| Objective The aim of the study was to develop and validate a nomogram to predict overall survival in patients with right-sided colon cancer undergoing surgery.Methods The clinical data of 451,241 patients with right colon cancer diagnosed in the SEER database from 2010 to 2015 were collected.After screening according to the inclusion and exclusion criteria,a total of 25,203 eligible patients with right colon cancer were included.The patients were randomly divided into training and validation queues at 7:3.The R studio software was used to count the clinical characteristics of patients,and the variable factors were analyzed by univariate COX regression.Incorporating variable factors of P<0.05 into multivariate COX regression analysis to obtain independent prognostic risk factors that affect OS in patients with right colon cancer after surgery.Combined with the results of LASSO regression analysis,and then using R software to construct the survival nomogram.The internal validation of the nomogram used the C index(C-index)Area under curve(AUC)and calibration curves.From January 2014 to December 2017,228 patients with right colon cancer were collected for external verification in the Department of Gastroenterology of Jiaxing First Hospital.Kaplan-Meier curve was drawn to compare the survival results among different risk groups.Results Age,Chemotherapy,CEA,T stage,N stage,M stage,Summary stage and Liver metastasis are independent prognostic risk factors of RCC.Based on the above factors,a nomogram is constructed to predict the total survival time of patients with RCC after operation.The C index of training data,internal verification data and external verification data are 0.851(95%CI:0.845-0.857),0.860(95%CI:0.850-0.870)and 0.834(95%CI:0.780-0.888),respectively.The calibration curve shows that there is a good consistency between the predicted survival status and the actual survival status of the nomogram.AUC results show that nomogram has good clinical practicability and prediction performance.The difference of Kaplan-Meier curve between different risk subgroups was statistically significant(P<0.05).Conclusion 1.This study found that Age,Chemotherapy,CEA,T stage,N stage,M stage,Summary stage and Liver metastasis are independent prognostic factors affecting the overall survival of patients with RCC.2.The nomogram model constructed in this study has a good correlation and accuracy between the prediction performance and the actual results,and can accurately predict the total cancer survival period of patients with RCC after initial treatment.3.This study provides a convenient,intuitive and practical prediction model for gastrointestinal surgeons,helps doctors evaluate the individual risk of RCC and select appropriate treatment plan,improves the quality of life of patients to a certain extent,and provides help and support in clinical work and scientific research. |
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