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Predicting Colon Cancer-Specific Survival for the Asian Population Using National Cancer Registry Data from Taiwan

  • Global Health Services Research
  • Published:
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Abstract

Purpose

Colon cancer is the third most incident and life-threatening cancer in Taiwan. A comprehensive survival prediction system would greatly benefit clinical practice in this area. This study was designed to develop an accurate prognostic model for colon cancer patients by using clinicopathological variables obtained from the Taiwan Cancer Registry database.

Methods

We analyzed 20,218 colon cancer patients from the Taiwan Cancer Registry database, who were diagnosed between 2007 and 2015, were followed up until December 31, 2017, and had undergone curative surgery. We proposed two prognostic models, with different combinations of predictors. The first model used only traditional clinical features. The second model included several colon cancer site-specific factors (circumferential resection margin, perineural invasion, obstruction, and perforation), in addition to the traditional features. Both prediction models were developed by using a Cox proportional hazards model. Furthermore, we investigated whether race is a significant predictor of survival in colon cancer patients by using Model 1 on the Surveillance, Epidemiology, and End Results (SEER) cancer registry dataset.

Results

The proposed models displayed a robust prediction performance (all Harrell's c-index >0.8). For both the calibration and validation steps, the differences between the predicted and observed mortality were mostly less than 5%.

Conclusions

The prediction model (Model 1) is an effective predictor of survival regardless of the ethnic background of patients and can potentially help to provide better prediction of colon cancer-specific survival outcomes, thus allowing physicians to improve treatment plans.

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Acknowledgments

This study was supported by the Health Promotion Administration, Ministry of Health and Welfare, grant no. A1081115: Tobacco Health and Welfare Taxation; and the Ministry of Science and Technology, Taiwan, (MOST-106-2314-B-002-134-MY2 and MOST-104-2314-B-002-107-MY2); and the Hammer Family Office. The content of this research may not represent the opinion of the Health Promotion Administration, Ministry of Health and Welfare. The funders had no role in study design, data collection and analysis, the decision to publish, or preparation of the manuscript. The authors thank Melissa Stauffer, PhD, for editing the manuscript.

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Authors and Affiliations

  1. Institute of Epidemiology and Preventive Medicine, Department of Public Health, College of Public Health, National Taiwan University, Taipei, Taiwan

    Han-Ching Chan MS, Ching-Chieh Huang MS, Amrita Chattopadhyay PhD, Wen-Chung Lee MD, PhD, Chun-Ju Chiang PhD, Hsin-Ying Lee MS & Tzu-Pin Lu PhD

  2. Department of Public Health, College of Public Health, National Taiwan University, Taipei, Taiwan

    Chi-Cheng Huang MD, PhD & Kuan-Hung Yeh BS

  3. Division of General Surgery, Department of Surgery, Taipei Veterans General Hospital, Taipei, Taiwan

    Chi-Cheng Huang MD, PhD

  4. Taiwan Cancer Registry, Taipei, Taiwan

    Wen-Chung Lee MD, PhD & Chun-Ju Chiang PhD

  5. Department of Radiation Oncology, Koo Foundation Sun Yat-Sen Cancer Center, Taipei, Taiwan

    Skye Hung-Chun Cheng MD

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  1. Han-Ching Chan MS
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Correspondence to Tzu-Pin Lu PhD.

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Chan, HC., Huang, CC., Huang, CC. et al. Predicting Colon Cancer-Specific Survival for the Asian Population Using National Cancer Registry Data from Taiwan. Ann Surg Oncol 29, 853–863 (2022). https://doi.org/10.1245/s10434-021-10646-2

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