Development and validation of web-based risk score predicting prognostic nomograms for elderly patients with primary...

Area of Science:

• Oncology
• Geriatric Medicine
• Biostatistics

Background:

• Primary colorectal lymphoma (PCL) is a rare cancer with increasing prevalence in the elderly.
• Advanced age is linked to poorer prognosis in PCL patients.
• Accurate prognostication is crucial for effective PCL management in older adults.

Purpose of the Study:

• To develop and validate an individualized survival prediction model (nomogram) for elderly patients with PCL.
• To stratify risk for elderly PCL patients to aid treatment and monitoring.
• To improve upon existing prognostic tools for PCL in the elderly.

Main Methods:

• Utilized data from the Surveillance, Epidemiology, and End Results (SEER) database (1975-2015).
• Employed Cox regression and LASSO regression to identify predictors of overall survival (OS).
• Constructed and validated nomograms using training, validation, and external cohorts, assessing performance with C-index, calibration curves, and DCA.

Main Results:

• Identified age, gender, marital status, Ann Arbor stage, primary site, surgery, histology, and chemotherapy as independent OS predictors.
• The nomogram demonstrated strong predictive accuracy (AUC 0.732-0.829) and outperformed the Ann Arbor stage system.
• Calibration curves showed excellent agreement between predicted and observed survival; DCA confirmed superior clinical utility.

Conclusions:

• This study presents the first validated predictive survival nomograms for elderly PCL patients.
• The developed nomogram is a more accurate prognostic tool than the Ann Arbor stage.
• The nomogram and associated online tool can aid clinicians in managing elderly PCL patients more effectively.