Prognostic nomogram for predicting overall survival in patients with medullary carcinoma of the colon

Abstract

Abstract Objective Medullary carcinoma (MC) of the colon is a rare malignancy, and there is no survival prediction for this tumor. This study aimed to construct a nomogram to predict the overall survival (OS) of patients with MC Methods We included 276 patients with a pathological diagnosis of MC between 2010 and 2015 from the Surveillance, Epidemiology, and End Results (SEER) database. The random forest method and multivariate Cox proportional risk model were used to identify independent prognostic factors for MC. The consistency index (C-index), the receiver operating characteristic (ROC) curve, and the calibration curve determined the nomogram's predictive accuracy and discriminative ability. Decision curve analysis (DCA) was used to evaluate the net clinical benefit of the nomogram. Results The Cox regression analysis showed that age, N-stage, M-stage, tumor size, and chemotherapy were associated with OS of MC. Based on the identified independent factors, we constructed a nomogram for predicting OS in MC patients. The C-index value of the nomogram for predicting OS was superior to the TNM staging system (0.705 vs. 0.673). ROC and calibration curves showed the nomogram's good discriminatory and calibration ability. DCA showed that the nomogram had a more significant net clinical benefit than the TNM staging system. Conclusion We developed a nomogram to accurately predict MC patients’ survival. The nomogram had excellent predictive efficacy and could help clinicians to assess the prognosis of MC patients.