A nomogram to predict survival in patients older than 65 years with
rectal cancer: A SEER-based population study
Abstract
Background: There has been no construction of nomograms specifically
geared towards pblueicting the prognosis of older patients with rectal
cancer. Our objective was to create a nomogram that can accurately
pblueict the chances of cancer-specific survival (CSS) and overall
survival (OS) for older patients with rectal cancer,stratifying them
into distinct risk groups. Methods: Data of older than 65 years with
rectal cancer from the Surveillance, Epidemiology, and End Results
(SEER) database between 2000 and 2020 were extracted. Results: A total
of 12,780 patients were collected in order to identify the independent
prognostic factors for cancer-specific survival (CSS) and overall
survival (OS) and construct nomograms. The factors included age, sex,
race,year of diagnos, marital status, grade, tumor size, CEA, T
classification, N classification, Months from diagnosis to treatment,
surgery, chemotherapy, and radiation. LASSO regression was used for this
purpose. The results showed that grade, chemotherapy, and months from
diagnosis to treatment were identified as independent prognostic factors
for OS, while grade, chemotherapy, and tumor size were identified as
independent prognostic factors for CSS. The concordance index of the CSS
nomogram was 0.609 (95% confidence interval [CI], 0.598-0.619) in
the training cohort and 0.682 (95%CI, 0.665-0.698) in the validation
cohort. The concordance index of the OS nomogram was 0.697 (95%CI,
0.686-0.708) in the training cohort and 0.605 (95%CI, 0.589-0.621) in
the validation cohort. Conclusion: Caution should be taken when
administering adjuvant therapy after surgery in older patients with
rectal cancer,as we have developed and validated a new pblueictive
nomogram for CSS and OS.