Weiser et al reported nomograms for evaluating a patient with locally advanced rectal cancer. One model predicts 5-year overall survival. The authors are from Memorial Sloan Kettering Cancer Center.
Patient selection: locally advanced rectal cancer (Stage II and III), treated with chemotherapy, radiotherapy and surgery.
Parameters:
(1) age in years, from 15 to 90 years
(2) AJCC T category, postoperative pathologic
(3) number of positive lymph nodes, from 0 to 17
(4) distance from anal verge (DTAV) in cm
(5) venous invasion
(6) perineural invasion (PNI)
|
Age of the Patient
|
Points
|
|
15 to 30
|
(0.005222 * ((age)^2)) - (0.05363 * (age)) - 0.3705
|
|
30 to 90
|
(0.03465 * ((age)^2)) - (2.569 * (age)) + 51.28
|
|
Number of Positive Lymph Nodes
|
Points
|
|
0
|
0
|
|
1
|
17.8
|
|
2
|
26.1
|
|
3 to 17
|
(1.682 * (LN)) + 23.91
|
|
Parameter
|
Finding
|
Points
|
|
AJCC T category
|
T0, T1, T2
|
0
|
|
|
T3
|
10.9
|
|
|
T4
|
54
|
|
DTAV
|
< 5 cm
|
16.8
|
|
|
>= 5 cm
|
0
|
|
venous invasion
|
no
|
0
|
|
|
yes
|
17.8
|
|
PNI
|
no
|
0
|
|
|
yes
|
26.2
|
total score =
= SUM(points for all of the parameters)
Interpretation:
• minimum score: 0
• maximum score: 267.5
value of X =
= (-0.0001248 * ((score)^2)) - (0.01119 * (score)) + 2.699
probability of 5-year overall survival =
= 1 / (1 + EXP((-1) * X))
Performance:
• The concordance index in the MSK validation set was 0.73.
