ArticleJournal of gastrointestinal oncology2025
Prognostic nomogram for overall survival in rectal cancer with synchronous lung metastases using Surveillance, Epidemiology, and End Results data and a single-center external validation cohort.
Article in Journal of gastrointestinal oncology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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Who cites it
1 citing paper in PubMed.
- Development and internal validation of a prognostic nomogram for lung metastasis in locally advanced rectal cancer incorporating molecular markers.Translational cancer research · 2026Article
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4 authors.
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Abstract
Background: Rectal cancer with synchronous lung metastases has a poor prognosis and high mortality. Despite treatment advancements, effective prognostic tools for early diagnosis and personalized treatment remain limited. This study develops and validates a survival nomogram to improve prognosis prediction and guide treatment strategies. Methods: A total of 1,257 patients with rectal cancer and synchronous lung metastasis were identified from the Surveillance, Epidemiology, and End Results (SEER) database. They were divided into a training cohort (n=880) and an internal validation cohort (n=377). An external validation cohort of 132 patients was retrospectively collected from Affiliated Dongyang Hospital of Wenzhou Medical University. A survival nomogram was developed using variables identified through univariate and multivariate Cox regression analyses and assessed using the concordance index (C-index), time-dependent receiver operating characteristic (ROC) curves, and calibration curves. Kaplan-Meier analysis and log-rank tests were used to compare overall survival (OS) outcomes. Results: Six key risk factors were identified: carcinoembryonic antigen (CEA) level, chemotherapy, tumor stage 2, tumor grade I, radiation therapy, and tumor size (5-100 mm). The nomogram demonstrated strong predictive accuracy for 1-, 3-, and 5-year OS, with area under the curve (AUC) ranging from 0.65 to 0.94. High-risk patients (score ≥104) had significantly worse OS than low-risk patients (P<0.001). Subgroup analysis confirmed that chemotherapy and radiotherapy significantly influenced survival (P<0.05). Conclusions: This validated survival nomogram provides a reliable tool for prognosis prediction and treatment planning in rectal cancer with synchronous lung metastasis, assisting in clinical decision-making.
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