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ORIGINAL RESEARCH article

Front. Oncol.
Sec. Gastrointestinal Cancers: Colorectal Cancer
Volume 15 - 2025 | doi: 10.3389/fonc.2025.1494255
This article is part of the Research Topic Recent Advances and New Challenges in Minimally Invasive Surgery and Chemotherapy for Colorectal Cancer-volume 2 View all 3 articles

Clinical Calculator Based on Clinicopathologic Characteristics Predicts Local Recurrence and Overall Survival Following Radical Resection of Stage II-III Colorectal Cancer

Provisionally accepted
Fei Huang Fei Huang 1Ran Wei Ran Wei 2Shiwen Mei Shiwen Mei 1Tixian Xiao Tixian Xiao 1Wei Zhao Wei Zhao 1Zhaoxu Zheng Zhaoxu Zheng 1*Qian Liu Qian Liu 1*
  • 1 Department of Colorectal Surgery, National Cancer Center, Cancer Hospital, Chinese Academy of Medical Sciences, Beijing, China
  • 2 The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong Province, China

The final, formatted version of the article will be published soon.

    Purpose Analyze the risk factors and survival prognosis of local recurrence in stage II-III colorectal cancer (CRC) and develop a clinical risk calculator and nomograms to predict local recurrence and survival for patients treated. Methods Patients who underwent radical surgery between January 2009 and December 2019 at the CNCC were included. Multivariate nomograms and a clinical risk calculator based on Cox regression were developed. Discrimination was measured with an area under curve (AUC) and variability in individual predictions was assessed with calibration curves. Stratify patients into different risk groups according to the established model to predict prognosis and guide clinical practice. Results The clinical risk calculator incorporated six variables: tumor thrombus, perineural invasion, tumor grade, pathology T-stage, pathology N-stage, and whether more than 12 lymph nodes were harvested. Our clinical risk calculator provided good discrimination, with AUC values of local recurrence-free survival (LRFS) (0.764) and overall survival (OS) (0.815) in the training cohort and LRFS (0.740) and OS (0.730) in the test cohort. Calibration plots illustrated excellent agreement between the clinical risk calculator predictions and actual observations for 3- and 5-year LRFS and OS. Recurrence risk-stratified analysis showed that low-risk patients have a higher opportunity of undergoing salvage radical surgery when recurrent disease exists. Conclusion The clinical calculator can better account for tumor and patient heterogeneity, providing a more individualized outcome prognostication of. The model is expected to aid in treatment planning, such as resectable evaluation, and it promised to be used in postoperative surveillance (https://oldcoloncancer.shinyapps.io/dynnomapp/).

    Keywords: colorectal cancer, nomogram, Clinical risk factor, prognosis, Local recurrence

    Received: 10 Sep 2024; Accepted: 13 Jan 2025.

    Copyright: © 2025 Huang, Wei, Mei, Xiao, Zhao, Zheng and Liu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence:
    Zhaoxu Zheng, Department of Colorectal Surgery, National Cancer Center, Cancer Hospital, Chinese Academy of Medical Sciences, Beijing, China
    Qian Liu, Department of Colorectal Surgery, National Cancer Center, Cancer Hospital, Chinese Academy of Medical Sciences, Beijing, China

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