Nomogram based on the log odds of negative lymph node/T stage can predict the prognosis of patients with colorectal cancer: a retrospective study based on SEER database and external validation in China
Objectives This study investigated the prognostic role of log odds of negative lymph node/T stage (LONT) and established a nomogram based on LONT to predict the prognosis in colorectal cancer (CRC) patients.Design A retrospective cohort study.Setting and participants We enrolled 80 518 CRC patients...
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BMJ Publishing Group
2024-12-01
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| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/14/12/e083942.full |
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| author | Xiaochun Chen Yimin Li Boyong Cai Mengli Zheng Zhicao Chen Canxin Zhong Guiquan Chen |
| author_facet | Xiaochun Chen Yimin Li Boyong Cai Mengli Zheng Zhicao Chen Canxin Zhong Guiquan Chen |
| author_sort | Xiaochun Chen |
| collection | DOAJ |
| description | Objectives This study investigated the prognostic role of log odds of negative lymph node/T stage (LONT) and established a nomogram based on LONT to predict the prognosis in colorectal cancer (CRC) patients.Design A retrospective cohort study.Setting and participants We enrolled 80 518 CRC patients from the Surveillance, Epidemiology and End Results database between 2010 and 2015. The dataset was split into a training cohort (56 364 patients) and a validation cohort (24 154 patients) at a ratio of 7:3. Furthermore, 500 CRC patients who underwent surgery in the Tenth Affiliated Hospital of Southern Medical University between 1 January 2017 and 20 December 2018, were recruited as the external validation set.Outcome measures 1-, 3- and 5-year cancer-specific survival (CSS).Methods The univariate and multivariate Cox regression analyses were carried out to identify the significant independent prognostic factors of CSS. A nomogram was established based on LONT to predict the prognosis. The performance of the nomogram was comprehensively assessed via the time-dependent receiver operating characteristic curve, concordance index (C-index), calibration curve and decision curve analysis (DCA) comprehensively. Moreover, Kaplan-Meier curves were performed to assess the CSS of the three risk subgroups.Result LONT was a significant independent prognostic factor for CSS (LONT1 vs LONT2, HR=0.670, 95% CI 0.642 to 0.698, p<0.001; LONT1 vs LONT3, HR=0.443, 95% CI 0.420 to 0.467, p<0.001). LONT, age, sex, race, subsite, differentiation, histology, tumour size, T stage, N stage, M stage and chemotherapy were included in the nomogram. The 1-, 3- and 5-year survival area under the curve were 0.856, 0.862 and 0.852, respectively. The C-index of the model was 0.809 (95% CI 0.825 to 0.839) in the model. The calibration curve and DCA verified the favourable predictive performance and clinical application of the nomogram.Conclusion CRC patients with a high LONT had a low incidence of CSS. The nomogram based on LONT could effectively predict the CSS of CRC. |
| format | Article |
| id | doaj-art-6a6b7a482d3548ae9e4119224e165809 |
| institution | Kabale University |
| issn | 2044-6055 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open |
| spelling | doaj-art-6a6b7a482d3548ae9e4119224e1658092025-01-14T08:55:12ZengBMJ Publishing GroupBMJ Open2044-60552024-12-01141210.1136/bmjopen-2024-083942Nomogram based on the log odds of negative lymph node/T stage can predict the prognosis of patients with colorectal cancer: a retrospective study based on SEER database and external validation in ChinaXiaochun Chen0Yimin Li1Boyong Cai2Mengli Zheng3Zhicao Chen4Canxin Zhong5Guiquan Chen6Department of Gastroenterology, The Tenth Affiliated Hospital, Southern Medical University (Dongguan People`s Hospital), Dongguan, ChinaDepartment of Gastroenterology, The Tenth Affiliated Hospital, Southern Medical University (Dongguan People`s Hospital), Dongguan, ChinaDepartment of Gastroenterology, The Tenth Affiliated Hospital, Southern Medical University (Dongguan People`s Hospital), Dongguan, ChinaDepartment of Gastroenterology, The Tenth Affiliated Hospital, Southern Medical University (Dongguan People`s Hospital), Dongguan, ChinaDepartment of Gastroenterology, The Tenth Affiliated Hospital, Southern Medical University (Dongguan People`s Hospital), Dongguan, ChinaDepartment of Gastroenterology, The Tenth Affiliated Hospital, Southern Medical University (Dongguan People`s Hospital), Dongguan, ChinaDepartment of Gastroenterology, The Tenth Affiliated Hospital, Southern Medical University (Dongguan People`s Hospital), Dongguan, ChinaObjectives This study investigated the prognostic role of log odds of negative lymph node/T stage (LONT) and established a nomogram based on LONT to predict the prognosis in colorectal cancer (CRC) patients.Design A retrospective cohort study.Setting and participants We enrolled 80 518 CRC patients from the Surveillance, Epidemiology and End Results database between 2010 and 2015. The dataset was split into a training cohort (56 364 patients) and a validation cohort (24 154 patients) at a ratio of 7:3. Furthermore, 500 CRC patients who underwent surgery in the Tenth Affiliated Hospital of Southern Medical University between 1 January 2017 and 20 December 2018, were recruited as the external validation set.Outcome measures 1-, 3- and 5-year cancer-specific survival (CSS).Methods The univariate and multivariate Cox regression analyses were carried out to identify the significant independent prognostic factors of CSS. A nomogram was established based on LONT to predict the prognosis. The performance of the nomogram was comprehensively assessed via the time-dependent receiver operating characteristic curve, concordance index (C-index), calibration curve and decision curve analysis (DCA) comprehensively. Moreover, Kaplan-Meier curves were performed to assess the CSS of the three risk subgroups.Result LONT was a significant independent prognostic factor for CSS (LONT1 vs LONT2, HR=0.670, 95% CI 0.642 to 0.698, p<0.001; LONT1 vs LONT3, HR=0.443, 95% CI 0.420 to 0.467, p<0.001). LONT, age, sex, race, subsite, differentiation, histology, tumour size, T stage, N stage, M stage and chemotherapy were included in the nomogram. The 1-, 3- and 5-year survival area under the curve were 0.856, 0.862 and 0.852, respectively. The C-index of the model was 0.809 (95% CI 0.825 to 0.839) in the model. The calibration curve and DCA verified the favourable predictive performance and clinical application of the nomogram.Conclusion CRC patients with a high LONT had a low incidence of CSS. The nomogram based on LONT could effectively predict the CSS of CRC.https://bmjopen.bmj.com/content/14/12/e083942.full |
| spellingShingle | Xiaochun Chen Yimin Li Boyong Cai Mengli Zheng Zhicao Chen Canxin Zhong Guiquan Chen Nomogram based on the log odds of negative lymph node/T stage can predict the prognosis of patients with colorectal cancer: a retrospective study based on SEER database and external validation in China BMJ Open |
| title | Nomogram based on the log odds of negative lymph node/T stage can predict the prognosis of patients with colorectal cancer: a retrospective study based on SEER database and external validation in China |
| title_full | Nomogram based on the log odds of negative lymph node/T stage can predict the prognosis of patients with colorectal cancer: a retrospective study based on SEER database and external validation in China |
| title_fullStr | Nomogram based on the log odds of negative lymph node/T stage can predict the prognosis of patients with colorectal cancer: a retrospective study based on SEER database and external validation in China |
| title_full_unstemmed | Nomogram based on the log odds of negative lymph node/T stage can predict the prognosis of patients with colorectal cancer: a retrospective study based on SEER database and external validation in China |
| title_short | Nomogram based on the log odds of negative lymph node/T stage can predict the prognosis of patients with colorectal cancer: a retrospective study based on SEER database and external validation in China |
| title_sort | nomogram based on the log odds of negative lymph node t stage can predict the prognosis of patients with colorectal cancer a retrospective study based on seer database and external validation in china |
| url | https://bmjopen.bmj.com/content/14/12/e083942.full |
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