Risk factors, prognostic factors, and nomograms for liver metastasis in stage Tis-T2 colorectal cancer patients from a population-based study

Abstract Liver metastasis(LM) is the primary cause of mortality in patients with colorectal cancer. The incidence of liver metastasis in patients with stage Tis-T2 colorectal cancer is uncommon, and there is limited research available. While nomograms have been increasingly utilized in oncology, the...

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Main Authors: Zejin Lin, Zeyu Lin, Taijun Yi, Yongling Liang, Ziyan Mai, Xingyu Li, Chengrui Zhong, Yunle Wan, Guolin Li
Format: Article
Language:English
Published: Nature Portfolio 2025-04-01
Series:Scientific Reports
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Online Access:https://doi.org/10.1038/s41598-025-99399-6
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author Zejin Lin
Zeyu Lin
Taijun Yi
Yongling Liang
Ziyan Mai
Xingyu Li
Chengrui Zhong
Yunle Wan
Guolin Li
author_facet Zejin Lin
Zeyu Lin
Taijun Yi
Yongling Liang
Ziyan Mai
Xingyu Li
Chengrui Zhong
Yunle Wan
Guolin Li
author_sort Zejin Lin
collection DOAJ
description Abstract Liver metastasis(LM) is the primary cause of mortality in patients with colorectal cancer. The incidence of liver metastasis in patients with stage Tis-T2 colorectal cancer is uncommon, and there is limited research available. While nomograms have been increasingly utilized in oncology, there is a lack of studies focusing on the diagnosis and prognostic assessment of liver metastasis in patients with stage Tis-T2 colorectal cancer. The data of patients with stage Tis-T2 colorectal cancer diagnosed between 2010 and 2015 were extracted from the Surveillance, Epidemiology, and End Results (SEER) database. Univariate and multivariate logistic regression analyses were conducted to identify the independent risk factors for liver metastasis in patients with stage Tis-T2 colorectal cancer. Additionally, both univariate and multivariate Cox proportional hazards regression analyses were performed to determine the independent prognostic factors in patients with stage Tis-T2 colorectal cancer who had liver metastasis. Subsequently, two nomograms were developed and the results were assessed using receiver operating characteristic (ROC) curves, calibration curves, and decision curve analysis (DCA). A total of 11,116 patients diagnosed with stage Tis-T2 colorectal cancer were studied, among whom 190 (1.71%) developed liver metastasis. The identified independent risk factors for liver metastasis in these patients included age, sex, primary tumor size, serum CEA levels, N stage, and histological type. Furthermore, sex, race, primary tumor size, serum CEA levels, and chemotherapy were found to be independent factors influencing the prognosis of patients with stage Tis-T2 colorectal cancer who developed liver metastasis. The accuracy of predicting the risk and prognosis of liver metastasis in these patients was confirmed through various analyses such as ROC curves, calibration curves, DCA curves, and Kaplan-Meier survival curves on both training and validation sets using two nomograms. The two nomograms are considered effective tools for predicting the risk of liver metastasis in patients with stage Tis-T2 colorectal cancer, as well as predicting the prognosis of patients with liver metastasis. These tools can aid in clinical decision-making.
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spelling doaj-art-e9879f35a78b4f1d85c70400d61f58b52025-08-20T01:48:53ZengNature PortfolioScientific Reports2045-23222025-04-0115111510.1038/s41598-025-99399-6Risk factors, prognostic factors, and nomograms for liver metastasis in stage Tis-T2 colorectal cancer patients from a population-based studyZejin Lin0Zeyu Lin1Taijun Yi2Yongling Liang3Ziyan Mai4Xingyu Li5Chengrui Zhong6Yunle Wan7Guolin Li8Department of General Surgery (Hepatobiliary, Pancreatic and Splenic Surgery), The Sixth Affiliated Hospital, Sun Yat-sen UniversityDepartment of General Surgery (Hepatobiliary, Pancreatic and Splenic Surgery), The Sixth Affiliated Hospital, Sun Yat-sen UniversityDepartment of General Surgery (Hepatobiliary, Pancreatic and Splenic Surgery), The Sixth Affiliated Hospital, Sun Yat-sen UniversityDepartment of General Surgery (Hepatobiliary, Pancreatic and Splenic Surgery), The Sixth Affiliated Hospital, Sun Yat-sen UniversityDepartment of General Surgery (Hepatobiliary, Pancreatic and Splenic Surgery), The Sixth Affiliated Hospital, Sun Yat-sen UniversityDepartment of General Surgery (Hepatobiliary, Pancreatic and Splenic Surgery), The Sixth Affiliated Hospital, Sun Yat-sen UniversityDepartment of General Surgery (Hepatobiliary, Pancreatic and Splenic Surgery), The Sixth Affiliated Hospital, Sun Yat-sen UniversityDepartment of General Surgery (Hepatobiliary, Pancreatic and Splenic Surgery), The Sixth Affiliated Hospital, Sun Yat-sen UniversityDepartment of General Surgery (Hepatobiliary, Pancreatic and Splenic Surgery), The Sixth Affiliated Hospital, Sun Yat-sen UniversityAbstract Liver metastasis(LM) is the primary cause of mortality in patients with colorectal cancer. The incidence of liver metastasis in patients with stage Tis-T2 colorectal cancer is uncommon, and there is limited research available. While nomograms have been increasingly utilized in oncology, there is a lack of studies focusing on the diagnosis and prognostic assessment of liver metastasis in patients with stage Tis-T2 colorectal cancer. The data of patients with stage Tis-T2 colorectal cancer diagnosed between 2010 and 2015 were extracted from the Surveillance, Epidemiology, and End Results (SEER) database. Univariate and multivariate logistic regression analyses were conducted to identify the independent risk factors for liver metastasis in patients with stage Tis-T2 colorectal cancer. Additionally, both univariate and multivariate Cox proportional hazards regression analyses were performed to determine the independent prognostic factors in patients with stage Tis-T2 colorectal cancer who had liver metastasis. Subsequently, two nomograms were developed and the results were assessed using receiver operating characteristic (ROC) curves, calibration curves, and decision curve analysis (DCA). A total of 11,116 patients diagnosed with stage Tis-T2 colorectal cancer were studied, among whom 190 (1.71%) developed liver metastasis. The identified independent risk factors for liver metastasis in these patients included age, sex, primary tumor size, serum CEA levels, N stage, and histological type. Furthermore, sex, race, primary tumor size, serum CEA levels, and chemotherapy were found to be independent factors influencing the prognosis of patients with stage Tis-T2 colorectal cancer who developed liver metastasis. The accuracy of predicting the risk and prognosis of liver metastasis in these patients was confirmed through various analyses such as ROC curves, calibration curves, DCA curves, and Kaplan-Meier survival curves on both training and validation sets using two nomograms. The two nomograms are considered effective tools for predicting the risk of liver metastasis in patients with stage Tis-T2 colorectal cancer, as well as predicting the prognosis of patients with liver metastasis. These tools can aid in clinical decision-making.https://doi.org/10.1038/s41598-025-99399-6Colorectal cancerLiver metastasisNomogramRiskPrognosis
spellingShingle Zejin Lin
Zeyu Lin
Taijun Yi
Yongling Liang
Ziyan Mai
Xingyu Li
Chengrui Zhong
Yunle Wan
Guolin Li
Risk factors, prognostic factors, and nomograms for liver metastasis in stage Tis-T2 colorectal cancer patients from a population-based study
Scientific Reports
Colorectal cancer
Liver metastasis
Nomogram
Risk
Prognosis
title Risk factors, prognostic factors, and nomograms for liver metastasis in stage Tis-T2 colorectal cancer patients from a population-based study
title_full Risk factors, prognostic factors, and nomograms for liver metastasis in stage Tis-T2 colorectal cancer patients from a population-based study
title_fullStr Risk factors, prognostic factors, and nomograms for liver metastasis in stage Tis-T2 colorectal cancer patients from a population-based study
title_full_unstemmed Risk factors, prognostic factors, and nomograms for liver metastasis in stage Tis-T2 colorectal cancer patients from a population-based study
title_short Risk factors, prognostic factors, and nomograms for liver metastasis in stage Tis-T2 colorectal cancer patients from a population-based study
title_sort risk factors prognostic factors and nomograms for liver metastasis in stage tis t2 colorectal cancer patients from a population based study
topic Colorectal cancer
Liver metastasis
Nomogram
Risk
Prognosis
url https://doi.org/10.1038/s41598-025-99399-6
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