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A clinical prediction model for the presence of brain metastases from colorectal cancer

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International Journal of Colorectal Disease Aims and scope Submit manuscript

Abstract

Background

We conducted this study to explore clinicopathological profiles of brain metastases (BM) and establish a clinical prediction model that predicts the presence of BM in colorectal cancer (CRC) patients.

Methods

Patients with initially diagnosed CRC were reviewed between the year 2010 and 2015. Multiple imputations are used for handling missing values. Prognostic factors were identified by the univariate and multivariate Cox regression model. Univariate and multivariate logistic regression was used to identify the predictive factors for the presence of BM. A nomogram was constructed based on statistically significant risk factors of the presence of BM. The decision curve analysis (DCA) was used to assess the clinical usefulness and net benefits of the nomogram for the presence of BM.

Results

Four hundred ninety-five patients with brain metastasis at the initial diagnosis were identified, representing 0.24% of the whole cohort and 0.91% of the metastatic cohort. Multivariable logistic regression demonstrated that young age, positive CEA, adenocarcinoma, lower differentiated grade, presence of liver metastases, presence of lung metastases, and presence of bone metastases were significantly associated with higher risk of developing BM. The decision curve analysis inform clinical decisions were better than a scenario in which all patients or no patients are screened across a wide range of threshold at ≥ 0.027%.

Conclusions

The risk estimates provided by the nomogram can be extremely useful for earlier diagnosis, especially when discussing screening strategy among high-risk patients.

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Data availability

I declare the data from this study are available.

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Author notes

  1. Xiaoqin Ge and Dan Li contributed equally to this work.

Authors and Affiliations

  1. Department of Medical Oncology, Ningbo First Hospital, Zhejiang, 315000, Ningbo, China

    Xiaoqin Ge, Xiaoxian Ye & Ruishuang Ma

  2. Department of Medical Oncology, The Second Affiliated Hospital, Zhejiang University School of Medicine, 88 Jiefang Road, Zhejiang, 310000, Hangzhou, China

    Dan Li & Ying Yuan

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  1. Xiaoqin Ge
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  2. Dan Li
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Contributions

Xiaoqin Ge and Dan Li wrote the main manuscript text, and Xiaoxian Ye and Ruishuang Ma prepared figures. Ying Yuan designed the research and revised the manuscript. All authors reviewed the manuscript.

Corresponding author

Correspondence to Ying Yuan.

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Appendix

Appendix

Table 4 Point assignment and predictive scores in the nomogram
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Fig. 5
figure 5

Calibration curve for estimating the predictive accuracy for brain metastases of the nomogram

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Ge, X., Li, D., Ye, X. et al. A clinical prediction model for the presence of brain metastases from colorectal cancer. Int J Colorectal Dis 37, 2469–2480 (2022). https://doi.org/10.1007/s00384-022-04289-2

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