Weiser et al developed 3 nomograms for predicting survival for a patient following curative colectomy for colon cancer. The authors are from Memorial Sloan-Kettering Cancer Center, Cleveland Clinic and Dana-Farber Cancer Center.
Patient selection: resectable colon cancer (not Stage IV)
Parameters:
(1) T stage
(2) N stage
(3) number of nodes identified
(4) number of lymph nodes positive for malignancy
Nomogram A
|
Parameter |
Stage |
Points |
|
T stage |
1 |
0 |
|
|
2 |
21 |
|
|
3 |
46 |
|
|
4a |
70 |
|
|
4b |
100 |
|
N stage |
0 |
0 |
|
|
1 (1 to 3 nodes positive) |
24 |
|
|
2a (4 to 6 nodes positive) |
56 |
|
|
2b (7 or more nodes positive) |
89 |
total score =
= SUM(points for both parameters)
|
Total Point |
Probability of 5 Year Survival |
|
0 to 172 |
(-0.000641 * ((points)^2)) – (0.2467 * (points)) + 80.5 |
|
173 to 200 |
< 20% |
Limitations:
• The maximum 5-year survival in the nomogram is 80% for a person T1N0. Normally this should have a very good prognosis. The issue may the use of overall mortality which takes into all causes of mortality, such as advanced age.
Nomogram B
|
Parameter |
Stage |
Points |
|
T stage |
1 |
0 |
|
|
2 |
17 |
|
|
3 |
36 |
|
|
4a |
50 |
|
|
4b |
68 |
points for number of positive nodes =
= MIN(100, (-0.0783 * ((nodes)^2)) + (7.219 * (nodes)) + 3.055)
points for total number of nodes examined =
= MAX(0,(0.01388 * ((nodes)^2)) – (1.85 * (nodes)) + 56.66)
|
Total Point |
Probability of 5 Year Survival |
|
0 to 3.8 |
> 90% |
|
3.9 to 170 |
(-0.001544 * ((points)^2)) – (0.2386 * (points)) + 91.97 |
|
> 170 |
< 10% |
Specialty: Hematology Oncology, Surgery, general, Gastroenterology
ICD-10: ,
