Published online Nov 14, 2020. doi: 10.3748/wjg.v26.i42.6638
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
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.
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.
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.
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.
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.
We established accurate nomograms and prediction models for predicting OS and DFS in patients with LARC after undergoing NT.
Larger prospective multicenter clinical studies need to be performed to validate the nomograms and risk score prediction models of OS and DFS.