Analysis of a Nomogram for Predicting Long-term Cardiovascular Specific Survival in Elderly Patients with Nonmetastatic Colon Cancer Treated with Colectomy
Objective To develop and validate a clinical nomogram for predicting long-term cardiovascular specific survival(CSS)in elderly patients with non-metastatic colon cancer treated with colectomy.Methods Elderly patients with non-metastatic colon cancer who underwent colectomy between 2004 and 2017 were searched from the Surveillance,epidemiol-ogy and End Results database,and a total of 9,302 patients were included.They were randomly assigned to the training set(n=6 511)and the verification set(n=2 791)in a ratio of 7∶3.CSS was the primary study endpoint.Cox regression anal-ysis was performed on the training set to identify independent predictors,and a column graph was constructed to predict CSS.The prediction efficiency of the nomogram model was evaluated by the area under the receiver operating characteristic(ROC)curve and the calibration curve.Results Multivariate Cox regression analysis identified five independent prognostic factors for CSS:chemotherapy,marital status,sex,race,and age.Based on these five factors,the establishment of a column graph to predict CSS in elderly patients with non-metastatic colon cancer after colectomy showed excellent performance.The area under ROC curve of CSS in training sets 5,8 and 10 years was 0.684,0.721 and 0.731,respectively,and the validation sets were 0.689,0.742 and 0.731,respectively.Conclusion This study identified independent prognostic factors for CSS in elderly patients with non-metastatic colon cancer treated by colectomy.A nomogram for predicting CSS in this patient population was established and validated,which can be used to aid clinical decision making and screening of high-risk patients to improve outcomes.
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