Abstract
BackgroundThis study aimed to develop nomograms for predicting survival in patients with non-metastatic colorectal cancer (CRC).ResultsOn multivariate analyses of the derivation set, the nomograms for OS and CSS shared common significant prognostic factors: age, first-degree relative cancer history, differentiation grade, vessels/nerves invasion, TNM stage, CEA, CA19-9 and PNI. The nomograms displayed good accuracy in predicting OS and CSS, with C-indexes of 0.75 and 0.76, respectively. The calibration plots also showed an excellent agreement between the predicted and observed survival probabilities. Furthermore, the predictive accuracy of the nomograms was confirmed in the validation set, with C-indexes of 0.79 and 0.83 for OS and CSS, respectively.Materials and MethodsOn the basis of data from 822 patients with resected non-metastatic CRC, nomograms for predicting overall survival (OS) and cancer-specific survival (CSS) were established using Cox regression model. The predictive performance of the nomograms was assessed by concordance index (C-index) and calibration plot. An independent external cohort of 171 patients was used to validate the nomograms.ConclusionsWe developed and validated two nomograms for patients with non-metastatic CRC, which could provide individual prediction of OS and CSS with high accuracy.
Highlights
Colorectal cancer (CRC) is the third most frequently diagnosed cancer in males and the second in females, with an estimated 1.4 million new cases and 693,900 deaths worldwide in 2012 [1]
The predictive accuracy of the nomograms was confirmed in the validation set, with C-indexes of 0.79 and 0.83 for overall survival (OS) and cancer-specific survival (CSS), respectively
Some advances have been made in the treatment of colorectal cancer (CRC) over the decades [2, 3], local recurrence and distant metastases continue to be a formidable challenge for clinicians [4]
Summary
Colorectal cancer (CRC) is the third most frequently diagnosed cancer in males and the second in females, with an estimated 1.4 million new cases and 693,900 deaths worldwide in 2012 [1]. Tumornode-metastasis (TNM) staging system is the most basic and prevalent for predicting prognosis of CRC patients undergoing radical surgery, whereas the predictive accuracy is limited, in patients with localized disease [5]. It has been gradually recognized that some other clinical factors could significantly contribute to individual prediction of prognosis, such as age, histology, systemic inflammation and nutritional status [6, 7]. Nomograms for predicting survival in patients with localized CRC have been relatively few to date [12]. We aimed to identify readily available clinical factors most helpful in predicting survival of patients with non-metastatic CRC, and to www.impactjournals.com/oncotarget develop prognostic nomograms that can serve as a useful guide in patient management. This study aimed to develop nomograms for predicting survival in patients with non-metastatic colorectal cancer (CRC)
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