Validated nomograms for non-metastatic colorectal cancer prognosis prediction: a population-based study

作者：Yudan Cao, Hongwei Sun, Tianxiao Li, Jiarui Xie, Xinran Shi, Qian Chen, Yue Chen, Zi-Yang Peng, Quan-Peng Qiu, Nuo-Xuan Niu, Junjun She, Xiang Li · 发表于：Frontiers in Oncology · 年份：2025 · DOI：10.3389/fonc.2025.1691693 · 被引用次数：4 · 研究领域：Inflammatory Biomarkers in Disease Prognosis、Colorectal Cancer Surgical Treatments、Ferroptosis and cancer prognosis

Introduction: The TNM staging system has limitations in predicting prognosis for colorectal cancer (CRC). This study aimed to develop and validate a nomogram incorporating the albumin-derived neutrophil-to-lymphocyte ratio (Alb-dNLR) score, a novel nutritional and inflammatory biomarker, to provide a more accurate and personalized prognostic prediction for patients with non-metastatic CRC. Methods: This retrospective study included a development cohort of 457 non-metastatic CRC patients who underwent radical colectomy, and an external validation cohort of 207 patients. Optimal cut-off values for continuous variables were determined by ROC curve analysis. Multivariable Cox and LASSO regression models were used to identify independent prognostic factors for cancer-specific survival (CSS) and to construct two nomograms. The performance of the nomograms was assessed by C-indexes, calibration plots, and decision curve analysis (DCA). Results: Multivariable analysis confirmed that a high Alb-dNLR score was an independent predictor for worse cancer-specific survival (CSS) (HR = 5.536, P < 0.001) and overall survival (OS) (HR = 4.690, P < 0.001). Both nomograms, developed from Cox and LASSO models, showed superior discrimination compared to the TNM staging system alone (C-index in development cohort: (0.785, 0.767 vs. 0.680). Calibration plots and DCA confirmed the nomograms' accuracy and clinical utility in both cohorts. Conclusions: The Alb-dNLR score is a simple and effective inde...