Published online May 27, 2023. doi: 10.4240/wjgs.v15.i5.892
Peer-review started: December 3, 2022
First decision: February 1, 2023
Revised: February 27, 2023
Accepted: March 27, 2023
Article in press: March 27, 2023
Published online: May 27, 2023
Surgery remains the primary treatment for localized colorectal cancer (CRC). Improving surgical decision-making for elderly CRC patients necessitates an accurate predictive tool.
To build a nomogram to predict the overall survival of elderly patients over 80 years undergoing CRC resection.
Two hundred and ninety-five elderly CRC patients over 80 years undergoing surgery at Singapore General Hospital between 2018 and 2021 were identified from the American College of Surgeons – National Surgical Quality Improvement Program (ACS-NSQIP) database. Prognostic variables were selected using uni
Eight predictors: Age, Charlson comorbidity index, body mass index, serum albumin level, distant metastasis, emergency surgery, postoperative pneumonia, and postoperative myocardial infarction, were included in the nomogram. The AUC values for the 1-year survival were 0.843 and 0.826 for the training and validation cohorts, respectively. The AUC values for the 3-year survival were 0.788 and 0.750 for the training and validation cohorts, respectively. C-index values of the training cohort (0.845) and validation cohort (0.793) suggested the excellent discriminative ability of the nomogram. Calibration curves demonstrated a good consistency between the predictions and actual observations of overall survival in both training and validation cohorts. A significant difference in overall survival was seen between elderly patients stratified into low- and high-risk groups (P < 0.001).
We constructed and validated a nomogram predicting 1- and 3-year survival probability in elderly patients over 80 years undergoing CRC resection, thereby facilitating holistic and informed decision-making among these patients.
Core Tip: This is the first predictive nomogram evaluating the survival outcomes among elderly colorectal cancer patients over 80 years. This nomogram has incorporated age, Charlson comorbidity index, body mass index, serum albumin level, the presence of metastatic disease, emergency surgery, as well as postoperative pneumonia and myocardial infarction. Our study is the first to link these variables together in predicting overall survival in elderly colorectal cancer patients over 80 years. This novel nomogram that accurately predicts survival probabilities may facilitate preoperative treatment decisions in the advancing age group.