Quantitative contribution of prognosticators to oncologic outcome after rectal cancer resection.
Dis Colon Rectum
; 58(6): 566-74, 2015 Jun.
Article
en En
| MEDLINE
| ID: mdl-25944428
ABSTRACT
BACKGROUND:
Prognostication is an important aspect of medical practice. It relies on statistical modeling testing the correlation of variables with the outcome of interest.OBJECTIVE:
In contrast with the classic approach of predictive modeling, this study aimed to estimate the unique, individual, and relative contributions. This includes the quantitative contributions of patient-, tumor-, and treatment-related factors to oncologic outcome after rectal cancer resection.DESIGN:
This was a retrospective analysis of prospectively registered data. SETTINGS The study included 65 hospitals participating on a voluntary basis in the Project on Cancer of the Rectum, a Belgian multidisciplinary improvement project of rectal cancer care. PATIENTS A total of 1470 patients presenting midrectal or low-rectal adenocarcinoma without distant metastasis were included. INTERVENTION The study intervention was total mesorectal excision with or without sphincter preservation. MAIN OUTCOMEMEASURES:
The unique, individual, and relative contributions of a set of covariables to the statistical variability of the distant metastasis rate and overall survival have been calculated.RESULTS:
The 5-year distant metastasis rate was 21% and overall survival 76%. A large amount of the variability of the outcomes (ie, 83.6% to 84.2%) could not be predicted by the prognostic factors. Unique contributions of the predictors ranged from 0.1% to 3.1%. The 3 risk factors with the highest unique contribution for distant metastasis were lymph node ratio, pathologic tumor stage, and total mesorectal quality; for overall survival they were age, lymph node ratio, and ASA score.LIMITATIONS:
The main weakness of this study was incomplete participation and registration in the Project on Cancer of the Rectum.CONCLUSIONS:
Several factors influence oncologic outcomes and are present in prediction models. However, the models predict relatively little of outcome variation.
Texto completo:
1
Colección:
01-internacional
Asunto principal:
Neoplasias del Recto
/
Adenocarcinoma
Tipo de estudio:
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Límite:
Aged
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Revista:
Dis Colon Rectum
Año:
2015
Tipo del documento:
Article
País de afiliación:
Bélgica