Prognostic prediction for stage Ⅱ-Ⅲ colorectal cancer patients using a nomogram model based on the logarithmic odds of positive lymph nodes
YANG Xiaoyu
MENG Qingkai
MA Bin
BI Xue
Abstract：Objective To establish a nomogram model based on the logarithmic odds of positive lymph nodes(LODDS)for accurate prognosis prediction in stage Ⅱ-Ⅲ colorectal cancer patients.Methods Using the Surveillance,Epidemiology,and End Results Program database(n=14212)and data from colorectal cancer patients(n=448)in Liaoning Cancer Hospital,the LODDS were stratified into three distinct prognostic tiers using X-tile software.Through multivariate Cox regression analysis,we identified significant prognostic variables and subsequently developed a comprehensive nomogram model,which underwent rigorous internal and external validation.Model performance was systematically evaluated through receiver operating characteristic(ROC)curve analysis,and calibration plots and decision curve analysis were employed to assess predictive accuracy and clinical utility.Finally,survival outcomes across different LODDS tiers were compared using Log-rank tests.Results T stage,LODDS classification,carcinoembryonic antigen level,and age were identified as independent prognostic factors for overall survival(OS)in colorectal cancer patients.A nomogram model was developed based on the above variables.When LODDS was included,the area under the ROC curve at 1,3,and 5 years of the model was 0.729,0.723 and 0.722,respectively.Both internal validation and external validation showed that the model was in good agreement with the ideal model and could achieve good clinical benefit in the range of 0.1-0.6.Survival analysis showed that the smaller the LODDS,the worse the prognosis of patients.Conclusion The model demonstrated favorable accuracy and consistency in predicting patient outcomes,with considerable clinical benefits.It could effectively compensate for the limitations of TNM staging and serve as a valuable reference for therapeutic decision-making.
Keywords：Colorectal cancerLogarithmic odds of positive lymph nodesPrognosisNomogram model
Publication Date：2025-04-28
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：7( 394-400 )