Prognostic value of patient-generated subjective global assessment for colorectal cancer patients and construction of a nomogram
Objective To investigate the prognostic value of patient-generated subjective global assessment(PG-SGA)for colorectal cancer patients,and construct a nutrition-related nomogram integrated with nutritional status with clinicopathologic parameters for survival prediction.Method A retrospective analysis was conducted on 202 colorectal cancer patients who underwent curative resection in Nantong Affiliated Hospital of Nanjing University of Chinese Medicine from January 2016 to January 2020.Preoperative nutritional status was evaluated by PG-SGA and its impact on overall survival(OS)of colorectal cancer patients was analyzed.The univariate and multivariate Cox regression analysis was used to determine independent prognostic factors.A nomogram model was constructed and its predictive performance was tested by the consistency index(C-index)and calibration plots.Result According to the PG-SGA,33.7%of patients had moderate malnutrition and 26.7%were severely malnourished.Patients with severe malnutrition had a larger tumor diameter(P=0.044)and a lower proportion of adjuvant chemotherapy following the surgery(P=0.029)than other patients.The 5-year OS rates of patients with well nutrition,moderate malnutrition,and severe malnutrition were 81.6%,63.2%,and 46.5%,respectively.There were significant survival differences between the groups(P<0.05).Tumor size(P=0.046),pT stage(P=0.002),lymph node metastasis(P=0.001),vascular invasion(P<0.001),and PG-SGA(P<0.001)were independent prognostic factors for colorectal cancer patients.A nomogram model was developed according to the above prognostic parameters,and its C-index was 0.781(95%CI=0.671-0.890).The calibration plots showed a good consistency between the predicted survival probability and actual survival probability.Conclusion PG-SGA is a useful tool for survival prediction of colorectal cancer patients,and it might further optimize the prognostic risk stratification of patients along with clinicopathologic parameters.
Colorectal cancerPatient generated subjective global assessmentNomogramPrognosticPrediction
万方数据
维普
