Predicting survival in colorectal carcinoma after curative resection: a new prognostic nomogram

Mahjoub, Mahiar; Sioson, Loretta; Sheen, Amy; Ahadi, Mahsa; Chou, Angela; Gill, Anthony J.; Fuchs, Talia L

doi:10.1016/j.pathol.2021.04.012

Cited by 4 publications

(3 citation statements)

References 15 publications

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“…Nomograms are handy and effective predictive tools that can assist users in effectively predicting an event. For clinical application, nomograms have been used to predict the efficacy of adjuvant chemotherapy, survival rate, and recurrence in CRC (23)(24)(25). In our study, a nomogram was established for predicting the risk of TD presence in patients with CRC-NDM incorporating significant clinicopathological characteristics selected from multivariate logistic regression.…”

Section: Discussionmentioning

confidence: 99%

Predictive and Prognostic Assessment Models for Tumor Deposit in Colorectal Cancer Patients With No Distant Metastasis

Chen

Zhang

et al. 2022

Front. Oncol.

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BackgroundMore and more evidence indicated that tumor deposit (TD) was significantly associated with local recurrence, distant metastasis (DM), and poor prognosis for patients with colorectal cancer (CRC). This study aims to explore the main clinical risk factors for the presence of TD in CRC patients with no DM (CRC-NDM) and the prognostic factors for TD-positive patients after surgery.MethodsThe data of patients with CRC-NDM between 2010 and 2017 were extracted from the Surveillance, Epidemiology, and End Results (SEER) database. A logistic regression model was used to identify risk factors for TD presence. Fine and Gray’s competing-risk model was performed to analyze prognostic factors for TD-positive CRC-NDM patients. A predictive nomogram was constructed using the multivariate logistic regression model. The concordance index (C-index), the area under the receiver operating characteristic (ROC) curve (AUC), and the calibration were used to evaluate the predictive nomogram. Also, a prognostic nomogram was built based on multivariate competing-risk regression. C-index, the calibration, and decision-curve analysis (DCA) were performed to validate the prognostic model.ResultsThe predictive nomogram to predict the presence of TD had a C-index of 0.785 and AUC of 0.787 and 0.782 in the training and validation sets, respectively. From the competing-risk analysis, chemotherapy (subdistribution hazard ratio (SHR) = 0.542, p < 0.001) can significantly reduce CRC-specific death (CCSD). The prognostic nomogram for the outcome prediction in postoperative CRC-NDM patients with TD had a C-index of 0.727. The 5-year survival of CCSD was 17.16%, 36.20%, and 63.19% in low-, medium-, and high-risk subgroups, respectively (Gray’s test, p < 0.001).ConclusionsWe constructed an easily predictive nomogram in identifying the high-risk TD-positive CRC-NDM patients. Besides, a prognostic nomogram was built to help clinicians identify poor-outcome individuals in postoperative CRC-NDM patients with TD. For the high-risk or medium-risk subgroup, additional chemotherapy may be more advantageous for the TD-positive patients rather than radiotherapy.

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Section: Discussionmentioning

confidence: 99%

Predictive and Prognostic Assessment Models for Tumor Deposit in Colorectal Cancer Patients With No Distant Metastasis

Chen

Zhang

et al. 2022

Front. Oncol.

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“…As a visualization tool, the nomogram enables clinical physicians to intuitively display predictive model results, providing more accurate decision-making criteria. Notably, our nomogram exhibits superior predictive capabilities with an AUC of 0.811, surpassing that of Memorial Sloan Kettering Cancer Center and AJCC TNM staging (with AUCs of 0.79 and 0.74, respectively) ( 17 ).…”

Section: Discussionmentioning

confidence: 94%

Construction and validation of a nomogram for predicting disease-free survival after radical resection of rectal cancer using perioperative inflammatory indicators

Sun,

Zhong,

Yin

et al. 2024

J Gastrointest Oncol

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Background Colorectal cancer is a common digestive tract malignancy that seriously affects patients’ quality of life and survival time. Surgery is the main treatment modality, but postoperative prognosis varies greatly. This study sought to explore the impact of perioperative inflammatory indicators on disease-free survival (DFS) in patients after radical resection of rectal cancer and to construct a nomogram for clinical reference. Methods A retrospective analysis was performed on 304 primary rectal adenocarcinoma patients who underwent laparoscopic radical resection of rectal cancer at the Affiliated Hospital of Xuzhou Medical University from May 1, 2018 to September 30, 2020. The patients were divided into a training set (n=213) and a validation set (n=91) at a ratio of 7:3. The cut-off values of each inflammatory indicator based on the receiver operating characteristic (ROC) curve were determined and each indicator was divided into high and low groups. The least absolute shrinkage and selection operator (LASSO)-Cox regression model was used to analyze the independent risk factors affecting DFS, and a nomogram was established. The model was internally validated using the validation set, and the discrimination, calibration, and clinical application value of the nomogram were evaluated using ROC curve, calibration curve, and clinical decision curve analysis (DCA). Results Tumor-node-metastasis (TNM) stage III, neural invasion, preoperative neutrophil-to-lymphocyte ratio (NLR) ≥1.995, postoperative systemic immune-inflammation index (SII) ≥451.05, and Δpan-immune-inflammation value (ΔPIV) ≥144.36 (P<0.05) were independent factors for predicting the 3-year DFS of patients after rectal cancer surgery. The area under the ROC curve (AUC) of the nomogram was 0.811 [95% confidence interval (CI): 0.778–0.889] in the training set and 0.808 (95% CI: 0.785–0.942) in the validation set. The nomogram showed good calibration, indicating good consistency between predicted and actual risks. DCA demonstrated the clinical utility of the nomogram. Conclusions The nomogram constructed based on TNM stage III, neural invasion, preoperative NLR ≥1.995, postoperative SII ≥451.05, and ΔPIV ≥144.36 can predict the risk of 3-year DFS in patients undergoing curative surgery for rectal cancer, enabling strict postoperative follow-up and timely adjuvant treatment for high-risk patients.

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“…The use of online risk calculators for a variety of surgical pathologies has already been demonstrated, including for colorectal cancers [20,21]. Online risk calculators have the benefit of easy access, and ideally can be accessed using smart devices available in day-to-day clinical practice.…”

Section: Discussionmentioning

confidence: 99%

Estimation of risk posed by malignant polyps amongst colorectal surgeons in Australia and New Zealand

Zammit,

Brown,

Hooper

et al. 2024

Ann Coloproctol

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Purpose: The estimation of the risk posed by malignant polyps for residual or lymphatic disease plays a central role. This study investigated colorectal surgeons’ assessment of these risks associated with malignant polyps.Methods: A cross-sectional questionnaire was electronically administered to colorectal surgeons in Australia and New Zealand in October 2022. The questionnaire contained 17 questions on demographics, when surgeons consider colorectal resection appropriate, and the risk assessment for 5 hypothetical malignant polyps.Results: The mean risk of residual or lymphatic disease that would prompt surgeons to recommend colonic resection was 5%. However, this increased to a mean risk of 10% if the malignant polyp was located in the rectum, and the only resection option was abdominoperineal resection with end-colostomy. There was high concordance between the estimated risk of residual or lymphatic disease by colorectal surgeons and the Association of Coloproctology of Great Britain and Ireland (ACPGBI) guidelines for the 5 hypothetical malignant polyps, with the ACPGBI estimated risk lying within the 95% confidence interval for 4 of the 5 malignant polyps. Nonetheless, 96.6% of surgeons felt that an online risk calculator would improve clinical practice.Conclusion: Colorectal surgeons in Australia and New Zealand accurately estimated the risk posed by malignant polyps. An online risk calculator may assist in better conveying risk to patients.

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Predicting survival in colorectal carcinoma after curative resection: a new prognostic nomogram

Cited by 4 publications

References 15 publications

Predictive and Prognostic Assessment Models for Tumor Deposit in Colorectal Cancer Patients With No Distant Metastasis

Predictive and Prognostic Assessment Models for Tumor Deposit in Colorectal Cancer Patients With No Distant Metastasis

Construction and validation of a nomogram for predicting disease-free survival after radical resection of rectal cancer using perioperative inflammatory indicators

Estimation of risk posed by malignant polyps amongst colorectal surgeons in Australia and New Zealand

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