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Updated: Jan 7, 2026
Competing-Risk Nomogram for Predicting Cancer-Specific Survival in Multiple Primary Colorectal Cancer Patients after Surgery
Published on: September 27, 2024
Prognostic Factors and Nomogram-Based Prediction Models for Colorectal Cancer Patients With Synchronous Peritoneal
Xiaoxu Ge1,2, Guanli Yang1,2, Huiming Wu1
1Department of Colorectal Surgery and Oncology (Key Laboratory of Cancer Prevention and Intervention, China National Ministry of Education), The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China.
This study identified key prognostic factors for colorectal cancer with synchronous peritoneal metastasis (CRC-SPM) and developed nomogram models to predict survival. Findings emphasize the importance of postoperative chemotherapy and lymph node dissection for improved patient outcomes.
Area of Science:
- Oncology
- Surgical Oncology
- Cancer Prognostics
Background:
- Colorectal cancer (CRC) with synchronous peritoneal metastasis (SPM) has a poor prognosis and presents significant treatment challenges.
- Cytoreductive surgery (CRS) is a complex treatment for CRC-SPM, necessitating accurate prognostic tools.
Purpose of the Study:
- To identify independent prognostic factors for overall survival (OS) and progression-free survival (PFS) in CRC patients with SPM (CRC-SPM) undergoing CRS.
- To develop and validate nomogram-based prediction models for OS and PFS in this patient cohort.
Main Methods:
- Retrospective analysis of 218 CRC-SPM patients treated with CRS.
- Univariate and multivariate Cox regression analyses to identify prognostic factors.
- Construction and validation of nomogram models using calibration curves, ROC curves, and Decision Curve Analysis (DCA).
Main Results:
- Independent prognostic factors for OS included age >65 years, N2 stage, lymph node resection count, and postoperative chemotherapy.
- Independent prognostic factors for PFS included age >65 years, concurrent liver metastasis, Peritoneal Cancer Index (PCI) score, and presence of ascites.
- Nomogram models demonstrated good predictive accuracy for OS and PFS at 1, 2, and 3 years.
Conclusions:
- Key prognostic factors for CRC-SPM were identified, enabling the development of reliable nomogram models.
- The study underscores the significance of postoperative chemotherapy and adequate lymph node dissection.
- Nomogram models offer a valuable tool for personalized prognosis assessment and treatment planning in CRC-SPM patients.
