065–1.543) | 0.009 | 1.041 (0.824–1.316) | 0.734 | 0.995 (0.783–1.265) | 0.970 |
De Ritis ratio (> 1.52 vs ≤ 1.52) | 1.327 (1.046–1.685) | 0.020 | 1.364 (1.068–1.743) | 0.013 | 1.254 (1.004–1.615) | 0.045 | 1.470 (1.094–1.975) | 0.011 |
APRI (> 0.12 vs ≤ 0.12) | 1.084 (0.870–1.352) | 0.473 | 1.077 (0.860–1.349) | 0.519 | 1.092 (0.841–1.418) | 0.510 | 1.058 (0.812–1.378) | 0.677 |
ALRI (> 7.50 vs ≤ 7.50) | 1.180 (0.981–1.418) | 0.079 | 1.168 (0.970–1.406) | 0.101 | 1.000 (0.809–1.236) | 0.998 | 1.019 (0.823–1.263) | 0.860 |
ANRI (> 3.18 vs ≤ 3.18) | 0.844 (0.697–1.022) | 0.083 | 0.832 (0.684–1.011) | 0.065 | 0.773 (0.617–0.969) | 0.025 | 0.745 (0.590–0.940) | 0.013 |
APPRI (> 0.46 vs ≤ 0.46) | 1.174 (0.972–1.419) | 0.096 | 1.147 (0.946–1.390) | 0.163 | 1.137 (0.892–1.448) | 0.300 | 1.023 (0.799–0.310) | 0.859 |