Nomograms and risk score models for predicting survival in rectal cancer patients with neoadjuvant therapy

Table 1 Patient demographics

Variable	Primary cohort (n = 155)		Validation cohort (n = 65)
	No. of patients	%	No. of patients	%
Age
Median	60.00		61.00
Range	52.00-66.00		51.00-65.50
BMI
Median	24.13		23.44
Range	21.78-26.50		21.80-25.27
Death
Yes	18	11.6	15	23.1
No	137	88.4	50	76.9
Her-2
1	34	21.9	18	27.7
2	17	11	6	9.2
3	3	1.9	2	3.1
4	1	0.6
5	100	64.5	39	60
BRAF-V600E
1	105	67.7	45	69.2
2	6	3.9
3	1	0.6
4	1	0.6	1	1.5
5	42	27.1	19	29.2
P53
1	11	7.1	2	3.1
2	7	4.5	1	1.5
3	1	0.6	2	3.1
4	15	9.7	7	10.8
5	121	78.1	53	81.5
ASA
1	3	1.9	3	4.6
2	122	78.7	48	73.8
3	30	19.4	14	21.5
Sex
Male	99	63.9	53	81.5
Female	56	36.1	12	18.5

BMI: Body mass index; ASA: American Society of Anesthesiologists; Her-2: 1-, 2+, 3++, 4+++, 5no; BRAF-V600E: 1-, 2+, 3++, 4no; P53: 1-, 2+, 3++, 4++, 5no.

Table 2 Clinical data before surgery

Variable	Primary cohort (n = 155)		Validation cohort (n = 65)
	No. of patients	%	No. of patients	%
Preoperative chemotherapy cycle
Median	2.00		3.00
Range	2.00-3.00		2.00-3.00
Surgery a few weeks after radiotherapy
Median	8.00		9.00
Range	7.00-11.00		7.00-15.00
Distance from margin before NT
Median	5.00		5.00
Range	3.00-7.00		3.00-7.00
Distance from margin after NT
Median	5.00		5.00
Range	3.00-7.00		3.00-7.00
Preoperative CEA
Median	2.85		3.35
Range	1.60-4.73		1.52-6.21
cT
2			1	1.5
3	120	77.4	52	80
4	35	22.6	12	18.5
cN
0	54	34.8	21	32.3
1	73	47.1	33	50.8
2	28	18.1	11	16.9
cM
0	146	94.2	62	95.4
1	9	5.8	3	4.6
cTNM
2	52	33.5	21	32.3
3	94	60.6	41	63.1
4	9	5.8	3	4.6
yT
0	22	14.2	8	12.3
1	4	26	1	1.5
2	34	21.9	15	23.1
3	84	54.2	35	53.8
4	11	7.1	6	9.2
yN
0	88	56.8	33	50.8
1	47	30.3	23	35.4
2	19	12.3	9	13.8
3	1	0.6
yM
0	146	94.2	62	95.4
1	9	5.8	3	4.6
ypTNM
0	21	13.5	8	12.3
1	28	18.1	12	18.5
2	39	25.2	15	23.1
3	58	37.4	27	41.5
4	9	5.8	3	4.6
Pathological changes after treatment
1	85	54.8	38	58.5
2	48	31	19	29.2
3	22	14.2	8	12.3
TRG
0	3	1.9	2	3.1
1	27	17.4	14	21.5
2	62	40	26	40.0
3	41	26.5	15	23.1
4	22	14.2	8	12.3
Preoperative simultaneous chemotherapy
Yes	126	81.3	51	78.5
No	29	18.7	14	21.5
Preoperative radiotherapy
Yes	3	1.9	4	6.2
No	152	98.1	61	93.8
Preoperative chemotherapy
Yes	26	16.8	10	15.4
No	129	83.2	55	84.6

CEA: Carcinoembryonic antigen; TRG: Tumor regression grade. Pathological changes after treatment, 1: no-downstaging; 2: downstaging; 3: Polymerase chain reaction.

Table 3 Surgical and pathological data

Variable	Primary cohort (n = 155)		Validation cohort (n = 65)
	No. of patients	%	No. of patients	%
Total number of lymph nodes
Median	16.00		17.00
Range	12.00-22.00		11.00-22.00
Positive lymph node status
Median	0.00		0.00
Range	0.00-1.00		0.00-2.00
Operating time
Median	193.00		209.00
Range	158.00-237.00		148.00-257.00
Matchmouth distance from the edge
Median	3.00		2.00
Range	0.00-4.00		1.00-4.00
Amount of bleeding during surgery
Median	50.00		50.00
Range	20.00-100.00		20.00-60.00
Joint organ cut
Yes	8	5.2	3	4.6
No	147	94.8	62	95.4
Side-side lymph node sweep
Yes	5	3.2	3	4.6
No	150	96.8	62	95.4
Preventive mouth-building
Yes	35	22.6	15	23.1
No	120	77.4	50	76.9
Retention of the left colon artery
Yes	9	5.8	6	9.2
No	146	94.2	59	90.8
Postoperative pathology
1	3	1.9	1	1.5
2	128	82.6	52	80
3	19	12.3	11	16.9
4	1	0.6	1	1.5
5	4	2.6
Cancer nodules
Yes	17	11	11	16.9
No	138	89	54	83.1
Nerve aggression
Yes	30	19.4	23	35.4
No	125	80.6	42	64.6
Vascular_tumors_bolt
Yes	17	11	9	13.8
No	138	89	56	86.2

Postoperative pathology, 1: Highly differentiated adenocarcinoma; 2: Moderately and Second differentiated adenocarcinoma; 3: Poorly and medium differentiated adenocarcinoma; 4: Signet-ring cell carcinoma; 5: mucinous adenocarcinoma.

Table 4 Clinical data after surgery

Variable	Primary cohort (n = 155)		Validation cohort (n = 65)
	No. of patients	%	No. of patients	%
Number of cycles of postoperative chemotherapy regimens
Median	4.00		4.00
Range	0.00-6.00		0.00-6.00
Postoperative exhaust
Median	3.00		3.00
Range	3.00-5.00		3.00-5.00
Postoperative defecation
Median	5.00		5.00
Range	3.00-6.00		4.00-6.00
Postoperative ureter removal time
Median	4.00		4.00
Range	4.00-5.00		3.00-5.00
Postoperative CEA
Median	2.41		2.55
Range	1.59-3.705		1.70-3.41
Postoperative adjuvant therapy
Yes	101	65.2	45	69.2
No	54	34.8	20	30.8
Postoperative bleeding
Yes	2	1.3
No	153	98.7	65	100
Postoperative intestinal fistula
Yes	5	3.2
No	150	96.8	65	100
Intestinal obstruction after surgery
Yes			1	1.5
No	155	100	64	98.5
Unplanned postoperative surgery
Yes	3	1.9
No	152	98.1	65	100
Cardiovascular accidents
Yes	1	0.6
No	154	99.4	65	100
Postoperative complications
Yes	7	4.5	1	1.5
No	148	95.5	64	98.5
Recurrence
Yes	30	19.4	17	26.2
No	125	80.6	48	73.8

CEA: Carcinoembryonic antigen.

Table 5 Cox regression analysis for the prognostic factors of overall survival

Variable	P value	OR	95%CI
yN	0.003
1 vs 0	0.947	576.353	0.000-4.138E+84
2 vs 0	0.935	2450.459	0.000-1.758E+85
3 vs 0	0.934	2902.876	0.000-2.084E+85
Cancer nodules	0.003	3.278	1.506-7.134
Nerve aggression	< 0.0001	3.446	1.726-6.882
Vascular_tumors_bolt	0.009	2.924	1.309-6.531
ypTNM	0.112
1 vs 0	0.110	0.267	0.053-1.346
2 vs 0	0.962	0.000	0.000-2.397E+244
3 vs 0	0.102	0.299	0.071-1.268
4 vs 0	0.801	0.856	0.254-2.886
cT	0.057
3 vs 2	0.018	14.337	1.585-129.724
4 vs 2	0.192	2.011	0.705-5.735
Matchmouth distance from the edge	0.012	0.805	0.679-0.953
Postoperative CEA	0.037	1.017	1.001-1.034
BMI	0.031	1.113	1.010-1.226
Operation time	0.068	1.004	1.000-1.008

CEA: Carcinoembryonic antigen; BMI: Body mass index.

Table 6 Cox regression analysis for the prognostic factors of disease-free survival

Variable	P value	OR	95%CI
ypTNM	0.001
1 vs 0	0.003	0.089	0.018-0.445
2 vs 0	0.001	0.032	0.004-0.266
3 vs 0	0.017	0.291	0.105-0.805
4 vs 0	0.198	0.558	0.230-1.355
Nerve aggression	< 0.0001	3.01	1.681-5.388

Table 7 Kaplan-Meier curves for the prognostic factors of overall survival

Variable	P value	HR	95%CI
yN	0.00083	0.51	0.35-0.75
Cancer nodules	0.0015	3.29	1.51-7.15
Nerve aggression	0.00018	3.45	1.73-6.89
Vascular tumors bolt	0.0059	2.93	1.31-6.55
Matchmouth distance from edge	0.0035	0.80	0.67-0.95
Postoperative CEA	0.55	1.02	1.00-1.03
BMI	0.036	1.12	1.02-1.23

CEA: Carcinoembryonic antigen; BMI: Body mass index.

Table 8 Kaplan-Meier curves for the prognostic factors of disease-free survival

Variable		P value	HR	95%CI
ypTNM		< 0.0001	0.73	0.56-0.96
Nerve aggression		< 0.0001	3.02	1.69-5.4