Treatment paradigm and prognostic factor analyses of rectal squamous cell carcinoma

Frontiers in Oncology

Oncology

Jin Yan¹  Rui Liu²  Jiahui Zhang³  Yinjie Zhang⁴ 

[1] Department of Clinical Medicine, Southwest Medical University, Luzhou, China;Department of Clinical Medicine, Southwest Medical University, Luzhou, China;Sichuan Cancer Hospital and Institute, Affiliated Cancer Hospital, School of Medicine, University of Electronic Science and Technology, Chengdu, China;Respiratory Department, The First People's Hospital of Ziyang, Ziyang, China;Sichuan Cancer Hospital and Institute, Affiliated Cancer Hospital, School of Medicine, University of Electronic Science and Technology, Chengdu, China;

关键词: rectal cancer (RC);    squamous cell carcinoma;    prognosis;    chemoradiotherapy (CRT);    SEER (surveillance epidemiology and end results) database;   

DOI  :  10.3389/fonc.2023.1160159

 received in 2023-02-06, accepted in 2023-05-02,  发布年份 2023

来源: Frontiers

【 摘 要 】

BackgroundRectal squamous cell carcinoma (rSCC) is a rare pathological subtype of rectal cancer. There is no consensus on the treatment paradigm for patients with rSCC. This study aimed to provide a paradigm for clinical treatment and develop a prognostic nomogram.MethodsPatients diagnosed with rSCC between 2010 and 2019 were identified in the Surveillance, Epidemiology, and End Results (SEER) database. According to the TNM staging system, Kaplan−Meier (K-M) survival analysis was used to identify the survival benefits of different treatments in patients with rSCC. The Cox regression method was used to identify independent prognostic risk factors. Nomograms were evaluated by Harrell’s concordance index (C-index), calibration curves, decision curve analysis (DCA) and K-M curves.ResultsData for 463 patients with rSCC were extracted from the SEER database. Survival analysis showed that there was no significant difference in median cancer-specific survival (CSS) among patients with TNM stage 1 rSCC treated with radiotherapy (RT), chemoradiotherapy (CRT) or surgery (P = 0.285). In TNM stage 2 patients, there was a significant difference in median CSS among those treated with surgery (49.5 months), RT (24 months), and CRT (63 months) (P = 0.003). In TNM stage 3 patients, there was a significant difference in median CSS among those treated with CRT (58 months), CRT plus surgery (56 months) and no treatment (9.5 months) (P < 0.001). In TNM stage 4 patients, there was no significant difference in median CSS among those treated with CRT, chemotherapy (CT), CRT plus surgery and no treatment (P = 0.122). Cox regression analysis showed that age, marital status, T stage, N stage, M stage, PNI, tumor size, RT, CT, and surgery were independent risk factors for CSS. The 1-, 3-, and 5-year C-indexes were 0.877, 0.781, and 0.767, respectively. The calibration curve showed that the model had excellent calibration. The DCA curve showed that the model had excellent clinical application value.ConclusionRT or surgery is recommended for patients with stage 1 rSCC, and CRT is recommended for patients with stage 2, and stage 3 rSCC. Age, marital status, T stage, N stage, M stage, PNI, tumor size, RT, CT, and surgery are independent risk factors for CSS in patients with rSCC. The model based on the above independent risk factors has excellent prediction efficiency.

【 授权许可】

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Copyright © 2023 Liu, Zhang, Zhang and Yan