<p>Prognostic Nomogram for Patients with Radical Surgery for Non-Metastatic Colorectal Cancer Incorporating Hematological Biomarkers and Clinical Characteristics</p>

Abstract

Background: There is a large difference in postoperative survival in patients with nonmetastatic colorectal cancer. We aimed to develop nomograms incorporating both hematological biomarkers and clinical characteristics to predict overall survival (OS) in patients with radical surgery for non-metastatic colorectal cancer. Methods: A retrospective analysis was performed on date from 508 patients who underwent radical resection of colorectal cancer at the Affiliated Tumor Hospital of Guangxi Medical University from December 2011 to December 2015. Simple random sampling was performed by dividing these patients into a training set (n=355) and validation set(n=153), which yielded a 7:3 ratio in the sample sizes between these groups. Based on COX regression analysis of the results from the training cohort, a nomogram was developed to predict the three-year and five-year overall survival rate, and internal verification was also performed. The nomogram prediction accuracy and discriminating ability were evaluated by Harrell's C-index (C-index), calibration curves and were compared with the colorectal cancer TNM staging system. Results: We found that age, degree of differentiation, T stage, N stage, neurological invasion, neutrophils, monocytes, HGB, and LDH were independent risk factors for predicting OS in patients with colorectal cancer. In the training cohort, the C index was 0.796 (95% CI: 0.761-0.831). In the validation cohort, the C index was 0.671 (95% CI: 0.656-0.686). The nomogram showed a stronger predictive ability than did TNM staging. Decision curve analysis showed that the nomogram had value in terms of clinical application. Conclusion: Our nomogram combined hematological biomarkers and clinical characteristics and was highly effective in predicting OS in patients with non-metastatic colorectal cancer. Hence, our nomogram may provide a reference tool for clinicians to guide individualized treatment and follow-ups for patients with colorectal cancer.

A SEER-based nomogram accurately predicts prognosis in Ewing’s sarcoma

“…Finally, because there is no information on blood biomarkers such as serum lactate dehydrogenase (LDH), alkaline phosphatase, and carcinoembryonic antigen (CEA) in the SEER database, and thus these were not included in the analysis. Some previous studies have shown that combining blood biomarkers, such as hemoglobin, neutrophils, and LDH, can improve the predictive capability of the nomogram 24 . We will include these data in future research to improve the nomogram.…”

Nomograms that predict the survival of patients with adenocarcinoma in villous adenoma of the colorectum: a SEER-based study

“…Next, our manuscript has not included other characteristics, such as hematological biomarkers and molecular parameters. As some studies suggested, combining some hematological biomarkers, such as HGB, neutrophils and LDH, can promote the predictive ability of a nomogram [31], while molecular parameters, including miRNA, CpG methylation and circular RNA, have been demonstrated to be useful for predicting the survival of patients [32][33][34]. Therefore, we will improve and perfect this work in our future study by combining these characteristics.…”

Anatomic Subsites and Prognosis of Gastric Signet Ring Cell Carcinoma: A SEER Population-Based 1 : 1 Propensity-Matched Study

“…Nomograms had been regarded as efficient tools in clinical practice, which couldpredict numerical probabilities for individual patients by incorporating critical prognostic factors [ 30 ]. Many nomograms had demonstrated superiority over the traditional TNM staging system in predicting survival in multiple malignancies [ 31 – 34 ]. Several studies had constructed prognostic nomogram of patients with GSRC; however, these researches had either limited population selection or absence of accurate tumor location.…”