Establishment and validation of a postoperative prognosis nomogram for early-onset stage Ⅲ colorectal cancer
YAO Jianan
GE Xianxiu
PENG Anyi
LIU Lei
HU Chenyue
MIAO Lin
Abstract：Objective To construct a prognostic nomogram for stage Ⅲ early-onset colorectal cancer(EOCRC)and provide recommendations for treatment decision-making.Method Based on the Surveillance,Epidemiology,and End Results(SEER)database,a retrospective analysis was conducted on the data of 3054 EOCRC patients who underwent surgical treatment from 2010 to 2015.These patients were divided into a training set and a validation set at a 7∶3 ratio.Meanwhile,104 EOCRC patients diagnosed at the Second Affiliated Hospital of Nanjing Medical University from 2010 to 2020 were selected as external validation.Cox regression analysis was used to screen independent factors affecting overall survival(OS),and further a nomogram was constructed.The value of the prognostic model was evaluated using C-index,receiver operating characteristic(ROC)curve,calibration chart,and decision curve analysis(DCA).Results A total of 3158 patients with stage Ⅲ EOCRC were enrolled,including 2138 in the training cohort,916 in the internal validation cohort,and 104 in the external validation cohort.Cox multivariate analysis showed that pathological grading,T staging,N stage,chemotherapy,CEA,and peripheral nerve invasion were independent factors affecting OS in patients with stage Ⅲ EOCRC(P＜0.05).A nomogram for predicting 3-year and 5-year survival rates was constructed by using the six variables mentioned above.The C-indices of the training cohort,internal validation cohort,and external validation cohort were 0.691,0.679,and 0.800,respectively.The ROC curve,calibration chart,and DCA showed that the nomogram was superior to TNM staging in prognostic-predicting and had good stability and adaptability.EOCRC patients were divided into high-risk scoring group and low-risk scoring group based on the nomogram score.The OS of the low-risk scoring group in each cohort was significantly higher than that of the high-risk group(P＜0.05).Conclusion The nomogram based on pathological grading,T staging,N stage,chemotherapy,CEA,and peripheral nerve invasion can effectively predict the prognosis of patients with stage Ⅲ EOCRC.
Keywords：Early-onset colorectal cancerNomogramPrognostic model
Publication Date：2024-08-28
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：8( 745-752 )