Development and validation of a nomogram prediction model for overall survival in patients with rectal cancer

doi:10.4251/wjgo.v17.i2.100908

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World Journal of Gastrointestinal Oncology

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1948-5204

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World J Gastrointest Oncol. Feb 15, 2025; 17(2): 100908
Published online Feb 15, 2025. doi: 10.4251/wjgo.v17.i2.100908

Table 1 Patient demographic and clinical information distribution

Variables	Overall (1846)	Training cohort (1293)	Validation cohort (553)	P value
Age¹	60.35 ± 12.62	60.19 ± 12.71	60.72 ± 12.42	0.416
KPS¹	81.79 ± 8.52	81.80 ± 8.43	81.75 ± 8.72	0.908
BMI, n (%)
< 18.5	110 (5.96)	79 (6.11)	31 (5.61)	0.841
18.5-23.9	1021 (55.31)	719 (55.61)	302 (54.61)
24-27.9	582 (31.53)	400 (30.94)	182 (32.91)
≥ 28	133 (7.20)	95 (7.35)	38 (6.87)
Sex, n (%)
Male	1062 (57.53)	731 (56.54)	331 (59.86)	0.204
Female	784 (42.47)	562 (43.46)	222 (40.14)
Marita, n (%)
Married	1712 (92.74)	1204 (93.12)	508 (91.86)	0.393
Others	134 (7.26)	89 (6.88)	45 (8.14)
Histology, n (%)
Adenocarcinoma	1831 (99.19)	1282 (99.15)	549 (99.28)	1.000
Others	15 (0.81)	11 (0.85)	4 (0.72)
TNM, n (%)
I-II	561 (30.39)	406 (31.40)	155 (28.03)	0.154
III	508 (27.52)	361 (27.92)	147 (26.58)
IV	777 (42.09)	526 (40.68)	251 (45.39)
Radiation, n (%)
No	1702 (92.20)	1195 (92.42)	507 (91.68)	0.655
Yes	144 (7.80)	98 (7.58)	46 (8.32)
Chemotherapy, n (%)
No	743 (40.25)	521 (40.29)	222 (40.14)	0.994
Yes	1103 (59.75)	772 (59.71)	331 (59.86)
Surgery, n (%)
No	663 (35.92)	458 (35.42)	205 (37.07)	0.533
Yes	1183 (64.08)	835 (64.58)	348 (62.93)
Immunotherapy, n (%)
No	1805 (97.78)	1262 (97.60)	543 (98.19)	0.539
Yes	41 (2.22)	31 (2.40)	10 (1.81)
Targeted, n (%)
No	1453 (78.71)	1020 (78.89)	433 (78.30)	0.826
Yes	393 (21.29)	273 (21.11)	120 (21.70)
Hypertension (%)
No	1416 (76.71)	986 (76.26)	430 (77.76)	0.523
Yes	430 (23.29)	307 (23.74)	123 (22.24)
Diabetes, n (%)
No	1601 (86.73)	1127 (87.16)	474 (85.71)	0.444
Yes	245 (13.27)	166 (12.84)	79 (14.29)
WBC²	6.03 (4.84, 7.69)	5.97 (4.81, 7.70)	6.10(4.94, 7.69)	0.570
β2.microglobulin²	2.50 (1.90, 3.20)	2.50 (1.87, 3.20)	2.50 (2.00, 3.20)	0.055
LDH²	186.20 (159.93, 230.38)	187.80 (161.70, 228.80)	184.60 (158.00, 235.00)	0.386
PLR²	170.84 (120.59, 246.22)	172.37 (122.60, 251.67)	168.29 (113.39, 234.88)	0.108
NLR²	2.81 (1.95, 4.44)	2.83 (1.98, 4.48)	2.75 (1.88, 4.36)	0.243
LMR²	3.15 (2.09, 4.46)	3.15 (2.10, 4.52)	3.14 (2.09, 4.28)	0.425
AGR²	1.35 (1.15, 1.56)	1.35 (1.16, 1.56)	1.35 (1.12, 1.57)	0.611
CD4/CD8²	1.66 (1.16, 2.31)	1.66 (1.16, 2.35)	1.64 (1.17, 2.24)	0.757

¹Expressed as mean ± SD.

²Expressed as median[P25, P75].

BMI: Body mass index; KPS: Karnofsky performance status; WBC: White blood cell count; LDH: Lactic dehydrogenase; PLR: Platelet-to-lymphocyte ratio; NLR: Neutrophil-to-lymphocyte ratio; LMR: Lymphocyte-to-monocyte ratio; AGR: Albumin-to-globulin ration.

Table 2 Results of univariate and multivariate analyses of prognostic factors in the training cohort

Variables	HR (univariable)	HR (multivariable)	Variables	HR (univariable)	HR (multivariable)
Age	1.01 (1.00-1.02, P = 0.006)	1.01 (1.00-1.02, P = 0.002)	KPS	0.95 (0.94-0.95, P < 0.001)	0.98 (0.97-0.99, P < 0.001)
BMI			Chemotherapy
< 18.5	ref		No
18.5-23.9	0.61 (0.44-0.85, P = 0.003)		Yes	0.64 (0.53-0.76, P < 0.001)	0.63 (0.50-0.79, P < 0.001)
24-27.9	0.47 (0.33-0.67, P < 0.001)		Surgery
≥ 28	0.41 (0.25-0.66, P < 0.001)		No
Sex			Yes	0.35 (0.29-0.42, P < 0.001)	0.70 (0.57-0.86, P = 0.001)
Male			Immunotherapy
Female	1.22 (1.02-1.45, P = 0.033)	1.32 (1.10-1.58, P = 0.003)	No
Marital			Yes	0.65 (0.31-1.38, P = 0.261)
Married			Targeted
Others	1.23 (0.87-1.74, P = 0.236)		No
Histology			Yes	2.12 (1.74-2.58, P < 0.001)	1.44 (1.13-1.84, P = 0.003)
Adenocarcinoma			WBC	1.06 (1.03-1.09, P < 0.001)
Others	1.03 (0.38-2.74, P = 0.961)		β2.microglobulin	1.19 (1.13-1.26, P < 0.001)	1.11 (1.03-1.18, P = 0.004)
TNM			LDH	1.01 (1.01-1.02, P < 0.001)	1.02 (1.01-1.03, P < 0.001)
I-II			PLR	1.02 (1.01-1.03, P = 0.002)
III	2.43 (1.73-3.43, P < 0.001)	2.82 (1.98-4.01, P < 0.001)	NLR	1.07 (1.05-1.09, P < 0.001)	1.04 (1.02-1.07, P = 0.001)
IV	9.92 (7.32-13.44, P < 0.001)	8.16 (5.82-11.44, P < 0.001)	LMR	0.98 (0.97-1.00, P = 0.085)
Radiation			AGR	0.40 (0.29-0.53, P < 0.001)
No			CD4/CD8	0.89 (0.81-0.99, P = 0.024)
Yes	1.67 (1.26-2.22, P < 0.001)

Citation: Liang L, Li XS, Huang ZJ, Hu ZH, Xu QJ, Yuan YL, Zhang W, Lei HK. Development and validation of a nomogram prediction model for overall survival in patients with rectal cancer. World J Gastrointest Oncol 2025; 17(2): 100908
URL: https://www.wjgnet.com/1948-5204/full/v17/i2/100908.htm
DOI: https://dx.doi.org/10.4251/wjgo.v17.i2.100908