Construction and validation of a nomogram for predicting disease-free survival after radical resection of rectal...

Area of Science:

• Oncology
• Surgical Oncology
• Inflammatory Markers

Background:

• Colorectal cancer poses a significant threat to patient survival and quality of life.
• Surgery is the primary treatment, but outcomes vary widely.
• Predicting postoperative prognosis in rectal cancer remains challenging.

Purpose of the Study:

• To investigate the influence of perioperative inflammatory indicators on disease-free survival (DFS) after rectal cancer resection.
• To develop a predictive nomogram for clinical use in assessing DFS risk.

Main Methods:

• Retrospective analysis of 304 rectal adenocarcinoma patients undergoing laparoscopic radical resection.
• Utilized a training (n=213) and validation (n=91) set.
• Employed LASSO-Cox regression to identify independent risk factors and construct a nomogram, validated using ROC, calibration curves, and DCA.

Main Results:

• TNM stage III, neural invasion, preoperative neutrophil-to-lymphocyte ratio (NLR) ≥1.995, postoperative systemic immune-inflammation index (SII) ≥451.05, and Δpan-immune-inflammation value (ΔPIV) ≥144.36 were significant predictors of 3-year DFS.
• The nomogram demonstrated good predictive accuracy with AUCs of 0.811 (training) and 0.808 (validation).
• The nomogram exhibited strong calibration and clinical utility.

Conclusions:

• A nomogram incorporating TNM stage, neural invasion, preoperative NLR, postoperative SII, and ΔPIV effectively predicts 3-year DFS in rectal cancer patients.
• This tool facilitates identification of high-risk patients for intensified postoperative monitoring and adjuvant therapy.
• The nomogram offers valuable clinical reference for personalized rectal cancer management.