ObjectiveTo analyze the relation between age and postoperative pathological features of patients with colorectal cancer from Database from Colorectal Cancerr （DACCA）. MethodsThe data in DACCA were updated on January 5, 2022. The patients were selected from DACCA according to the established screening conditions, then were divided into ≤35, 35–59, and ≥60 years old groups. The differences of postoperative pathological （p） TNM （pTNM）, pT, pN, pM stages, perineural invasion （PNI）, high-risk factors grade, and tumor regression grade （TRG） among the three age groups were analyzed, and the correlation between them was analyzed. ResultsAfter screening, 5 628 data rows were enrolled, of whom 196 patients were <35 years old, 2 382 patients were 35–59 years old, and 3 050 patients were >59 years old. Statistical analysis showed that: ① There were statistical differences in the proportions of pN stage, PNI, and high-risk factors grade in the patients of different age groups （H=27.867, P<0.001; H=6.248, P=0.044; H=19.712, P<0.001, respectively）; However, it was not found that there were statistical differences in the proportions of pTNM, pT, pM stages, and TRG after neoadjuvant therapy among different age patients （H=0.920, P=0.631; H=4.923, P=0.085; H=2.272, P=0.321; H=2.337, P=0.311, respectively）. The Spearman correlation analysis results showed that there was a weakly negative correlation between the age and pN stage or grade of high-risk factors （rs=–0.070, P<0.001; rs=–0.067, P<0.001, respectively） and a weakly positive correlation between age and TRG after neoadjuvant therapy （rs=0.100, P=0.009）. ConclusionDACCA data analysis finds that patients of different age groups shows a negative correlation trend with pN stage or grade of high-risk factors and a positive correlation trend with TRG, which needs to be further verified.
ObjectiveTo develop a nomogram prediction model for predicting the objective response rate (ORR) in patients with unresectable hepatocellular carcinoma (uHCC) receiving transarterial chemoembolization (TACE) combined with targeted therapy and immunotherapy. MethodsClinicopathological data of uHCC patients treated with TACE combined with targeted therapy and immunotherapy at Leshan People’s Hospital from January 2018 to November 2023 were collected. Patients were randomly divided into a training set and a validation set at a 7∶3 ratio. Univariate and multivariate logistic regression analyses were used to identify independent risk factors for ORR. Variables with P<0.05 in the multivariate analysis, together with clinically important factors [such as Eastern Cooperative Oncology Group performance status (ECOG PS) score and portal vein tumor thrombus (PVTT)], were incorporated into the nomogram model. Model performance and clinical utility were assessed using the area under the receiver operating characteristic curve (AUC), concordance index (C-index), calibration curves, and decision curve analysis. ResultsA total of 105 patients with uHCC were enrolled, including 73 in the training set and 32 in the validation set. Multivariate logistic regression analysis identified alpha-fetoprotein (AFP), Barcelona Clinic Liver Cancer (BCLC) stage, and prothrombin time (PT) as independent predictors of ORR (P<0.05). The nomogram incorporating these factors along with ECOG PS score and PVTT achieved AUCs (95%CI) of 0.81 (0.71, 0.91) in the training set and 0.80 (0.64, 0.96) in the validation set. Bootstrap internal validation (1 000 resamples) yielded a mean C-index (95%CI) of 0.76 (0.63, 0.89). The Hosmer-Lemeshow test indicated good model fit (training set: χ2=5.64, P=0.58; validation set: χ2=3.89, P=0.69), and calibration curves showed close alignment with the ideal diagonal in both sets. Decision curve analysis demonstrated positive net clinical benefit within threshold probability ranges of 0.02–0.78 (training set) and 0.10–0.80 (validation set). ConclusionThe nomogram prediction model based on AFP, BCLC stage, PT, ECOG PS score, and PVTT effectively predicts ORR in uHCC patients receiving TACE combined with targeted therapy and immunotherapy, providing a reference for individualized treatment decisions.
