Zhang et al reported two nomograms for evaluating a patient with colorectal cancer that has been resected without pre-operative therapy. One model predicts overall survival. The authors are from Shanghai East Hospital and Tongji University Hospital in China.
Patient selection: colorectal cancer, status post resection, age from 10 to 100 years, without preoperative therapy
Parameters:
(1) size in cm
(2) extent of the surgical resection
(3) histologic grade
(4) site
(5) gender
(6) marital status
(7) histologic type
(8) lymph node count (LNC)
(9) CEA status
(10) race
(11) depth of invasion (T status)
(12) lymph node ratio (LNR)
(13) metastases (M status)
(14) age in years
|
Parameter |
Finding |
Points |
|
size |
<= 5 cm |
0 |
|
|
> 5 cm |
1.1 |
|
|
unknown |
3.2 |
|
extent of surgery |
local or segmental |
0 |
|
|
partial colectomy |
1.8 |
|
|
total colectomy |
7.1 |
|
histologic grade |
G1 or G2 |
0 |
|
|
G3 or G4 |
7.1 |
|
|
unknown |
2.1 |
|
site |
descending colon |
0 |
|
|
proximal colon (cecum to sigmoid flexion) |
3.5 |
|
|
rectum |
2.8 |
|
|
overlapping |
8.0 |
|
gender |
female |
0 |
|
|
male |
9.2 |
|
marital status |
married |
0 |
|
|
widowed |
8.9 |
|
|
divorced |
8.5 |
|
|
single |
10.6 |
|
|
unknown |
5.7 |
|
histologic type |
adenocarcinoma |
0 |
|
|
signet ring cell |
13.5 |
|
CEA status |
negative |
0 |
|
|
positive |
16.5 |
|
race |
yellow |
0 |
|
|
white |
14.2 |
|
|
black |
21.3 |
|
|
other |
14.0 |
|
depth of invasion |
T1 |
0 |
|
|
T2 |
14.2 |
|
|
T3 |
24.4 |
|
|
T4a |
38.6 |
|
|
T4b |
42.1 |
|
metastases |
negative (M0) |
0 |
|
|
positive (M1) |
51.1 |
|
Age in Years |
Points |
|
10 to 60 |
(0.1163 * (age)) - 1.163 |
|
60 to 100 |
(0.02123 * ((age)^2)) - (1.005 * (age)) - 11.05 |
|
Lymph Node Count |
Points |
|
0 to 30 |
(0.005319 * ((LNC)^2)) - (0.6915 * (LNC)) + 15.78 |
|
30 to 90 |
(0.112 * (LNC)) - 3.273 |
|
Lymph Node Ratio |
Points |
|
0 to 30 |
(-0.0227 * ((LNR)^2)) + (1.391 * (LNR)) + 0.156 |
|
30 to 100 |
(0.3445 * (LNR)) + 11.3 |
total score =
= SUM(points for all of the findings)
Interpretation:
• minimum score: 0
• maximum score: 342.1
|
Total Score |
5-Year Overall Survival |
|
<14.9 |
> 95% |
|
14.9 to 123 |
X = 3.38 - (0.02702 * (score)) probability = 1 / (1 + EXP((-1) * X)) |
|
123 to 202.1 |
X = (-0.0004786 * ((score)^2)) + (0.09932 * (score)) - 5.043; probability = 1 / (1 + EXP((-1) * X)) |
|
>202.1 |
< 1% |
Performance:
• The area under the ROC curve is 0.78.
Specialty: Hematology Oncology
