Prognostic nomograms for predicting overall survival and cancer-specific survival of patients with very early onset colorectal cancer: a population‑based analysis

Authors

  • Bingtian Dong Department of Ultrasound, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, Fujian, China. https://orcid.org/0000-0003-0268-4445
  • Yuping Chen Department of Endocrinology, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, Fujian, China https://orcid.org/0000-0003-0268-4445
  • Guorong Lyu Department of Ultrasound, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, Fujian, China; Department of Clinical Medicine, Quanzhou Medical College, Quanzhou, Fujian, China https://orcid.org/0000-0001-5109-5474

DOI:

https://doi.org/10.17305/bjbms.2021.7035

Keywords:

Very early onset colorectal cancer, prognostic nomogram, overall survival, cancer-specific survival, SEER

Abstract

In contrast to the declining incidence in older populations, the incidence of very early onset colorectal cancer (VEO-CRC) patients (aged ≤40 years) has been increasing in different regions of the world. In this study, we aimed to establish nomogram models for the prognostic prediction of patients with VEO-CRC for both overall survival (OS) and cancer-specific survival (CSS). Patients diagnosed with VEO-CRC between 2010 and 2015 from the Surveillance, Epidemiology, and End Results (SEER) database were collected and randomly assigned to the training cohort and validation cohort at a ratio of 7:3 for model construction and internal validation. Using univariate and multivariate Cox regression analysis to screen important variables, which were then used to construct a nomogram. The nomogram was evaluated using calibration curves and the receiver operating characteristic (ROC) curves. A total of 3061 patients were included and randomly divided into the training cohort (n = 2145) and validation cohort (n = 916). Five independent prognostic factors, including race, grade, tumor size, AJCC stage, and AJCC T stage were all significantly identified in OS multivariate Cox regression analysis. Meanwhile in CSS, multivariate Cox regression analysis demonstrated that race, grade, tumor size, AJCC stage, AJCC T stage, AJCC N stage, and SEER stage were independent prognostic factors.  The calibration plots of the established nomograms indicated high correlations between the predicted and observed results. C-index and ROC analysis implied that our nomogram model has a strong predictive ability. Moreover, nomograms also showed higher C-index values compared to tumor-node-metastasis (TNM) and SEER stages. We established and validated a simple-to-use nomogram to evaluate the 1-, 3-, and 5-year OS and CSS prognosis of patients with VEO-CRC. This tool can assist clinicians to optimize individualized treatment plans.

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Published

2022-03-27

How to Cite

1.
Dong B, Chen Y, Lyu G. Prognostic nomograms for predicting overall survival and cancer-specific survival of patients with very early onset colorectal cancer: a population‑based analysis. Bosn J of Basic Med Sci [Internet]. 2022Mar.27 [cited 2022May24];. Available from: https://www.bjbms.org/ojs/index.php/bjbms/article/view/7035

Issue

Section

Translational and Clinical Research