Nomograms for colorectal cancer: A systematic review

Table 1 Nomograms predicting stage I-III colorectal cancer oncological prognosis

Ref.	Year	Cancer location	Targeted patients	Predicted outcome	Number of patients	C-index	Validation	Calibration	Variables	Comments
Weiser et al[8]	2008	Colon	Stage I-III	RFS	1320	0.77	Absent	Present	Age, CEA, No. of positive and negative nodes, pT, adjuvant chemotherapy, cancer location, differentiation, lymphovascular invasion, perineural invasion
Segelman et al[9]	2014	Colorectal	Stage I-III	Peritoneal carcinomatosis	8044	0.78-0.80	Absent	Present	Age, cancer location, pT, pN, radicality, type of surgery, preoperative radiotherapy, nodes examined, adjuvant chemotherapy	Only web-calculator was available
Ying et al[10]	2014	Colorectal	Stage I-III	RFS, OS, CSS	205	0.80-0.81	Absent	Absent	Chemotherapy, tumor size, cell differentiation, TNM stage, neutrophil-to-lymphocyte ratio
Zhang et al[11]	2013	Colon	Stage II	RFS	735	0.65-0.82	Present	Present	Expression of microRNA, pT, internal obstruction or perforation, nodes examined, tumor grade
Goossens-Beumer et al[12]	2015	Colorectal	Stage II/III	RFS	93	0.80	Present	Present	Expression of microRNA, TNM stage, age, gender
Peng et al[13]	2014	Rectal	Stage II/III	OS, distant metastasis	883	0.68-0.76	Present	Absent	Gender, age, CEA, cancer location, pT, pN, ratio of metastatic lymph nodes, adjuvant chemotherapy, adjuvant chemoradiotherapy
Valentini et al[14]	2011	Rectal	Clinical stage II/III patients undergoing adjuvant radiotherapy or chemora	OS, local recurrence, distant metastasis	2795	0.68-0.73	Present	Present	pT, cT, pN, age, concomitant and adjuvant chemotherapy, surgical procedure, gender, dose of radiotherapy
van Gijn et al[15]	2015	Rectal	Stage I-III	OS, local recurrence, distant metastasis	2881	0.75-0.79	Absent	Absent	Age, pT, pN, PA-stage, distance, residual cancer, surgical type, gender, radiotherapy, complications

RFS: Recurrence-free survival; OS: Overall survival; CSS: Cancer-specific survival; C-index: Concordance index; CEA: Carcinoembryonic antigen.

Table 2 Nomograms predicting stage IV colorectal cancer oncological prognosis

Ref.	Year	Targeted cancer	Treatment	Predicted outcome	Number of patients	C-index	Validation	Calibration	Variables
Beppu et al[18]	2012	Liver metastasis	Hepatic resection	DFS	727	Not assessed	Validated by Okuno et al[26]	Absent	Metachronous or synchronous, pN, No. of tumors, largest tumor diameter, extrahepatic metastasis, CA19-9
Kanemitsu et al[19]	2008	Liver metastasis	Hepatic resection	OS, CSS	578	0.66-0.68	Validated by Takakura et al[27]	Present	Histology, No. of lymph node metastases, No. of tumors, extrahepatic metastasis, metastasis of hilar lymph nodes, surgical margin, CEA
Kattan et al[20]	2008	Liver metastasis	Hepatic resection	CSS	1477	0.61	Validated by Takakura et al[27], Reddy et al[28], and Nathan et al[29]	Present	Gender, age, primary site, disease-free interval, CEA, No. of tumors, largest tumor diameter, bilateral resection, > 1 lobe, pN
Kanemitsu et al[21]	2004	Lung metastasis	Thoracotomy	OS	313	0.66-0.72	Validated by Kanemitsu et al[30]	Present	Histology, No. of tumors, hilar/mediastinal lymph nodes, extrathoracic metastasis, CEA
Elias et al[22]	2014	Liver and/or Peritoneal metastasis	Optimal surgery plus chemotherapy	OS	287	0.61	Absent	Present	No. of lymph node metastases, peritoneal carcinomatosis index, planified procedure
Kawai et al[23]	2015	Metastatic CRC	Curative resection	DFS, OS	1133	0.60-0.64	Present	Present	Postoperative CEA, pT, pN, No. of metastatic organs, peritoneal dissemination
Manceau et al[24]	2014	Metastatic CRC, KRAS-wild-type, refractory to chemotherapy	Anti-EGFR antibodies	Risk of progression	132	> 0.7	Present	Absent	MicroRNA expression and BRAF mutations
Massacesi et al[25]	2000	Locally advanced or metastatic CRC	Chemotherapy	OS	1057	Not assessed	Absent	Absent	Response to chemotherapy, No. of metastatic sites, CEA, performance status

DFS: Disease-free survival; OS: Overall survival; CSS: Cancer-specific survival; CRC: Colorectal cancer; C-index: Concordance index; CEA: Carcinoembryonic antigen; KRAS: Kirsten rat sarcoma viral oncogene homolog; EGFR: Epidermal growth factor receptor; BRAF: B-Raf proto-oncogene, serine/threonine kinase.

Table 3 Nomograms predicting short-term outcomes of surgery for colorectal cancer

Ref.	Year	Cancer location	Targeted patients	Predicted outcome	Number of patients	C-index	Validation	Calibration	Variables	Comments
Kiran et al[31]	2013	Colorectal	All colorectal surgeries	30-d mortality	30900	0.89	Present	Present	Age, ASA, albumin, functional dependency, renal failure, emergency surgery, disseminated cancer
Hedrick et al[32]	2013	Colorectal	All colorectal surgeries	Superficial SSI, deep incisional SSI, and combination thereof	18403	0.64-0.65	Absent	Present	Diabetes, smoking, disseminated cancer, BMI, open or laparoscopic surgery
de Campos-Lobato et al[33]	2009	Small bowel/colorectal	All colorectal surgeries	Organ space SSI	12373	0.65	Present	Present	Surgical site, smoking, ASA, wound class, diabetes, steroid use, prior surgery, radiotherapy, open or laparoscopic surgery, age, BMI, creatinine, albumin, gender, transfusion, operative time
Frasson et al[34]	2014	Colon	All colorectal surgeries	Anastomotic leakage	3193	0.62-0.63	Absent	Absent	Oral anticoagulants, intraoperative complications, BMI, total protein, gender, No. of beds	Decision-tree diagram was also presented
Yao et al[35]	2014	Rectal	Laparoscopic anterior resection with intracorporeal rectal transection and double-stapling technique anastomosis	Anastomotic leakage	476	0.84	Internal validation	Absent	Cancer location, operative time, preservation of the left colic artery
Russell et al[36]	2013	Rectal/rectosigmoid	Stage I-III	Rate of margin positivity	85190	0.75	Absent	Present	Age, gender, ethnicity, cancer location, TNM stage, tumor size, tumor grade, insurance status, histology

SSI: Surgical site infection; ASA: American Society of Anesthesiologists; BMI: Body mass index; C-index: Concordance index.

Table 4 Other nomograms relevant to colorectal cancer

Ref.	Year	Targeted patients	Treatment	Predicted outcome	Number of patients	C-index	Validation	Calibration	Variables	Comments
Jwa et al[37]	2014	Non-metastatic rectal cancer	CRT + surgery	ypN status	891	0.77-0.81	Present	Present	ypT, cN, histology, lymphovascular invasion, perineural invasion, age
van Stiphout et al[38]	2011	Rectal cancer	CRT + surgery	Pathologic complete response	953	Not assessed	Present	Present	tumor length, RI, SUV	Pre- and post-CRT PET-CTs were used to predict response
van Stiphout et al[39]	2014	Rectal cancer	CRT + surgery	Pathologic complete response	190	0.70-0.78	Present	Absent	Maximal diameter at day 15, RI, cN	Pre- and intra-CRT PET-CTs were used to predict response
Omata et al[40]	2011	Asymptomatic individuals		Colorectal neoplasms	1085	Not assessed	Absent	Absent	Quantitative fecal immunochemical test, gender, age, BMI
Kawai et al[41]	2014	Colorectal cancer	Surgery	Postoperative development of metachronous colorectal neoplasms	309	0.71	Present	Present	Gender, age, No. of synchronous adenomas and colorectal cancers
Wells et al[42]	2014	Age > 45		Colorectal cancer development	180630	0.68	Absent	Present	Age, ethnicity, smoking, alcoholic drinks, BMI, education, aspirin, estrogen, family history of CRC, NSAIDs, multivitamins, red meat intake, diabetes, physical activity

CRT: Chemoradiotherapy; PET-CT: Positron emission tomography-computed tomography; RI: Response index; SUV: Standardized uptake value; CRC: Colorectal cancer; BMI: Body mass index; C-index: Concordance index; NSAID: Non-steroidal anti-inflammatory drug.