Clinical and Translational Research
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Cardiol. Aug 26, 2024; 16(8): 458-468
Published online Aug 26, 2024. doi: 10.4330/wjc.v16.i8.458
Nomogram predicting the cardiovascular disease mortality for older patients with colorectal cancer: A real-world population-based study
Jia-Yu Tan, Shuo-Hao Shen
Jia-Yu Tan, Department of Medical Ultrasound, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Jinan 250000, Shandong Province, China
Shuo-Hao Shen, Department of General Surgery, Qilu Hospital of Shandong University, Jinan 250000, Shandong Province, China
Author contributions: Shen SH and Tan JY designed the research study; Shen SH and Tan JY performed the research. Shen SH and Tan JY analyzed the data and wrote the manuscript; all authors have read and approved the final manuscript.
Supported by the Youth Project of Natural Science Foundation of Shandong Province, No. ZR2022QH346.
Conflict-of-interest statement: Authors declare no conflicts of interest for this article.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Shuo-Hao Shen, MD, Doctor, Department of General Surgery, Qilu Hospital of Shandong University, No. 107 Wenhuaxi Road, Jinan 250000, Shandong Province, China. shenshh13@126.com
Received: May 30, 2024
Revised: July 24, 2024
Accepted: August 6, 2024
Published online: August 26, 2024
Processing time: 87 Days and 21.4 Hours
Abstract
BACKGROUND

Cardio-oncology has received increasing attention especially among older patients with colorectal cancer (CRC). Cardiovascular disease (CVD)-specific mortality is the second-most frequent cause of death. The risk factors for CVD-specific mortality among older patients with CRC are still poorly understood.

AIM

To identify the prognostic factors and construct a nomogram-based model to predict the CVD-specific mortality among older patients with CRC.

METHODS

The data on older patients diagnosed with CRC were retrieved from The Surveillance, Epidemiology, and End Results database from 2004 to 2015. The prognostic factors and a nomogram-based model predicting the CVD-specific mortality were assessed using least absolute shrinkage and selection operator and Cox regression.

RESULTS

A total of 141251 eligible patients with CRC were enrolled, of which 41459 patients died of CRC and 12651 patients died of CVD. The age at diagnosis, sex, marital status, year of diagnosis, surgery, and chemotherapy were independent prognostic factors associated with CVD-specific mortality among older patients with CRC. We used these variables to develop a model to predict CVD-specific mortality. The calibration curves for CVD-specific mortality probabilities showed that the model was in good agreement with actual observations. The C-index value of the model in the training cohort and testing cohort for predicting CVD-specific mortality was 0.728 and 0.734, respectively.

CONCLUSION

The proposed nomogram-based model for CVD-specific mortality can be used for accurate prognostic prediction among older patients with CRC. This model is a potentially useful tool for clinicians to identify high-risk patients and develop personalized treatment plans.

Keywords: Older patients; Colorectal cancer; Cardio-oncology; Nomogram; Outcome

Core Tip: For older patients with colorectal cancer (CRC), cardiovascular disease (CVD)-specific mortality is the second-most frequent cause of death. Herein, we analyzed data from the Surveillance, Epidemiology, and End Results program. The age at diagnosis, sex, marital status, year of diagnosis, surgery, and chemotherapy were independent prognostic factors associated with CVD-specific mortality among older patients with CRC. Six variables were independent prognostic factors. Subsequently, we proposed a nomogram-based model of the CVD-specific mortality that could be used for accurate prognostic prediction of older patients with CRC.