Wei FZ, Mei SW, Chen JN, Wang ZJ, Shen HY, Li J, Zhao FQ, Liu Z, Liu Q. Nomograms and risk score models for predicting survival in rectal cancer patients with neoadjuvant therapy. World J Gastroenterol 2020; 26(42): 6638-6657 [PMID: 33268952 DOI: 10.3748/wjg.v26.i42.6638]
Corresponding Author of This Article
Qian Liu, MD, Chief Doctor, Professor, Surgeon, Department of Colorectal Surgery, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 17 Panjiayuan Nanli, Chaoyang District, Beijing 100021, China. fcwpumch@163.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Retrospective Cohort Study
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Wei FZ, Mei SW, Chen JN, Wang ZJ, Shen HY, Li J, Zhao FQ, Liu Z, Liu Q. Nomograms and risk score models for predicting survival in rectal cancer patients with neoadjuvant therapy. World J Gastroenterol 2020; 26(42): 6638-6657 [PMID: 33268952 DOI: 10.3748/wjg.v26.i42.6638]
World J Gastroenterol. Nov 14, 2020; 26(42): 6638-6657 Published online Nov 14, 2020. doi: 10.3748/wjg.v26.i42.6638
Nomograms and risk score models for predicting survival in rectal cancer patients with neoadjuvant therapy
Fang-Ze Wei, Shi-Wen Mei, Jia-Nan Chen, Zhi-Jie Wang, Hai-Yu Shen, Juan Li, Fu-Qiang Zhao, Zheng Liu, Qian Liu
Fang-Ze Wei, Shi-Wen Mei, Jia-Nan Chen, Zhi-Jie Wang, Hai-Yu Shen, Juan Li, Fu-Qiang Zhao, Zheng Liu, Qian Liu, Department of Colorectal Surgery, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union College, Beijing 100021, China
Author contributions: Wei FZ and Chen JN designed the research; Mei SW, Wei FZ, Shen HY, Li J and Zhao FQ collected the data; Liu Z and Wei FZ analyzed the data; Wei FZ drafted the manuscript; Liu Q revised the manuscript.
Supported byThe National Key Research and Development Plan "Research on Prevention and Control of Major Chronic Noncommunicable Diseases", No. 2019YFC1315705; and the Medicine and Health Technology Innovation Project of the Chinese Academy of Medical Sciences, No. 2017-12M-1-006.
Institutional review board statement: Our investigation received approval from the ethics committee of the National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College.
Informed consent statement: All patients signed informed consent forms.
Conflict-of-interest statement: The authors declare that they have no potential conflicts of interest.
Data sharing statement: No additional data are available.
STROBE statement: The authors have carefully read the STROBE Statement—checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-checklist of items.
Corresponding author: Qian Liu, MD, Chief Doctor, Professor, Surgeon, Department of Colorectal Surgery, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 17 Panjiayuan Nanli, Chaoyang District, Beijing 100021, China. fcwpumch@163.com
Received: August 18, 2020 Peer-review started: August 18, 2020 First decision: September 12, 2020 Revised: September 15, 2020 Accepted: September 25, 2020 Article in press: September 25, 2020 Published online: November 14, 2020 Processing time: 87 Days and 1 Hours
ARTICLE HIGHLIGHTS
Research background
Neoadjuvant therapy (NT) has been increasingly used as the standard treatment for clinical stage II/III rectal cancer. Risk factors after administration of neoadjuvant therapy for locally advanced rectal cancer (LARC) are still under debate.
Research motivation
There is a lack of consensus concerning the risk factors after administration of neoadjuvant therapy for LARC. Nomograms and risk prediction models for survival can help clinicians to choose therapy according to patient's individual risk.
Research objectives
The main aim of this study was to explore the prognostic factors and establish effective prognostic nomograms and risk score prediction models to predict overall survival (OS) and disease-free survival (DFS) for LARC treated with NT.
Research methods
Nomograms and risk factor score prediction models were based on patients who received NT. LASSO regression was utilized to screen for prognostic risk factors, which were validated by the Cox regression. ROC curves, C-index and calibration curves were performed to evaluate the prediction models and nomograms.
Research results
Seven features, including vascular_tumors_bolt, cancer nodules, yN, body mass index (BMI), matchmouth distance from the edge, nerve aggression and postoperative carcinoembryonic antigen (CEA), were significantly associated with OS. The nomogram for predicting DFS included ypTNM and nerve aggression. The primary and validate cohort showed good predictive value. The prediction model for OS and DFS had good predictive value.
Research conclusions
We established accurate nomograms and prediction models for predicting OS and DFS in patients with LARC after undergoing NT.
Research perspectives
Larger prospective multicenter clinical studies need to be performed to validate the nomograms and risk score prediction models of OS and DFS.
