Published online Nov 27, 2023. doi: 10.4240/wjgs.v15.i11.2430
Peer-review started: July 7, 2023
First decision: September 18, 2023
Revised: September 28, 2023
Accepted: November 2, 2023
Article in press: November 2, 2023
Published online: November 27, 2023
Colon cancer (CC) is one of the most common cancers of the digestive tract, the third most common cancer worldwide, and the second most common cause of cancer-related deaths. A higher risk of lymph node metastasis (LNM) in young patients with CC. It might be reasonable to treat patients with early-onset locally advanced CC with extended lymph node dissection. However, few studies have focused on early-onset CC (ECC) patients with LNM.
To compare the predictive values of different LN indicators in ECC patients.
The prognostic values of four lymph node staging indices were compared. And the best nomogram for patients with ECC was established.
The patients obtained from the Surveillance, Epidemiology, and End Results database were randomly divided into a training group and a testing group. The model was constructed by the training group and verified by the testing group. Using multiple Cox regression models to compare the prediction efficiency of LNM indicators, nomograms were built based on the best model selected for overall survival (OS) and cause-specific survival (CSS). In the two groups, the performance of the nomogram was evaluated by constructing a calibration plot, time-dependent area under the curve (AUC), and decision curve analysis. Finally, the patients were grouped based on the risk score predicted by the prognosis model, and the survival curve was constructed after comparing the survival status of the high and low-risk groups.
Log odds of PLN (LODDS) were considered to be independent predictors of OS and CSS. The prediction model including LODDS is composed of minimal Akaike information criterion, maximal concordance indexes, and AUCs. The nomograms of OS and CSS were constructed, which representing both cohorts had been successfully verified in terms of prediction accuracy and clinical practicability.
LODDS is superior to N-stage, PLN, and LNR of ECC. The nomogram based on LODDS might be helpful in tumor evaluation and clinical decision-making, since it provides an appropriate prediction of ECC.
The nomogram containing LODDS may be helpful in tumor evaluation and clinical decision-making.