New Personal Model for Forecasting the Outcome of Patients with Histological Grade III-IV Colorectal Cancer Based on Regional Lymph Nodes.

ABSTRACT

Background: Metastases at regional lymph nodes could easily occur in patients with high-histological-grade colorectal cancer (CRC). However, few models were built on the basis of lymph nodes to predict the outcome of patients with histological grades III-IV CRC. Methods: Data in the Surveillance, Epidemiology, and End Results databases were used. Univariate and multivariate analyses were performed. A personalized prediction model was built in accordance with the results of the analyses. A nomogram was tested in two datasets and assessed using a calibration curve, a consistency index (C-index), and an area under the curve (AUC). Results: A total of 14,039 cases were obtained from the database. They were separated into two groups (9828 cases for constructing the model and 4211 cases for validation). Logistic and Cox regression analyses were then conducted. Factors such as log odds of positive lymph nodes (LODDS) were utilized. Then, a personalized prediction model was established. The C-index in the construction and validation groups was 0.770. The 1-, 3-, and 5-year AUCs were 0793, 0.828, and 0.830 in the construction group, respectively, and 0.796, 0.833, and 0.832 in the validation group, respectively. The calibration curves showed well consistency in the 1-, 3- and 5-year OS between prediction and reality in both groups. Conclusion: The nomogram built based on LODDS exhibited considerable reliability and accuracy.