A Prognostic Nomogram for T3N0 Rectal Cancer After Total Mesorectal Excision to Help Select Patients for Adjuvant Therapy

BackgroundThe recurrence rate of T3N0 rectal cancer after total mesorectal excision (TME) is relatively low, meaning that not all patients need adjuvant therapy (AT) (radiotherapy, chemotherapy, or chemoradiotherapy).MethodsPatients diagnosed with pT3N0M0 rectal cancer after TME were analyzed using...

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Autores principales:	Chao Zhang, Shutao Zhao, Xudong Wang
Formato:	article
Lenguaje:	EN
Publicado:	Frontiers Media S.A. 2021
Materias:	T3N0 rectal cancer nomogram prognosis adjuvant therapy TME Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282
Acceso en línea:	https://doaj.org/article/b09db2ccdab544f7aacd918f7ba68b14
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spelling	oai:doaj.org-article:b09db2ccdab544f7aacd918f7ba68b142021-11-30T21:08:21ZA Prognostic Nomogram for T3N0 Rectal Cancer After Total Mesorectal Excision to Help Select Patients for Adjuvant Therapy2234-943X10.3389/fonc.2021.698866https://doaj.org/article/b09db2ccdab544f7aacd918f7ba68b142021-11-01T00:00:00Zhttps://www.frontiersin.org/articles/10.3389/fonc.2021.698866/fullhttps://doaj.org/toc/2234-943XBackgroundThe recurrence rate of T3N0 rectal cancer after total mesorectal excision (TME) is relatively low, meaning that not all patients need adjuvant therapy (AT) (radiotherapy, chemotherapy, or chemoradiotherapy).MethodsPatients diagnosed with pT3N0M0 rectal cancer after TME were analyzed using the SEER database, of which 4367 did not receive AT and 2794 received AT. Propensity score matching was used to balance the two groups in terms of confounding factors. Cox proportional hazards regression analysis was used to screen independent prognostic factors, which were then used to establish a nomogram. The patients were then divided into three groups with X-tile software according to their risk scores. We enrolled 334 patients as external validation.ResultsThe C-index of the model was 0.725 (95% confidence interval: 0.694–0.756). We divided the patients into three different risk layers based on the nomogram prediction scores, and found that AT did not improve the prognosis of low- and moderate-risk patients, while high-risk patients benefited from AT. External validation data also support the above conclusions.ConclusionThis study developed a nomogram that effectively and comprehensively evaluates the prognosis of T3N0 rectal cancer patients after TME. After using the nomogram, we recommend AT for high-risk patients, but not for low- and moderate-risk patients.Chao ZhangShutao ZhaoXudong WangFrontiers Media S.A.articleT3N0 rectal cancernomogramprognosisadjuvant therapyTMENeoplasms. Tumors. Oncology. Including cancer and carcinogensRC254-282ENFrontiers in Oncology, Vol 11 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	T3N0 rectal cancer nomogram prognosis adjuvant therapy TME Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282
spellingShingle	T3N0 rectal cancer nomogram prognosis adjuvant therapy TME Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282 Chao Zhang Shutao Zhao Xudong Wang A Prognostic Nomogram for T3N0 Rectal Cancer After Total Mesorectal Excision to Help Select Patients for Adjuvant Therapy
description	BackgroundThe recurrence rate of T3N0 rectal cancer after total mesorectal excision (TME) is relatively low, meaning that not all patients need adjuvant therapy (AT) (radiotherapy, chemotherapy, or chemoradiotherapy).MethodsPatients diagnosed with pT3N0M0 rectal cancer after TME were analyzed using the SEER database, of which 4367 did not receive AT and 2794 received AT. Propensity score matching was used to balance the two groups in terms of confounding factors. Cox proportional hazards regression analysis was used to screen independent prognostic factors, which were then used to establish a nomogram. The patients were then divided into three groups with X-tile software according to their risk scores. We enrolled 334 patients as external validation.ResultsThe C-index of the model was 0.725 (95% confidence interval: 0.694–0.756). We divided the patients into three different risk layers based on the nomogram prediction scores, and found that AT did not improve the prognosis of low- and moderate-risk patients, while high-risk patients benefited from AT. External validation data also support the above conclusions.ConclusionThis study developed a nomogram that effectively and comprehensively evaluates the prognosis of T3N0 rectal cancer patients after TME. After using the nomogram, we recommend AT for high-risk patients, but not for low- and moderate-risk patients.
format	article
author	Chao Zhang Shutao Zhao Xudong Wang
author_facet	Chao Zhang Shutao Zhao Xudong Wang
author_sort	Chao Zhang
title	A Prognostic Nomogram for T3N0 Rectal Cancer After Total Mesorectal Excision to Help Select Patients for Adjuvant Therapy
title_short	A Prognostic Nomogram for T3N0 Rectal Cancer After Total Mesorectal Excision to Help Select Patients for Adjuvant Therapy
title_full	A Prognostic Nomogram for T3N0 Rectal Cancer After Total Mesorectal Excision to Help Select Patients for Adjuvant Therapy
title_fullStr	A Prognostic Nomogram for T3N0 Rectal Cancer After Total Mesorectal Excision to Help Select Patients for Adjuvant Therapy
title_full_unstemmed	A Prognostic Nomogram for T3N0 Rectal Cancer After Total Mesorectal Excision to Help Select Patients for Adjuvant Therapy
title_sort	prognostic nomogram for t3n0 rectal cancer after total mesorectal excision to help select patients for adjuvant therapy
publisher	Frontiers Media S.A.
publishDate	2021
url	https://doaj.org/article/b09db2ccdab544f7aacd918f7ba68b14
work_keys_str_mv	AT chaozhang aprognosticnomogramfort3n0rectalcanceraftertotalmesorectalexcisiontohelpselectpatientsforadjuvanttherapy AT shutaozhao aprognosticnomogramfort3n0rectalcanceraftertotalmesorectalexcisiontohelpselectpatientsforadjuvanttherapy AT xudongwang aprognosticnomogramfort3n0rectalcanceraftertotalmesorectalexcisiontohelpselectpatientsforadjuvanttherapy AT chaozhang prognosticnomogramfort3n0rectalcanceraftertotalmesorectalexcisiontohelpselectpatientsforadjuvanttherapy AT shutaozhao prognosticnomogramfort3n0rectalcanceraftertotalmesorectalexcisiontohelpselectpatientsforadjuvanttherapy AT xudongwang prognosticnomogramfort3n0rectalcanceraftertotalmesorectalexcisiontohelpselectpatientsforadjuvanttherapy
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A Prognostic Nomogram for T3N0 Rectal Cancer After Total Mesorectal Excision to Help Select Patients for Adjuvant Therapy

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