Work

Evaluation of the utility of a nomogram for predicting lymph node metastasis in T1 colorectal cancer in shared decision-making in clinical practice: a survey-based study

Year: 2025

Type: article

Abstract: PURPOSE: In 2019, we reported a novel nomogram to predict lymph node metastasis (LNM) in T1 colorectal cancer. Herein, we conducted a survey-based study to evaluate the clinical utility of this nomogram in determining the need for additional surgery after endoscopic resection for high-risk T1 colorectal cancer. METHODS: A survey was conducted among 77 members of the Korean Society of Coloproctology and 25 members of the Korean Society of Gastrointestinal Endoscopy. The survey assessed decision-making regarding additional surgery after endoscopic resection for high-risk T1 colorectal cancer according to various predicted LNM rates (3%, 10%, and 27%) and tumor locations (anal verge [AV] 2, 7, and 25 cm). Additionally, participants provided feedback regarding the reliability, usefulness, and potential adoptability of the prediction model in patient counseling. RESULTS: Of the 2,314 surveys distributed, 102 responses were analyzed. A trend was observed in which tumors located closer to the anus and associated with a lower predicted risk of LNM were less likely to lead respondents to opt for surgery (e.g., AV 2 cm and 3% of predicted LNM risk, 21.6% opt for surgery vs. AV 25 cm and 27% of predicted LNM risk, 98.0% opt for surgery). Additionally, 94.1% of the respondents reported that the prediction model would be helpful in clinical decision-making and patient counseling. CONCLUSIONS: Our findings suggest that the nomogram is an effective and reliable tool for guiding treatment strategies and enhancing consultations in patients with T1 colorectal cancer.

Source: Annals of Coloproctology

DOI: 10.3393/ac.2025.00318.0045