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. 2023 Sep 21;28(1):362.
doi: 10.1186/s40001-023-01357-3.

Development and validation of a competitive risk model in patients with rectal cancer: based on SEER database

Ruobing Hu  1 , Xiuling Li  1 , Xiaomin Zhou  2 , Songze Ding  3
Affiliations

Development and validation of a competitive risk model in patients with rectal cancer: based on SEER database

Ruobing Hu et al. Eur J Med Res. .

Abstract

Background: Rectal cancer is one of the most common malignancies. To predict the specific mortality risk of rectal cancer patients, we constructed a predictive nomogram based on a competing risk model.

Methods: The information on rectal cancer patients was extracted from the SEER database. Traditional survival analysis and specific death analysis were performed separately on the data.

Results: The present study included 23,680 patients, with 16,580 in the training set and 7100 in the validation set. The specific mortality rate calculated by the competing risk model was lower than that of the traditional survival analysis. Age, Marriage, Race, Sex, ICD-O-3Hist/Behav, Grade, AJCC stage, T stage, N stage, Surgery, Examined LN, RX SUMM-SURG OTH, Chemotherapy, CEA, Deposits, Regional nodes positive, Brain, Bone, Liver, Lung, Tumor size, and Malignant were independent influencing factors of specific death. The overall C statistic of the model in the training set was 0.821 (Se = 0.001), and the areas under the ROC curve for cancer-specific survival (CSS) at 1, 3, and 5 years were 0.842, 0.830, and 0.812, respectively. The overall C statistic of the model in the validation set was 0.829 (Se = 0.002), and the areas under the ROC curve for CSS at 1, 3, and 5 years were 0.851, 0.836, and 0.813, respectively.

Conclusions: The predictive nomogram based on a competing risk model for time-specific mortality in patients with rectal cancer has very desirable accuracy. Thus, the application of the predictive nomogram in clinical practice can help physicians make clinical decisions and follow-up strategies.

Keywords: Competitive risk model; Rectal cancer; SEER database; Validation.

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Conflict of interest statement

The authors declare that they have no conflicts of interest to report regarding the present study.

Figures

Fig. 1
Fig. 1
The competitive risk model nomogram of patients with Rectal Cancer at 1, 3, and 5 years
Fig. 2
Fig. 2
AUC for predicting 1-, 3-, and 5-year Rectal Cancer in training cohort (A) and validation cohort (B)
Fig. 3
Fig. 3
Calibration curve of the nomogram in training cohort (A) and validation cohort (B)
See this image and copyright information in PMC

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