Constructing and Validating a Prognosis Predictive Nomogram for Cancer-Specific Survival in Rectal Cancer Patients Receiving Preoperative Radiotherapy

Autor: Yunjie Shi, Xinxing Li, Xukun Zhang, Shengyun Wang, Jun Pu, Lihua Zhang, Zhiqian Hu
Jazyk: angličtina
Rok vydání: 2022
Předmět:
Zdroj: Journal of Investigative Surgery, Vol 35, Iss 7, Pp 1526-1535 (2022)
Druh dokumentu: article
ISSN: 0894-1939
1521-0553
08941939
DOI: 10.1080/08941939.2022.2078021
Popis: Background A predictive tool is required to identify the cancer-specific survival in rectal cancer (RC) patients who have opted to receive preoperative radiotherapy. Methods A database containing the data on RC patients’ records of Surveillance, Epidemiology, and End Results (SEER) receiving surgery during 2000–2014 was selected. All patients received neoadjuvant radiotherapy (NR). The correlation of clinicopathological parameters was analyzed using the Chi-square test and the survival risk factors were analyzed using the Cox proportional hazards analysis (univariate and multivariate). Finally, the nomogram was developed and validated to visually represent an accurate prediction of the probability of 3- and 5-year cancer-specific survival (CSS) based on the screened variables of the cohort. Results 11,499 rectal cancer patients were included in our cohort. Patients’ records were randomly allocated to either the development or validation cohorts based on an equal ratio (1:1). Performing the multivariate Cox regression analysis incorporating these variables in the development cohort determined 11 independent prognostic factors. Statistically significant differences were recorded among subgroups using log-rank tests, which confirmed the appropriateness and acceptability of factor stratifications. Then, the nomogram was constructed and its concordance index (C-index) values in the development cohort (0.720) and validation cohort (0.717) were evaluated to be higher (P
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