Development and validation of a nomogram to predict survival after curative resection of nonmetastatic colorectal cancer
Autor: | Ying Zhang, Tingting Hong, Xiaohong Wu, Linfang Jin, Dong Hua, Ting-Xun Lu, Dongyan Cai |
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Rok vydání: | 2019 |
Předmět: |
0301 basic medicine
Curative resection Male Cancer Research genetic structures Colorectal cancer urologic and male genital diseases nonmetastatic colorectal cancer 0302 clinical medicine Carcinoembryonic antigen Prospective cohort study Original Research Aged 80 and over biology Middle Aged lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens Prognosis Survival Rate Oncology 030220 oncology & carcinogenesis Female Radiology Colorectal Neoplasms Adult medicine.medical_specialty overall survival Recursive partitioning lcsh:RC254-282 nomogram 03 medical and health sciences Young Adult medicine Humans Radiology Nuclear Medicine and imaging Aged Retrospective Studies Receiver operating characteristic business.industry curative resection Clinical Cancer Research Retrospective cohort study Nomogram medicine.disease Nomograms 030104 developmental biology ROC Curve biology.protein business Colorectal Surgery Follow-Up Studies |
Zdroj: | Cancer Medicine Cancer Medicine, Vol 9, Iss 12, Pp 4126-4136 (2020) |
ISSN: | 2045-7634 |
Popis: | Background We aimed to develop a clinical applicable nomogram to predict overall survival (OS) for patients with curatively resected nonmetastatic colorectal cancer. Methods Records from a retrospective cohort of 846 patients with complete information were used to construct the nomogram. The nomogram was validated in a prospective cohort of 379 patients. The performance of the nomogram was evaluated with concordance index (c‐index), time‐dependent receiver operating characteristic (ROC) curves, calibration plots, and decision curve analyses for discrimination, accuracy, calibration ability, and clinical net benefits respectively, and further compared with AJCC 8th TNM staging and the MSKCC nomogram. Risk stratification based on nomogram scores was performed with recursive partitioning analysis. Results The nomogram incorporated age, Glasgow prognostic score, pretreatment carcinoembryonic antigen levels, T staging, N staging, number of harvested lymph nodes, and histological grade. Compared with the 8th AJCC staging and MSKCC model, the nomogram had a statistically higher c‐index (0.77, 95% CI: 0.73‐0.80), bigger areas under the time‐dependent ROC curves (AUC at 3 years: 79; at 5 years: 79), and improved clinical net benefits. Calibration plots revealed no deviations from reference lines. All results were reproducible in the validation cohort. Nomogram‐based risk stratification successfully discriminated patients within each AJCC stage (all log‐rank P We developed and validated a prognostic nomogram for non‐metastatic colorectal cancer incorporating routinely available factors. Nomogram based risk stratification successfully discriminated patients within each AJCC stage. The nomogram outperformed the 8th AJCC staging and the MSKCC model. |
Databáze: | OpenAIRE |
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