Construction and verification of a long-term survival prediction model for rectal cancer－Nomogram_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

TAN Ling , LIU Zilin , TANG Linghan ,  XIAO Jiangwei

Department of Gastrointestinal Surgery, The First Affiliated Hospital of Chengdu Medical College, Chengdu 610500, P. R. China;

Corresponding author：

XIAO Jiangwei, Email: magic163@yeah.net

Keywords：

rectal cancer; long-term survival; Nomogram; SEER database

DOI：

10.7507/1007-9424.202012027

Video：

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Objective Based on a large sample of data, study the factors affecting the survival and prognosis of patients with rectal cancer and construct a prediction model for the survival and prognosis.Methods The clinical data of 26 028 patients with rectal cancer were screened from the Surveillance, Epidemiology, and End Results (SEER) clinical database of the National Cancer Institute. Univariate and multivariate Cox proportional hazard regression analysis were used to screen related risk factors. Finally, the Nomogram prediction model was summarized and its accuracy was verified.Results Result of multivariate Cox proportional hazard regression analysis showed that the risk factors affecting the survival probability of rectal cancer included: age, gender, marital status, TMN staging, T staging, tumor size, degree of tissue differentiation, total number of lymph nodes removed, positive lymph node ratio, radiotherapy, and chemotherapy (P<0.05). Then we further built the Nomogram prediction model. The C index of the training cohort and the validation cohort were 0.764 and 0.770, respectively. The area under the ROC curve (0.777 and 0.762) for 3 years and 5 years, and the calibration curves of internal and external validation all indicated that the model could effectively predict the survival probability of rectal cancer.Conclusion The constructed Nomogram model can predict the survival probability of rectal cancer, and has clinical guiding significance for the prognostic intervention of rectal cancer.

Citation： TAN Ling, LIU Zilin, TANG Linghan, XIAO Jiangwei. Construction and verification of a long-term survival prediction model for rectal cancer－Nomogram. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2021, 28(8): 1031-1038. doi: 10.7507/1007-9424.202012027 Copy

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13.	Wang Y, Li J, Xia Y, et al. Prognostic nomogram for intrahepatic cholangiocarcinoma after partial hepatectomy. J Clin Oncol, 2013, 31(9): 1188-1195.
14.	邓若语. 影响结直肠癌患者预后因素的探讨分析. 昆明医科大学, 2018.
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17.	Zhang XY, Wang S, Li XT, et al. MRI of extramural venous invasion in locally advanced rectal cancer: Relationship to tumor recurrence and overall survival. Radiology, 2018, 289(3): 677-685.
18.	Xu Z, Berho ME, Becerra AZ, et al. Lymph node yield is an independent predictor of survival in rectal cancer regardless of receipt of neoadjuvant therapy. J Clin Pathol, 2017, 70(7): 584-592.
19.	张宇. 淋巴结转移度对Ⅲ期结直肠癌患者术后复发或转移影响的研究. 中国预防医学杂志, 2020, 21(4): 477-480.
20.	张家驹, 赵恩宏, 李英健, 等. 结直肠癌患者预后的影响因素. 临床医药文献电子杂志, 2020, 7(31): 186, 190.
21.	Boyce S, Nassar N, Lee CY, et al. Young-onset colorectal cancer in New South Wales: a population-based study. Med J Aust, 2016, 205(10): 465-470.
22.	Saluja SS, Manipadam JM, Mishra PK, et al. Young onset colorectal cancer: How does it differ from its older counterpart? Indian J Cancer, 2014, 51(4): 565-569.
23.	You YN, Dozois EJ, Boardman LA, et al. Young-onset rectal cancer: presentation, pattern of care and long-term oncologic outcomes compared to a matched older-onset cohort. Ann Surg Oncol, 2011, 18(9): 2469-2476.

1. Bray F, Ferlay J, Soerjomataram I, et al. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin, 2018, 68(6): 394-424.
2. Feng RM, Zong YN, Cao SM, et al. Current cancer situation in China: good or bad news from the 2018 Global Cancer Statistics? Cancer Commun (Lond), 2019, 39(1): 22.
3. Murphy CC, Wallace K, Sandler RS, et al. Racial disparities in incidence of young-onset colorectal cancer and patient survival. Gastroenterology, 2019, 156(4): 958-965.
4. 李小升, 雷海科, 谭婧宇, 等. 直肠癌患者生存随访调查及预后影响因素研究. 重庆医科大学学报, 2020, 45(10): 1414-1420.
5. 陈力, 黄学锋. 阳性淋巴结比值比在预测术前放化疗后直肠癌术后患者生存的价值. 中国实用医药, 2019, 14(1): 1-6.
6. 杨剑, 王春明, 孙晓光. 0~Ⅲ期直肠癌根治术后生存状况及预后影响因素分析. 中国现代普通外科进展, 2018, 21(2): 138-140.
7. 李博文. 影响直肠癌疗效的预后风险因素分析. 心理月刊, 2020, 15(1): 5, 8.
8. 唐浩. 直肠癌预后因素分析. 中国医科大学, 2019.
9. Cronin KA, Ries LA, Edwards BK. The Surveillance, Epidemiology, and End Results (SEER) Program of the National Cancer Institute. Cancer, 2014, 120(Suppl 23): 3755-3757.
10. Edge SB, Compton CC. The American Joint Committee on Cancer: the 7th edition of the AJCC cancer staging manual and the future of TNM. Ann Surg Oncol, 2010, 17(6): 1471-1474.
11. Duan J, Xie Y, Qu L, et al. A nomogram-based immunoprofile predicts overall survival for previously untreated patients with esophageal squamous cell carcinoma after esophagectomy. J Immunother Cancer, 2018, 6(1): 100.
12. Nieder C, Mehta MP, Geinitz H, et al. Prognostic and predictive factors in patients with brain metastases from solid tumors: A review of published nomograms. Crit Rev Oncol Hematol, 2018, 126: 13-18.
13. Wang Y, Li J, Xia Y, et al. Prognostic nomogram for intrahepatic cholangiocarcinoma after partial hepatectomy. J Clin Oncol, 2013, 31(9): 1188-1195.
14. 邓若语. 影响结直肠癌患者预后因素的探讨分析. 昆明医科大学, 2018.
15. Sharp L, McDevitt J, Brown C, et al. Association between smoking at diagnosis and cause-specific survival in patients with rectal cancer: Results from a population-based analysis of 10,794 cases. Cancer, 2017, 123(13): 2543-2550.
16. Boström P, Haapamäki MM, Rutegård J, et al. Population-based cohort study of the impact on postoperative mortality of anastomotic leakage after anterior resection for rectal cancer. BJS Open, 2018, 3(1): 106-111.
17. Zhang XY, Wang S, Li XT, et al. MRI of extramural venous invasion in locally advanced rectal cancer: Relationship to tumor recurrence and overall survival. Radiology, 2018, 289(3): 677-685.
18. Xu Z, Berho ME, Becerra AZ, et al. Lymph node yield is an independent predictor of survival in rectal cancer regardless of receipt of neoadjuvant therapy. J Clin Pathol, 2017, 70(7): 584-592.
19. 张宇. 淋巴结转移度对Ⅲ期结直肠癌患者术后复发或转移影响的研究. 中国预防医学杂志, 2020, 21(4): 477-480.
20. 张家驹, 赵恩宏, 李英健, 等. 结直肠癌患者预后的影响因素. 临床医药文献电子杂志, 2020, 7(31): 186, 190.
21. Boyce S, Nassar N, Lee CY, et al. Young-onset colorectal cancer in New South Wales: a population-based study. Med J Aust, 2016, 205(10): 465-470.
22. Saluja SS, Manipadam JM, Mishra PK, et al. Young onset colorectal cancer: How does it differ from its older counterpart? Indian J Cancer, 2014, 51(4): 565-569.
23. You YN, Dozois EJ, Boardman LA, et al. Young-onset rectal cancer: presentation, pattern of care and long-term oncologic outcomes compared to a matched older-onset cohort. Ann Surg Oncol, 2011, 18(9): 2469-2476.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Construction and verification of a long-term survival prediction model for rectal cancer－Nomogram

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