One-year mortality of colorectal cancer patients: development and validation of a prediction model using linked national electronic data
Menée à partir de données anglaises et galloises portant au total sur 57 705 patients atteints d'un cancer colorectal, cette étude évalue la performance d'un modèle, basé sur des variables clinico-pathologiques (âge, genre, statut socioéconomique, localisation et stade de la tumeur, ...), pour prédire le risque de décès dans les 90, 180 et 365 jours après le diagnostic
Background: The existing literature does not provide a prediction model for mortality of all colorectal cancer patients using contemporary national hospital data. We developed and validated such a model to predict colorectal cancer death within 90, 180 and 365 days after diagnosis.
Methods: Cohort study using linked national cancer and death records. The development population included 27,480 patients diagnosed in England in 2015. The test populations were diagnosed in England in 2016 (n = 26,411) and Wales in 2015–2016 (n = 3814). Predictors were age, gender, socioeconomic status, referral source, performance status, tumour site, TNM stage and treatment intent. Cox regression models were assessed using Brier scores, c-indices and calibration plots.
Results: In the development population, 7.4, 11.7 and 17.9% of patients died from colorectal cancer within 90, 180 and 365 days after diagnosis. T4 versus T1 tumour stage had the largest adjusted association with the outcome (HR 4.67; 95% CI: 3.59–6.09). C-indices were 0.873–0.890 (England) and 0.856–0.873 (Wales) in the test populations, indicating excellent separation of predicted risks by outcome status. Models were generally well calibrated.
Conclusions: The model was valid for predicting short-term colorectal cancer mortality. It can provide personalised information to support clinical practice and research.
British Journal of Cancer , résumé, 2020