Kanemitsu et al reported prognostic nomograms for a patient with colon cancer who has had a complete mesocolic excision. One nomogram predicts recurrence-survival and the second predicts overall survival. The authors are from the National Cancer Centre Hospital, Tokyo Medical and Dental University, University of Tokyo, National Defense Medical College and Aichi Cancer Centre in Japan.
Patient selection: colon cancer with complete mesocolic excision
Parameters:
(1) age in years, from 10 to 100
(2) sex
(3) extent of lymphadenectomy
(4) preoperative CEA concentration in ng/mL
(5) pT stage
(6) lymphatic invasion
(7) number of lymph nodes with metastases, from 0 to 25
(8) number of lymph nodes examined, from 0 to 110
|
Age
|
Points
|
|
10 to 50
|
(0.2292 * (age)) + 12.03
|
|
51 to 59
|
0.5
|
|
60 to 100
|
(0.04311 * ((age)^2)) - (4.318 * (age)) + 102.2
|
|
Nodes with Metastases
|
Points
|
|
0
|
0
|
|
1
|
9.7
|
|
2
|
19.4
|
|
3
|
21.45
|
|
4 to 25
|
(0.01096 * ((LN)^2)) + (0.3361 * (LN)) + 22.1
|
|
Nodes Examined
|
Points
|
|
0 to 10
|
48.7 - (3.36 * (LN))
|
|
10 to 30
|
18.95 - (0.385 * (LN))
|
|
30 to 50
|
9.05 - (0.055 * (LN))
|
|
50 to 110
|
11.55 - (0.105 * (LN))
|
|
Parameter
|
Finding
|
Points
|
|
sex
|
female
|
0
|
|
|
male
|
11.6
|
|
extent lymphadenectomy
|
D0
|
49.9
|
|
|
D1
|
7.4
|
|
|
D2 (for cT2)
|
2.3
|
|
|
D3 (for cT3 or cT4)
|
0
|
|
preopeartive CEA
|
<= 5.0 ng/mL
|
0
|
|
|
5.1 to 10 ng/mL
|
7.9
|
|
|
10.1 to 20 ng/mL
|
12.8
|
|
|
> 20 ng/mL
|
23.5
|
|
pT
|
T1
|
0
|
|
|
T2
|
18.3
|
|
|
T3
|
24
|
|
|
T4a
|
56.6
|
|
|
T4b
|
57.3
|
|
lymphatic invasion
|
lyo (none)
|
0
|
|
|
ly1 (minimal)
|
1.6
|
|
|
ly2 (moderate)
|
1.7
|
|
|
ly3 (marked)
|
41.8
|
total score =
= SUM(points for all of the parameters)
Interpretation:
• minimum score: 0
• maximum score: 370.6
value of X =
= (-0.0001686 * ((score)^2)) - (0.001206 * (score)) + 3.343
probability of 5-year overall survival =
= 1 / (1 + EXP((-1) * X))
Performance:
• The area under the ROC curve is 0.74.
