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Construction of a nomogram based on clinicopathologic features to predict the likelihood of No. 253 lymph node metastasis in rectal cancer patients

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Langenbeck's Archives of Surgery Aims and scope Submit manuscript

Abstract

Purpose

To explore the high-risk factors for rectal cancer No.253 lymph node metastasis (LNM) and to construct a risk nomogram for the individualized prediction of No.253 LNM.

Methods

This was a retrospective analysis of 425 patients with rectal cancer who underwent laparoscopic-assisted radical surgery. Independent risk factors for rectal cancer No.253 LNM was identified using multivariate logistic regression analysis, and a risk prediction nomogram was constructed based on the independent risk factors. In addition, the performance of the model was evaluated by discrimination, calibration, and clinical benefit.

Results

Multivariate logistic regression analysis showed that No.253 lymphadenectasis on CT (OR 10.697, P < 0.001), preoperative T4-stage (OR 4.431, P = 0.001), undifferentiation (OR 3.753, P = 0.004), and preoperative Ca199 level > 27 U/ml (OR 2.628, P = 0.037) were independent risk factors for No.253 LNM. A nomogram was constructed based on the above four factors. The calibration curve of the nomogram was closer to the ideal diagonal, indicating that the nomogram had a better fitting ability. The area under the ROC curve (AUC) was 0.865, which indicated that the nomogram had high discriminative ability. In addition, decision curve analysis (DCA) showed that the model could show better clinical benefit when the threshold probability was between 1% and 50%.

Conclusion

Preoperative No.253 lymphadenectasis on CT, preoperative T4-stage, undifferentiation, and elevated preoperative Ca199 level were found to be independent risk factors for the No.253 LNM. A predictive model based on these risk factors can help surgeons make rational clinical decisions.

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Data availability

The data sets used or analyzed in this study are available from the corresponding author on reasonable request.

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Acknowledgements

Thank American Journal Experts (AJE) for proofreading the English grammar and spelling of our paper.

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Authors and Affiliations

  1. The School of Clinical Medicine, Fujian Medical University, Fuzhou, Fujian, 350122, China

    Weixiang Chen, Zhiming Cai, Jinfeng Zhou, Zhengnan Xu, Zhixiong Li, Zipei Guo & Yanchang Xu

  2. Gastrointestinal Surgery Unit 1, The First Hospital of Putian City, Putian, Fujian, 351100, China

    Weixiang Chen, Zhiming Cai, Jinfeng Zhou, Zhengnan Xu, Zhixiong Li, Zhixing Guo, Junpeng Li, Zipei Guo & Yanchang Xu

  3. Department of Pathology, The First Hospital of Putian City, Putian, Fujian, 351100, China

    Haiyan Wu

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Contributions

Conception and design: WXC, ZMC, YCX. Performed the research and acquired the data: WXC, ZMC, JFZ, ZNX, ZXL, ZXG, JPL, ZPG, HYW, YCX. Analyzed the data: WXC, ZMC. Manuscript writing: WXC, ZMC, JFZ, YCX. Final approval of manuscript: All authors.

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Correspondence to Yanchang Xu.

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Weixiang Chen, Zhiming Cai, and Jinfeng Zhou have contributed equally to this work, and should be regarded as first co-authors.

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Chen, W., Cai, Z., Zhou, J. et al. Construction of a nomogram based on clinicopathologic features to predict the likelihood of No. 253 lymph node metastasis in rectal cancer patients. Langenbecks Arch Surg 409, 161 (2024). https://doi.org/10.1007/s00423-024-03353-5

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