Abstract
Background: The incidence of colorectal cancer in patients younger than 50 years has been increasing in recent years.Objective: Develop and validate prognostic nomograms predicting overall survival (OS) and cancer-specific survival (CSS) for early-onset locally advanced colon cancer (EOLACC) based on the Surveillance, Epidemiology, and End Results (SEER) database.Results: The entire cohort comprised 13,755 patients with EOLACC. The nomogram predicting OS for EOLACC displayed that T stage contributed the most to prognosis, followed by N stage, regional nodes examined (RNE) and surgery. The nomogram predicting CSS for EOLACC demonstrated similar results. Various methods identified the discriminating superiority of the nomograms. X-tile software was used to classify patients into high-risk, medium-risk, and low-risk according to the risk score of the nomograms. The risk stratification effectively avoided the survival paradox.Conclusions: We established and validated nomograms for predicting OS and CSS based on a national cohort of almost 13,000 EOLACC patients. The nomograms could effectively solve the issue of survival paradox of the AJCC staging system and be an excellent tool to integrate the clinical characteristics to guide the therapeutic choice for EOLACC patients.Methods: Nomograms were constructed based on the SEER database and the Cox regression model.
Highlights
Colorectal cancer ranks as the fourth most frequently diagnosed cancer and the second leading cause of cancer death in the United States [1]
The entire cohort from the SEER database comprised 13,755 patients with histologically confirmed locally advanced colon cancer, who were younger than 50year-old; these were distributed into a training group or a verification group randomly according to the ratio of 2:1
Numerous studies have focused on colon cancer as a whole or even on elderly patients with colon cancer resulting in the fact that the current treatment strategies are tailored for late-onset colon cancer
Summary
Colorectal cancer ranks as the fourth most frequently diagnosed cancer and the second leading cause of cancer death in the United States [1]. The incidence and mortality rates of colorectal cancer have decreased in recent years thanks to the popularity of colonoscopy screening and the advancement of treatment [2]. The incidence of colorectal cancer in patients younger than 50 years has been increasing [3]. It is difficult to advise treatment options for early-onset colorectal cancer because the prognosis of colon cancer among young patients is not www.aging-us.com well known [4]. The incidence of colorectal cancer in patients younger than 50 years has been increasing in recent years. Objective: Develop and validate prognostic nomograms predicting overall survival (OS) and cancer-specific survival (CSS) for early-onset locally advanced colon cancer (EOLACC) based on the Surveillance, Epidemiology, and End Results (SEER) database. Conclusions: We established and validated nomograms for predicting OS and CSS based on a national cohort of almost 13,000 EOLACC patients. Methods: Nomograms were constructed based on the SEER database and the Cox regression model
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