Assessing the Therapeutic Value of Primary Tumor Resection in Colorectal Cancer Lung Metastases: A Dynamic Visualization Clinical Tool Constructed Based on the SEER Database.

BACKGROUND

The efficacy of primary tumor resection (PTR) for colorectal cancer lung metastases (CRLM) is unclear. This study used the SEER database to investigate if PTR improves prognosis in CRLM patients and developed a nomogram to predict the likelihood of benefiting from PTR.

METHODS

Patients with CRLM from the SEER database (2010-2019) were included. Propensity score matching (PSM) balanced PTR and non-PTR groups. Kaplan-Meier analysis compared overall and cancer-specific survival. Cox regression identified survival factors. The PTR group was divided into training and validation sets (7:3 ratio) for nomogram development using logistic regression. Nomogram performance was validated using ROC curves, calibration curves, and decision curve analysis.

RESULTS

A total of 3264 CRLM patients were included (2459 with PTR, 805 without). After 1:1 PSM, each group had 484 patients. PTR significantly improved survival (p < 0.001). Logistic regression identified age, race, T-stage, chemotherapy, and metastases to the liver, brain, and bone as risk factors. The nomogram showed excellent predictive performance and clinical utility.

CONCLUSION

PTR improves survival in CRLM patients, and the nomogram effectively predicts the benefit of PTR.