Abstract
Purpose: Nomogram is a widely used tool that precisely predicts individualized cancer prognoses. We aimed to develop and validate a reliable nomogram including serum tumor biomarkers to predict individual overall survival (OS) for patients with resected rectal cancer (RC) and compare the predictive value with the American Joint Committee on Cancer (AJCC) stages.Patients and methods: We analyzed 520 patients who were diagnosed with non-metastatic rectal cancer as training cohort. External validation was performed in a cohort of 11851 patients from the Surveillance, Epidemiology, and End Results (SEER) database. Independent prognostic factors were identified and integrated to build a nomogram using the Cox proportional hazard regression model. The nomogram was evaluated by Harrell’s concordance index (C-index) and calibration plots in both training and validation cohort.Results: The calibration curves for probability of 1-, 3-, and 5-year OS in both cohorts showed favorable accordance between the nomogram prediction and the actual observation. The C-indices of the nomograms to predict OS were 0.71 in training cohort and 0.69 in the SEER cohort, which were higher than that of the seventh edition American Joint Committee on Cancer TNM staging system for predicting OS (training cohort, 0.71 vs. 0.58, respectively; P-value < 0.001; validation cohort, 0.69 vs. 0.57, respectively; P-value < 0.001).Conclusion: We developed and validated a novel nomogram based on CEA and other factors for predicting OS in patients with resected RC, which could assist clinical decision making and improvement of prognosis prediction for individual RC patients after surgery.
Highlights
Colorectal cancer (CRC) is the fourth most common cancer and ranks second in terms of mortality in the United States [1]
Favorable long-term survival and a better quality of life after a curative resection are usually achieved in patients with non-metastatic rectal cancer (RC) [4]; distant metastases and local recurrences that result in poor survival still remain the primary concerns in this entity [5]
Our results indicated the profile of carcinoembryonic antigen (CEA) and cancer antigen 19-9 (CA19-9) undergone profound changes before and after surgery in RC patients
Summary
Colorectal cancer (CRC) is the fourth most common cancer and ranks second in terms of mortality in the United States [1]. In 2018, it is estimated that more than 1.8 million new cases of colorectal cancer and 881,000 deaths occurred in the world, accounting for approximately 10% cancer cases and deaths [2]. According to the latest data released by the National Cancer Center, there were 370,000 new cases of colorectal cancer in China in 2015, accounting for 26% of the world. The incidence and mortality were 28 and 13.61 per 100,000, ranking third and fifth among all malignant tumors, respectively [3]. The tumor, node, metastasis (TNM) staging system is a widely used cancer staging system for predicting the prognosis and determining the appropriate treatment strategy.
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
