Development and validation of nomograms for predicting survival in patients with non-metastatic colorectal cancer

BACKGROUND This study aimed to develop nomograms for predicting survival in patients with non-metastatic colorectal cancer (CRC). RESULTS On multivariate analyses of the derivation set, the nomograms for OS and CSS shared common significant prognostic factors: age, first-degree relative cancer history, differentiation grade, vessels/nerves invasion, TNM stage, CEA, CA19-9 and PNI. The nomograms displayed good accuracy in predicting OS and CSS, with C-indexes of 0.75 and 0.76, respectively. The calibration plots also showed an excellent agreement between the predicted and observed survival probabilities. Furthermore, the predictive accuracy of the nomograms was confirmed in the validation set, with C-indexes of 0.79 and 0.83 for OS and CSS, respectively. MATERIALS AND METHODS On the basis of data from 822 patients with resected non-metastatic CRC, nomograms for predicting overall survival (OS) and cancer-specific survival (CSS) were established using Cox regression model. The predictive performance of the nomograms was assessed by concordance index (C-index) and calibration plot. An independent external cohort of 171 patients was used to validate the nomograms. CONCLUSIONS We developed and validated two nomograms for patients with non-metastatic CRC, which could provide individual prediction of OS and CSS with high accuracy.