Multicenter nomogram integrating clinicopathological features for prognosis in stage II-III deficient/microsatellite instability-high rectal cancer

doi:10.5306/wjco.122710

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World Journal of Clinical Oncology

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2218-4333

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

Observational Study

Copyright: ©Author(s) 2026. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution-NonCommercial (CC BY-NC 4.0) license. No commercial re-use. See permissions. Published by Baishideng Publishing Group Inc.

World J Clin Oncol. Jul 24, 2026; 17(7): 122710
Published online Jul 24, 2026. doi: 10.5306/wjco.122710

Table 1 Baseline clinicopathological characteristics of the patients

Patient characteristics		Number	Percentage
Age (years)	mean ± SD	53.82 ± 12.42
Age (years)	≥ 53	42	39.3%
	< 53	65	60.7%
Sex	Male	70	65.4%
	Female	37	34.6%
BMI (kg/m²)	mean ± SD	22.79 ± 3.38
MutL homolog 1	+	45	42.1%
	-	62	57.9%
PMS1 homolog 2	+	53	49.5%
	-	54	50.5%
MutS homolog 2	+	40	37.4%
	-	67	52.6%
MutS homolog 6	+	49	45.8%
	-	58	54.2%
Deficient mismatch repair protein	1	36	33.6%
	2	62	57.9%
	3	9	8.4%
T stage	1	1	0.9%
	2	3	2.8%
	3	87	81.3%
	4	16	15.0%
N stage	0	73	68.2%
	1	22	20.6%
	2	12	11.2%
AJCC TNM staging system	II	73	68.2%
	III	34	31.8%
LVI	Positive	23	21.5%
	Negative	84	78.5%
PNI	Positive	14	13.1%
	Negative	93	86.9%
CA19-9 (35 U/mL)	mean ± SD	47.2 ± 135.5
CEA (5 ng/mL)	mean ± SD	8.2 ± 26.0
CA19-9 (35 U/mL)	Elevated	18	16.8%
	Normal	87	81.3%
	Missing data	2	1.9%
CEA (5 ng/mL)	Elevated	28	26.2%
	Normal	77	72.0%
	Missing data	2	1.9%
Recurrence	Yes	21	19.6%
	No	86	80.4%

BMI: Body mass index; AJCC: American Joint Committee on Cancer; TNM: Tumor-node-metastasis; LVI: Lymphovascular invasion; PNI: Perineural invasion; CEA: Carcinoembryonic antigen; CA19-9: Cancer antigen 19-9.

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Table 2 Relationship between lymphovascular invasion and clinical characteristics, n (%)

Variables		LVI negative (n = 84)	LVI positive (n = 23)	P value
Age (≥ 53 years/< 53 years)		34 (40.5)/50 (59.5)	8 (34.8)/15 (65.2)	0.787
BMI (kg/m²)	mean ± SD	23.1 ± 3.3	55.8 ± 3.3	0.798
Sex (female/male)		29 (34.5)/55 (65.5)	8 (34.8)/15 (65.2)	1.000
CA19-9 (< 35 U/mL/≥ 35 U/mL)	Missing data	70 (83.3)/13 (15.5)/1 (1.2)	17 (73.9)/5 (21.7)/1 (4.3)	0.643
CEA (< 5 ng/mL/≥ 5 ng/mL)	Missing data	61 (72.6)/22 (26.2)/1 (1.2)	16 (69.6)/6 (26.1)/1 (4.3)	1.000
PNI (negative/positive)		77 (91.7)/7 (8.3)	16 (69.6)/7 (30.4)	0.015
T stage (1/2/3/4)		1 (1.2)/1 (1.2)/69 (82.1)/13 (15.5)	0 (0)/2 (8.7)/18 (78.3)/3 (13.0)	0.261
N stage (0/1/2)		64 (76.2)/16 (19.0)/4 (4.8)	9 (39.1)/6 (26.1)/8 (34.8)	< 0.001
AJCC TNM staging system (II/III)		73 (86.9)/11 (13.1)	10 (43.5)/13 (56.5)	< 0.001
Recurrence (no/yes)		76 (90.5)/8 (9.5)	10 (43.5)/13 (56.5)	< 0.001

LVI: Lymphovascular invasion; BMI: Body mass index; CA19-9: Cancer antigen 19-9; CEA: Carcinoembryonic antigen; PNI: Perineural invasion; AJCC: American Joint Committee on Cancer; TNM: Tumor-node-metastasis.

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Table 3 Relationship between perineural invasion and clinical characteristics, n (%)

Variables		PNI negative (n = 93)	PNI positive (n = 14)	P value
Age (≥ 53 years/< 53 years)		37 (39.8)/56 (60.2)	5 (35.7)/9 (64.3)	1.000
BMI (kg/m²)	mean ± SD	23.0 ± 3.2	23.0 ± 3.2	0.700
Gender (female/male)		37(39.8)/56 (60.2)	0 (0)/14 (100.0)	0.009
CA19-9 (< 35 U/mL/≥ 35 U/mL)	Missing data	77 (82.8)/15 (16.1)/1 (1.1)	10 (71.4)/3 (21.4)/1 (7.1)	0.831
CEA (< 5 ng/mL/≥ 5 ng/mL)	Missing data	68 (73.1)/24 (25.8)/1 (1.1)	9 (64.3)/4 (28.6)/1 (7.1)	0.982
LVI (negative/positive)		77 (82.8)/16 (17.)	7 (50.0)/7 (50.0)	0.015
T stage (1/2/3/4)		1 (1.1)/2(2.2)/78 (83.9)/12 (12.9)	0 (0)/1 (7.1)/9 (64.3)/4 (28.6)	0.283
N stage (0/1/2)		71 (76.3)/14 (15.1)/8 (8.6)	2 (14.3)/8 (57.1)/4 (28.6)	< 0.001
AJCC TNM staging system (II/III)		77 (82.8)/16 (17.2)	6 (42.9)/8 (57.1)	0.003
Recurrence (no/yes)		78 (83.9)/15 (16.1)	8 (57.1)/6 (42.9)	0.047

PNI: Perineural invasion; BMI: Body mass index; CA19-9: Cancer antigen 19-9; CEA: Carcinoembryonic antigen; LVI: Lymphovascular invasion; AJCC: American Joint Committee on Cancer; TNM: Tumor-node-metastasis.

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Table 4 Results of the univariate and multivariate Cox regression analysis for recurrence-free survival among the clinical characteristics

Variables	Univariate Cox analysis		Multivariate Cox analysis
Variables	HR (95%CI)	P value	HR (95%CI)	P value
Age (years)		0.326
mean ± SD	1.02 (0.98-1.05)
BMI (kg/m²)		0.278
mean ± SD	0.92 (0.80-1.07)
LVI		< 0.001		0.018
Negative	Reference		Reference
Positive	7.34 (3.02-17.86)		3.31 (1.23-8.91)
PNI		0.001		0.305
Negative	Reference		Reference
Positive	5.11 (1.92-13.60)		1.75 (0.60-5.14)
Gender		0.200		0.768
Male	Reference
Female	0.52 (0.19-1.42)		1.19 (0.37-3.87)
AJCC TNM staging system		< 0.001		0.003
II	Reference		Reference
III	8.98 (3.61-22.34)		5.23 (1.75-15.62)
CA19-9 (35 U/mL)		0.582
< 35	Reference
≥ 35	0.71 (0.21-2.42)
CEA (5 ng/mL)		0.765
< 5	Reference
≥ 5	1.16 (0.45-2.98)

HR: Hazard ratio; CI: Confidence interval; BMI: Body mass index; LVI: Lymphovascular invasion; PNI: Perineural invasion; AJCC: American Joint Committee on Cancer; TNM: Tumor-node-metastasis; CA19-9: Cancer antigen 19-9; CEA: Carcinoembryonic antigen.

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Citation: Zhang DY, Liao YJ, Tang X, Chen G, Zhang RX. Multicenter nomogram integrating clinicopathological features for prognosis in stage II-III deficient/microsatellite instability-high rectal cancer. World J Clin Oncol 2026; 17(7): 122710
URL: https://www.wjgnet.com/2218-4333/full/v17/i7/122710.htm
DOI: https://dx.doi.org/10.5306/wjco.122710

Zhang DY, Liao YJ, Tang X, Chen G, Zhang RX. Multicenter nomogram integrating clinicopathological features for prognosis in stage II-III deficient/microsatellite instability-high rectal cancer. World J Clin Oncol 2026; 17(7): 122710 [DOI: 10.5306/wjco.122710]

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