Development and validation of a nomogram predicting unfavorable outcomes in patients with stage I–III rectal cancer

The study included 154 patients who underwent surgical and combined treatment for rectal cancer. For the purpose of predicting disease progression, two groups of patients were identified: those without disease progression (83 patients) and those with progression within five years (71 patients). The main prognostic factors investigated were: sex, age, type of treatment, tumor longitudinal size, disease stage, depth of tumor invasion into the bowel wall, presence of lymph node metastases, degree of neoplasm differentiation, antitumor immunity markers, angiogenesis marker, neuroendocrine differentiation marker (chromogranin A), and markers of proliferation and apoptosis. Based on univariate and multivariate logistic regression analyses, independent risk factors for progression were identified (disease stage, expression of immunohistochemical markers CD3, CD20, IgA, and tumor longitudinal size). These factors were used to develop a nomogram. The nomogram demonstrated good prognostic performance. The area under the curve (AUC) was 0,972 (95%CI: 0,943–1,000) for the training group and 0,893 (95%CI: 0,798–0,989) for the test group.

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