ORIGINAL RESEARCH article
Front. Surg.
Sec. Colorectal and Proctological Surgery
Volume 12 - 2025 | doi: 10.3389/fsurg.2025.1589875
This article is part of the Research TopicEnhancing outcomes in colorectal cancer: Multidisciplinary approaches to therapy and pain managementView all 4 articles
Development of a Cancer-Specific Survival Assessment for Lymph Node-Positive Colorectal Cancer Patients Treated with Adjuvant Chemotherapy
Provisionally accepted
- 1Department of General Surgery, the Second Affiliated Hospital of Bengbu Medical University, Bengbu 233080, Anhui Province, China, Bengbu, China
- 2Department of Medical Oncology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, 230001, China., Bengbu, China
- 3The First Hospital of Hunan University of Chinese Medicine,Changsha,Hunan, China, Changsha, China
- 4Department of Radiotherapy, the Second Afliated Hospital of Bengbu Medical University, Bengbu 233080, Anhui Province, China, Bengbu, China
- 5Bengbu Medical University, Bengbu, Anhui, 233080, China, Bengbu, Anhui Province, China
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To construct a prognostic model for predicting cancer-specific survival in lymph nodepositive colorectal cancer patients treated with adjuvant chemotherapy after surgery. Methods: Data were collected from the 2010-2015 SEER database and from CRC patients at the Second Affiliated Hospital of Bengbu Medical University (2017-2023). Lasso regression and random survival forest methods were used to screen ten clinicopathologic features. Cox regression analysis identified independent prognostic factors for CRC. Nomogram plot model was used to predict 1-, 3-, and 5-year survival rates, with its accuracy verified through ROC curves, calibration curves, and decision curve analysis (DCA). The X-tile software differentiated between high and low-risk groups and illustrated survival differences using Kaplan-Meier curves.Results: Age, histologic grade, stage, CEA, nerve invasion, and LNR were independent prognostic risk factors for colorectal cancer (P < 0.001); and LNR were the five variables used to construct the Nomogram. The area under the curve (AUC) was 0.83, 0.85, and 0.84 at 1, 3, and 5 years for the training cohort; 0.83, 0.85, and 0.84 at 1, 3, and 5 years for the internal validation cohort; and 0.83, 0.85, and 0.84 at 1, 3, and 5 years for the external validation cohort, respectively. calibration curves, C-indexes, and DCA curves validated the accuracy of the model, respectively. The survival prognosis of the high-risk group was lower than that of the low-risk group in all three data sets.
Keywords: Lymph node positivity, colorectal cancer, Cancer-specific survival, Adjuvant chemotherapy, Prognostic model
Received: 08 Mar 2025; Accepted: 23 Apr 2025.
Copyright: © 2025 Zhang, Gao, Lin, Hu, Zhang, Tang, Hu, Wang and Chu. 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: Lei Zhang, Department of General Surgery, the Second Affiliated Hospital of Bengbu Medical University, Bengbu 233080, Anhui Province, China, Bengbu, China
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