Abstract:
Objective To investigate survival and prognostic risk factors in patients with metastatic colorectal cancer and then construct and validate a prognostic risk prediction score.
Methods Patients who were diagnosed with metastatic colorectal cancer between 2010 and 2015 in the Surveillance, Epidemiology, and End Results (SEER) cohort were included in this study. Kaplan–Meier analysis was used to calculate the survival rate and multivariable Cox regression analysis was used to investigate prognostic risk factors for metastatic colorectal cancer. A prognostic risk prediction score based on the above prognostic factors was constructed, and the score was validated internally. Moreover, external validation was carried out among patients diagnosed with metastatic colorectal cancer in 2016.
Results A total of 37,092 patients with metastatic colorectal cancer were included, with a 5-year survival rate of 10.6%. Advanced age; Black patients; lower differentiation grade; higher T and N stages; higher levels of carcinoembryonic antigen;and bone, brain, liver, and lung metastasis were risk factors for overall survival. Female sex, married status, insurance status, left-sided colon cancer, and surgery of the primary site were protective factors against mortality. The validation results showed that the prognostic risk prediction score has high reproducibility and external application.
Conclusions The prognosis of patients with metastatic colorectal cancer is relatively poor. The present risk prediction score, established based on prognostic risk factors, could accurately predict overall survival in patients with metastatic colorectal cancer. The use of the established risk score may help physicians to tailor individualized treatment programs and improve the survival rate in this patient population.
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