Development and validation of nomograms for predicting survival in patients with non-metastatic colorectal cancer

// Huihong Jiang 1, * , Erjiang Tang 2, * , Dan Xu 2 , Ying Chen 2 , Yong Zhang 3 , Min Tang 3 , Yihua Xiao 3 , Zhiyong Zhang 4 , Xiaxing Deng 1 , Huaguang Li 2 , Moubin Lin 2, 3 1 Department of General Surgery, Ruijin Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China 2 Center for Translational Medicine, Yangpu Hospital, Tongji University School of Medicine, Shanghai, China 3 Department of General Surgery, Yangpu Hospital, Tongji University School of Medicine, Shanghai, China 4 Department of General Surgery, Zhuji People's Hospital of Zhejiang Province, Zhejiang, China * These authors have contributed equally to this work Correspondence to: Moubin Lin, email: lmbin@hotmail.com Huaguang Li, email: yzxhgli@126.com Keywords: colorectal cancer, nomogram, prognostic, overall survival, cancer-specific survival Received: December 20, 2016      Accepted: March 03, 2017      Published: March 13, 2017 ABSTRACT Background: This study aimed to develop nomograms for predicting survival in patients with non-metastatic colorectal cancer (CRC). Results: On multivariate analyses of the derivation set, the nomograms for OS and CSS shared common significant prognostic factors: age, first-degree relative cancer history, differentiation grade, vessels/nerves invasion, TNM stage, CEA, CA19-9 and PNI. The nomograms displayed good accuracy in predicting OS and CSS, with C-indexes of 0.75 and 0.76, respectively. The calibration plots also showed an excellent agreement between the predicted and observed survival probabilities. Furthermore, the predictive accuracy of the nomograms was confirmed in the validation set, with C-indexes of 0.79 and 0.83 for OS and CSS, respectively. Materials and Methods: On the basis of data from 822 patients with resected non-metastatic CRC, nomograms for predicting overall survival (OS) and cancer-specific survival (CSS) were established using Cox regression model. The predictive performance of the nomograms was assessed by concordance index (C-index) and calibration plot. An independent external cohort of 171 patients was used to validate the nomograms. Conclusions: We developed and validated two nomograms for patients with non-metastatic CRC, which could provide individual prediction of OS and CSS with high accuracy.