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Updated: May 21, 2025

Competing-Risk Nomogram for Predicting Cancer-Specific Survival in Multiple Primary Colorectal Cancer Patients after Surgery
Published on: September 27, 2024
Using a nomogram based on the controlling nutritional status score to predict prognosis after surgery in patients
Xinghao Ma1, Xiaoyang Jiang1, Hao Guo2
1Department of Clinical Nutrition, Lu'an Hospital, Anhui Medical University, NO. 21 of Wanxi West Road, Jin'an District, Lu'an, 237005, China.
Background:
Various studies have shown that the controlling nutritional status (CONUT) score contributes to assessing the prognosis of cancer patients. This study aimed to establish a nomogram based on the CONUT score and several other important parameters based on patient age and tumor characteristics to accurately forecast the overall survival (OS) of patients with resectable gastric cancer (GC).
Methods:
This study retrospectively recruited 404 individuals who received a potentially curative radical gastrectomy performed by the same group of surgeons at our medical center from January 2019 to December 2021. We used Cox regression analysis to identify independent prognostic factors influencing patients' OS. We establish a nomogram based on the outcomes of the multivariate analysis to forecast the 1, 2, and 3-year OS of GC patients.
Results:
Univariate Cox regression analysis revealed that the age, body mass index (BMI), hemoglobin (HGB), serum albumin (ALB), Serum carcinoembryonic antigen (CEA), CONUT score, tumor size, pT stage, pN stage, nerve invasion, vascular invasion, tumor differentiation, and postoperative chemotherapy were prognostic indicators of postoperative OS in GC patients (all P < 0.05). Multivariate Cox regression analysis indicated that the age (P = 0.015), CONUT score (P = 0.002), pT stage (T3 vs T1: P = 0.011, T4 vs T1: P = 0.026), pN stage (N2 vs N0: P = 0.002, N3 vs N0: P < 0.001), nerve invasion (P = 0.021) were the independent risk factors. The nomogram based on the CONUT score, with a C-index of 0.792, enhanced the predictive ability of the TNM staging system alone, which had a C-index of 0.718 for OS.
Conclusion:
The CONUT score can independently predict the OS for individuals with GC following surgery. The nomogram based on the CONUT score is a reliable tool for forecasting the postoperative survival of individuals with GC and may identify those patients wholesale benefit from a more aggressive treatment protocol.
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