Evidence map›Paper›PMID 41329308›Full record

ArticleAnnals of surgical oncology2026

Development and Validation of Time-to-Event Machine Learning Models for Predicting Disease-Free Survival in Patients with Locally Advanced Colorectal Cancer: A Multicenter Cohort Study.

Yongjie Zhou, Zhichao Zuo, Jinhong Zhao, Yongming Tan, Jinqiu Deng, Xiang Wei, Hao Li, Lianggeng Gong, Lan Liu, Linhua Zhong

Abstract readMulticenter StudyValidation Study
PubMed Publisher
In one paragraph

Article in Annals of surgical oncology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.

0numbers the graph read from it
0cells of the map it votes in
9citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

9 citing papers in PubMed.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Yongjie Zhou *Department of Radiology, Jiangxi Cancer Hospital & Institute, Jiangxi Clinical Research Center for Cancer, The Second Affiliated Hospital of Nanchang Medical College, Nanchang, China.
Zhichao Zuo *Department of Radiology, Xiangtan Central Hospital, Xiangtan, China.
Jinhong Zhao *Department of Radiology, The Second Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, China.
Yongming TanDepartment of Radiology, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, China.
Jinqiu DengSchool of Mathematics and Computational Science, Xiangtan University, Xiangtan, China.
Xiang WeiDepartment of Pathology, Jiangxi Cancer Hospital, Nanchang, China.
Hao LiDepartment of Radiology, Jiangxi Cancer Hospital & Institute, Jiangxi Clinical Research Center for Cancer, The Second Affiliated Hospital of Nanchang Medical College, Nanchang, China.
Lianggeng GongDepartment of Radiology, The Second Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, China.
Lan LiuDepartment of Radiology, Jiangxi Cancer Hospital & Institute, Jiangxi Clinical Research Center for Cancer, The Second Affiliated Hospital of Nanchang Medical College, Nanchang, China. liulan202306@163.com.
Linhua ZhongDepartment of Radiology, Jiangxi Cancer Hospital & Institute, Jiangxi Clinical Research Center for Cancer, The Second Affiliated Hospital of Nanchang Medical College, Nanchang, China. 823155926@qq.com.

Funding

Clinical research ISL20250793Science and Technology Planning Project of Jiangxi Provincial Health Commission 202410394Science and Technology Planning Project of Jiangxi Provincial Health Commission 202510320Science and Technology Planning Project of Jiangxi Provincial Health Commission 202510509
6 · The paper itself

Abstract

backgroundThe postoperative prognosis of locally advanced colorectal cancer (LACRC) exhibits significant heterogeneity. However, conventional models for predicting disease-free survival (DFS) often lack the necessary precision. Therefore, we aim to develop and validate time-to-event machine learning (ML) models for predicting DFS in patients with LACRC, ultimately improving prognostic accuracy. PATIENTS AND

methodsThis multicenter cohort study enrolled 456 patients with LACRC from three medical centers. A training cohort consisting of 350 patients was formed from centers 1 and 2, while an external validation cohort comprising 106 patients was sourced from center 3. Preoperative computed tomography (CT) images were segmented to extract radiomics features, and a radiomics score (radscore) was calculated through feature engineering. In addition, intratumor heterogeneity (ITH) scores were derived by integrating clustered mask regions with global pixel distribution patterns. To predict DFS, five time-to-event ML models were trained: Cox proportional hazards, FastKernelSurvivalSVM, GradientBoostingSurvival (GB-Survival), RandomSurvivalForest, and ExtraSurvivalTrees. Model performance was assessed using the concordance index (C-index), and Survival SHapley Additive exPlanations over time (SurvSHAP (t)) analysis was conducted for model interpretation.

resultsAmong the models tested, GB-Survival demonstrated the highest predictive performance for DFS, achieving a C-index of 0.7823. SurvSHAP (t) analysis revealed that the key prognostic factors included the ITH score, pathological TNM stage, lymphovascular invasion, radscore, and the prognostic nutritional index.

conclusionsThe GB-Survival model that integrates multimodal data outperforms other time-to-event ML models in predicting DFS for LACRC. This approach may facilitate the development of data-driven treatment strategies and personalized risk stratification for patients with LACRC.

Indexed as

Colorectal NeoplasmsMachine LearningAgedDisease-Free SurvivalFemaleFollow-Up StudiesHumansMaleMiddle AgedPrognosisSurvival RateTomography, X-Ray ComputedDisease-free survivalIntratumor heterogeneity scoreLocally advanced colorectal cancerRadiomicsTime-to-event machine learning

Identifiers

PMID41329308

What Socratic holds

Textmetadata
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.