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External validation of models predicting the individual risk of metachronous peritoneal carcinomatosis from colon and rectal cancer
Author(s) -
Segelman J.,
Akre O.,
Gustafsson U. O.,
Bottai M.,
Martling A.
Publication year - 2016
Publication title -
colorectal disease
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.029
H-Index - 89
eISSN - 1463-1318
pISSN - 1462-8910
DOI - 10.1111/codi.13219
Subject(s) - medicine , colorectal cancer , concordance , stage (stratigraphy) , oncology , laparotomy , cancer , proportional hazards model , population , surgery , paleontology , environmental health , biology
Aim To externally validate previously published predictive models of the risk of developing metachronous peritoneal carcinomatosis ( PC ) after resection of nonmetastatic colon or rectal cancer and to update the predictive model for colon cancer by adding new prognostic predictors. Method Data from all patients with Stage I–III colorectal cancer identified from a population‐based database in Stockholm between 2008 and 2010 were used. We assessed the concordance between the predicted and observed probabilities of PC and utilized proportional‐hazard regression to update the predictive model for colon cancer. Results When applied to the new validation dataset ( n = 2011), the colon and rectal cancer risk‐score models predicted metachronous PC with a concordance index of 79% and 67%, respectively. After adding the subclasses of pT 3 and pT 4 stage and mucinous tumour to the colon cancer model, the concordance index increased to 82%. Conclusion In validation of external and recent cohorts, the predictive accuracy was strong in colon cancer and moderate in rectal cancer patients. The model can be used to identify high‐risk patients for planned second‐look laparoscopy/laparotomy for possible subsequent cytoreductive surgery and hyperthermic intraperitoneal chemotherapy.