The following is a summary of “Validation of a Clinical Calculator Predicting Freedom From Colon Cancer Recurrence After Surgery on the Basis of Molecular and Clinical Variables,” published in the February 2024 issue of Gastroenterology by Khan, et al.
The Memorial Sloan Kettering clinical calculator was created when microsatellite instability was tested selectively based on patient age, family history, and histologic features. It estimates the likelihood of freedom from colon cancer recurrence based on clinical and molecular variables. If no testing was done, microsatellite stability was thought to be true. For a study, researchers sought to prove the tool worked in a group of patients who had all been checked for microsatellite instability. The study looked at a group of people who had successful surgery for stage I, II, or III colon cancer between 2017 and 2019. Microsatellite trait testing should be done in all cases.
The correlation index and a calibration plot of expected versus real freedom from return 3 years after surgery were used to test how well the computer could predict what would happen. In a second sensitivity study, having one or more tumor deposits (disease category N1c) was thought to be the same as having one positive lymph node (category N1a).
The usual follow-up time for survivors was 32 months, and the correlation score for the 745 patients in the sample was 0.748 (95% CI, 0.693–0.801). A plot of expected versus actual recurrences was close to the 45° vertical, which means the model was good at telling the difference between the two. It was 0.755 (95% CI, 0.700–0.806) in the supplementary sensitivity analysis for tumor deposits. The study had some problems because it was historical and only looked at one school. They can say that these results, based on real rather than assumed microsatellite stability status and tumor deposits, show that the tool is accurate and reliable at making predictions.
