• cardiovascular disease
• diabetes
• mortality
• prediabetes
• prognostic nutritional index

• Humans
• Male
• Female
• Prediabetic State/mortality
• Cardiovascular Diseases/mortality
• Middle Aged
• Prognosis
• Nutrition Surveys
• Aged
• Diabetes Mellitus/mortality
• Diabetes Mellitus/epidemiology
• Nutritional Status
• Adult
• Nutrition Assessment
• Cause of Death
• ROC Curve
• United States/epidemiology
• Risk Factors

• Prognosis
• Rectal neoplasms
• Tomography
• X-ray computed

• 2022YFS0249 the Key Research Project of Sichuan Province

• Non-small cell lung cancer (NSCLC)
• intratumor heterogeneity (ITH)
• molecular biomarkers
• tumor mutational burden (TMB)

• Carcinoembryonic antigen
• Inflammation-related markers
• Locally advanced rectal cancer
• Neoadjuvant chemoradiotherapy
• Pathological complete response
• Prognosis
• Tumor deposit

Colorectal cancer is currently the third most common malignant tumor and the second leading cause of cancer-related death worldwide. Neoadjuvant chemoradiotherapy (nCRT) is standard for locally advanced rectal cancer (LARC). Except for pathological examination after resection, it is not known exactly whether LARC patients have achieved pathological complete response (pCR) before surgery. To date, there are no clear clinical indicators that can predict the efficacy of nCRT and patient outcomes.

To investigate the indicators that can predict pCR and long-term outcomes following nCRT in patients with LARC.

Clinical data of 128 LARC patients admitted to our hospital between September 2013 and November 2022 were retrospectively analyzed. Patients were categorized into pCR and non-pCR groups. Univariate analysis (using the χ² test or Fisher’s exact test) and logistic multivariate regression analysis were used to study clinical predictors affecting pCR. The 5-year disease-free survival (DFS) and overall survival (OS) rates were calculated using Kaplan-Meier analysis, and differences in survival curves were assessed with the log-rank test.

Univariate analysis showed that pretreatment carcinoembryonic antigen (CEA) level, lymphocyte-monocyte ratio (LMR), time interval between neoadjuvant therapy completion and total mesorectal excision, and tumor size were correlated with pCR. Multivariate results showed that CEA ≤ 5 ng/mL (P = 0.039), LMR > 2.73 (P = 0.023), and time interval > 10 wk (P = 0.039) were independent predictors for pCR. Survival analysis demonstrated that patients in the pCR group had significantly higher 5-year DFS rates (94.7% vs 59.7%, P = 0.002) and 5-year OS rates (95.8% vs 80.1%, P = 0.019) compared to the non-pCR group. Tumor deposits (TDs) were significantly correlated with shorter DFS (P = 0.002) and OS (P < 0.001).

Pretreatment CEA, LMR, and time interval contribute to predicting nCRT efficacy in LARC patients. Achieving pCR demonstrates longer DFS and OS. TDs correlate with poor prognosis.

• Locally advanced rectal cancer
• Neoadjuvant chemoradiotherapy
• Pathological complete response
• Carcinoembryonic antigen
• Inflammation-related markers
• Tumor deposit
• Prognosis

• CEA
• Rectal cancer
• distant metastasis
• extramural vascular invasion
• risk factors

• Rectal cancer (RC)
• carcinoembryonic antigen (CEA)
• magnetic resonance imaging (MRI)
• prognosis
• tumor volume

• Postoperative mortality
• carcino-embryogenic antigen
• colon cancer

• Competitive risk model
• Rectal cancer
• SEER database
• Validation

• Humans
• Rectal Neoplasms/epidemiology
• Brain
• Liver
• Nomograms
• Physicians

• 51282 Henan Provincial Government-Health and Family Planning Commission Research Science Innovative Talents Project

• diagnostic markers
• gastric cancer
• negative lymph node
• negative lymph node/T stage
• prognosis

• Nomogram
• Non-metastatic
• Prediction
• Rectal adenocarcinoma
• Survival prediction

Colorectal cancer is a highly malignant tumor. Anus-preserving surgery can effectively prolong the survival of patients with ultra-low rectal cancer. However, the postoperative survival of patients is affected by many factors. Identification of the relevant prognostic factors is of important guiding value in enhancing postoperative intervention and improving the quality of life of patients.

To explore the survival of patients with ultra-low rectal cancer after anus-preserving surgery, and to analyze the prognostic factors.

A total of 152 patients with low rectal cancer were selected from March 2016 to March 2018 at our hospital, all of whom received anus-preserving surgery for ultra-low rectal cancer. The overall survival rate and disease-free survival rate at 1, 2, and 3 years after surgery were analyzed. The perioperative clinical data of patients with different prognostic conditions were compared, and the prognostic factors were analyzed.

The 1-, 2-, and 3-year overall survival rates were 100%, 89.8% and 70.75%, respectively, and the 1-, 2-, and 3-year disease-free survival rates were 91.16%, 76.19%, and 60.54%, respectively. Age at surgery, tumor diameter, serum carbohydrate antigen 125 (CA125), carcinoembryonic antigen (CEA), hypoxia-inducing-factor 1α (HIF-1α) levels, TNM stage, and postoperative catheter indwelling time of patients who survived 3 years after surgery were all lower than those of patients who died, and the incidence of lymph node metastasis, vascular invasion, and nerve invasion was lower than that of patients who died. The distance from anal margin, serum miR-192 level, differentiation degree, and PNAG score were all significantly higher than those of dead patients (P < 0.05). The distance to the anal margin, serum CA125, CEA, HIF-1α, and miR-192 levels, PNAG score, and postoperative catheter indwelling time were significantly correlated with the prognosis of patients with ultra-low rectal cancer after anus-preserving surgery (P < 0.05).

The 3-year overall survival rate of patients with ultra-low rectal cancer after anus-preserving surgery is more than 70%. The distance between tumor and anal margin, serum CA125, CEA, HIF-1α, and miR-192 levels, PNAG score, and postoperative catheter indwelling time are prognostic factors for these patients.

• Rectal cancer
• Anus-preserving surgery for ultra-low rectal cancer
• Survival
• Prognostic factors

•

Radiomics analysis of pretreatment MR images could predict overall survival (OS) in patients.

We compared the ability of a radiomics model, morphological imaging model, and clinicopathological risk model to predict 3-year overall survival (OS) in 206 patients with rectal cancer who underwent radical surgery and had magnetic resonance imaging, clinicopathological, and OS data available. The patients were randomized to a training cohort (n = 146) and a verification cohort (n = 60). Radiomics features were extracted from preoperative T2-weighted images, and a radiomics score model was constructed. Factors that were significant in the Cox multivariate analysis were used to construct the final morphological tumor model and clinicopathological model. A comprehensive model in the form of a line chart was established by combining the three models. Ten radiomics features significantly related to OS were selected to construct the radiomics feature model and calculate the radiomics score. In the morphological model, mesorectal extension depth and distance between the lower tumor margin and the anal margin were significant prognostic factors. N stage was the only significant clinicopathological factor. The comprehensive model combined with the above factors had the best prediction performance for OS. The C-index had a predictive performance of 0.872 (95% confidence interval [CI]: 0.832–0.912) in the training cohort and 0.944 (95% CI: 0.890–0.990) in the verification cohort, which was better than for any single model. The comprehensive model was divided into high-risk and low-risk groups. Kaplan-Meier curve analysis showed that all factors were significantly correlated with poor OS in the high-risk group. A comprehensive nomogram based on multi-model radiomics features can predict 3-year OS after rectal cancer surgery.

The prognosis of borderline ovarian tumors (BOTs) has been the concern of clinicians and patients. It is urgent to develop a model to predict the survival of patients with BOTs.

To construct a nomogram to predict the likelihood of overall survival (OS) in patients with BOTs.

A total of 192 patients with histologically verified BOTs and 374 patients with epithelial ovarian cancer (EOC) were retrospectively investigated for clinical characteristics and survival outcomes. A 1:1 propensity score matching (PSM) analysis was performed to eliminate selection bias. Survival was analyzed by using the log-rank test and the restricted mean survival time (RMST). Next, univariate and multivariate Cox regression analyses were used to identify meaningful independent prognostic factors. In addition, a nomogram model was developed to predict the 1-, 3-, and 5-year overall survival of patients with BOTs. The predictive performance of the model was assessed by using the concordance index (C-index), calibration curves, and decision curve analysis (DCA).

For clinical data, there was no significant difference in body mass index, preoperative CA199 concentration, or tumor localization between the BOTs group and EOC group. Women with BOTs were significantly younger than those with EOC. There was a significant difference in menopausal status, parity, preoperative serum CA125 concentration, Federation International of gynecology and obstetrics (FIGO) stage, and whether patients accepted postoperative adjuvant therapy between the BOT and EOC group. After PSM, patients with BOTs had better overall survival than patients with EOC (P value = 0.0067); more importantly, the 5-year RMST of BOTs was longer than that of EOC (P value = 0.0002, 95%CI -1.137 to -0.263). Multivariate Cox regression analysis showed that diagnosed age and surgical type were independent risk factors for BOT patient OS (P value < 0.05). A nomogram was developed based on diagnosed age, preoperative serum CA125 and CA199 Levels, surgical type, FIGO stage, and tumor size. Moreover, the c-index (0.959, 95% confidence interval 0.8708–1.0472), calibration plot of 1-, 3-, and 5-year OS, and decision curve analysis indicated the accurate predictive ability of this model.

Patients with BOTs had a better prognosis than patients with EOC. The nomogram we constructed might be helpful for clinicians in personalized treatment planning and patient counseling.

• Borderline ovarian tumors
• Epithelial ovarian cancer
• Nomogram
• Survival

• Nomogram
• Overall survival
• Rectal cancer
• Young patients

The recurrence rate of T3N0 rectal cancer after total mesorectal excision (TME) is relatively low, meaning that not all patients need adjuvant therapy (AT) (radiotherapy, chemotherapy, or chemoradiotherapy).

Patients diagnosed with pT3N0M0 rectal cancer after TME were analyzed using the SEER database, of which 4367 did not receive AT and 2794 received AT. Propensity score matching was used to balance the two groups in terms of confounding factors. Cox proportional hazards regression analysis was used to screen independent prognostic factors, which were then used to establish a nomogram. The patients were then divided into three groups with X-tile software according to their risk scores. We enrolled 334 patients as external validation.

The C-index of the model was 0.725 (95% confidence interval: 0.694–0.756). We divided the patients into three different risk layers based on the nomogram prediction scores, and found that AT did not improve the prognosis of low- and moderate-risk patients, while high-risk patients benefited from AT. External validation data also support the above conclusions.

This study developed a nomogram that effectively and comprehensively evaluates the prognosis of T3N0 rectal cancer patients after TME. After using the nomogram, we recommend AT for high-risk patients, but not for low- and moderate-risk patients.

• T3N0 rectal cancer
• TME
• adjuvant therapy
• nomogram
• prognosis

• Carcinoembryonic antigen (CEA)
• maximum tumor diameter (DMAX)
• prognosis
• stage II colorectal cancer

The number of negative lymph nodes (NLNs) and tumor size are associated with prognosis in rectal cancer patients undergoing surgical resection. However, little is known about the prognostic significance of the NLN count after adjusting for tumor size.

To assess the prognostic impact of the log odds of NLN/tumor size (LONS) in rectal cancer patients.

Data of patients with stage I–III rectal cancer were extracted from the Surveillance, Epidemiology, and End Results Program database. These patients were randomly divided into a training cohort and a validation cohort. Univariate and multivariate Cox regression analyses were used to determine the prognostic value of the LONS. The optimal cutoff values of LONS were calculated using the "X-tile" program. Stratified analysis of the effect of LONS on cancer-specific survival (CSS) and overall survival (OS) were performed. The Kaplan-Meier method with the log-rank test was used to plot the survival curve and compare the survival data among the different groups.

In all, 41080 patients who met the inclusion criteria were randomly divided into a training cohort (n = 28775, 70%) and a validation cohort (n = 12325, 30%). Univariate and multivariate analyses identified the continuous variable LONS as an independent prognostic factor for CSS [training cohort: Hazard ratio (HR) = 0.47, 95% confidence interval (CI): 0.44–0.51, P < 0.001; validation cohort: HR = 0.46, 95%CI: 0.41-0.52, P < 0.001] and OS (training cohort: HR = 0.53, 95%CI: 0.49-0.56, P < 0.001; validation cohort: HR = 0.52, 95%CI: 0.42-0.52, P < 0.001). The X-tile program indicated that the difference in CSS was the most significant for LONS of -0.8, and the cutoff value of -0.4 can further distinguish patients with a better prognosis in the high LONS group. Stratified analysis of the effect of the categorical variable LONS on CSS and OS revealed that LONS was also an independent predictor, independent of pN stage, pT stage, tumor-node-metastasis stage, site, age, sex, the number of examined lymph nodes, race, preoperative radiotherapy and carcinoembryonic antigen level.

LONS is associated with improved survival of rectal cancer patients independent of other clinicopathological factors.

• Rectal cancer
• Negative lymph nodes
• Negative lymph nodes/tumor size
• Prognosis
• Survival analysis
• Surveillance, Epidemiology, and End Results Program

• CEA
• LARC
• carcinoembryonic antigen
• locally advanced rectal cancer
• rectal cancer

• Carcinoembryonic antigen
• Clinical trial
• Colorectal cancer
• Follow-up
• Post-hoc analysis

Nomograms for prognosis prediction in colorectal cancer patients are few, and prognostic indicators differ with age.

To construct a new nomogram survival prediction tool for middle-aged and elderly patients with stage III rectal adenocarcinoma.

A total of 2773 eligible patients were divided into the training cohort (70%) and the validation cohort (30%). Optimal cutoff values were calculated using the X-tile software for continuous variables. Univariate and multivariate Cox proportional hazards regression analyses were used to determine overall survival (OS) and cancer-specific survival (CSS)-related prognostic factors. Two nomograms were successfully constructed. The discriminant and predictive ability and clinical usefulness of the model were also assessed by multiple methods of analysis.

The 95%CI in the training group was 0.719 (0.690-0.749) and 0.733 (0.702-0.74), while that in the validation group was 0.739 (0.696-0.782) and 0.750 (0.701-0.800) for the OS and CSS nomogram prediction models, respectively. In the validation group, the AUC of the three-year survival rate was 0.762 and 0.770, while the AUC of the five-year survival rate was 0.722 and 0.744 for the OS and CSS nomograms, respectively. The nomogram distinguishes all-cause mortality from cancer-specific mortality in patients with different risk grades. The time-dependent AUC and decision curve analysis showed that the nomogram had good clinical predictive ability and decision efficacy and was significantly better than the tumor-node-metastases staging system.

The survival prediction model constructed in this study is helpful in evaluating the prognosis of patients and can aid physicians in clinical diagnosis and treatment.

• Rectal adenocarcinoma
• Lymph node positive rate
• Nomogram
• Prognostic model
• Predictive model
• Survival time

• health care use
• quality of life
• survival
• symptoms
• treatment response

• Adult
• Aged
• Aged, 80 and over
• Female
• Gastrointestinal Neoplasms/epidemiology
• Gastrointestinal Neoplasms/pathology
• Gastrointestinal Neoplasms/therapy
• Humans
• Male
• Middle Aged
• Patient Reported Outcome Measures
• Progression-Free Survival
• Quality of Life
• Surveys and Questionnaires
• Treatment Outcome

• neoadjuvant chemoradiotherapy
• nomogram
• overall survival
• rectal cancer

Colorectal cancer (CRC) patients with different molecular phenotypes, including microsatellite instability (MSI), CpG island methylator phenotype (CIMP), and somatic mutations in BRAF and KRAS gene, vary in treatment response and prognosis. However, molecular phenotyping under adequate quality control in a community-based setting may be difficult. We aimed to build the nomograms based on easily accessible clinicopathological characteristics to predict molecular phenotypes.

Three hundred and six patients with pathologically confirmed stage I-IV CRC were included in the cohort. The assays for MSI, CIMP, and mutations in BRAF and KRAS gene were performed using resected tumor samples. The candidate predictors were identified from clinicopathological variables using multivariate Logistic regression analyses to construct the nomograms that could predict each molecular phenotype.

The incidences of MSI, CIMP, BRAF mutation and KRAS mutation were 25.3% (72/285), 2.5% (7/270), 3.4% (10/293), and 34.8% (96/276) respectively. In the multivariate Logistic analysis, poor differentiation and high neutrophil/lymphocyte ratio (NLR) were independently associated with MSI; poor differentiation, high NLR and high carcinoembryonic antigen/tumor size ratio (CSR) were independently associated with CIMP; poor differentiation, lymphovascular invasion and high CSR were independently associated with BRAF mutation; poor differentiation, proximal tumor, mucinous tumor and high NLR were independently associated with KRAS mutation. Four nomograms for MSI, CIMP, BRAF mutation and KRAS mutation were developed based on these independent predictors, the C-indexes of which were 61.22% (95% CI: 60.28–62.16%), 95.57% (95% CI: 95.20–95.94%), 83.56% (95% CI: 81.54–85.58%), and 69.12% (95% CI: 68.30–69.94%) respectively.

We established four nomograms using easily accessible variables that could well predict the presence of MSI, CIMP, BRAF mutation and KRAS mutation in CRC patients.

• BRAF
• CpG island methylator phenotype
• KRAS
• colorectal cancer
• microsatellite instability
• nomogram
• prediction of molecular subtypes