Nomograms and risk score models for predicting survival in rectal cancer patients with neoadjuvant therapy

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.