Prognostic nomogram for early-onset locally advanced rectal cancer treated with neoadjuvant chemoradiotherapy: a SEER analysis.

Yi-Kai Kao, Pin-Chun Chen, Po-Wen Yang, Chia-Hung Chen, Chih-I Chen

Abstract read

In one paragraph

Article in Updates in surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it

0cells of the map it votes in

0citing 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

0 citing papers in PubMed.

No citing paper in PubMed yet.

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

5 authors.

Yi-Kai KaoDivision of Colon and Rectal Surgery, Department of Surgery, E-DA Hospital, I-Shou University, No. 1 Sec. 1 Xuecheng Rd., Dashu Dist., Kaohsiung City, 840203, Taiwan (R.O.C.).

Pin-Chun ChenDivision of Colon and Rectal Surgery, Department of Surgery, E-DA Hospital, I-Shou University, No. 1 Sec. 1 Xuecheng Rd., Dashu Dist., Kaohsiung City, 840203, Taiwan (R.O.C.).

Po-Wen YangDivision of Colon and Rectal Surgery, Department of Surgery, E-DA Hospital, I-Shou University, No. 1 Sec. 1 Xuecheng Rd., Dashu Dist., Kaohsiung City, 840203, Taiwan (R.O.C.).

Chia-Hung ChenDivision of Colon and Rectal Surgery, Department of Surgery, E-DA Hospital, I-Shou University, No. 1 Sec. 1 Xuecheng Rd., Dashu Dist., Kaohsiung City, 840203, Taiwan (R.O.C.).

Chih-I ChenDivision of Colon and Rectal Surgery, Department of Surgery, E-DA Hospital, I-Shou University, No. 1 Sec. 1 Xuecheng Rd., Dashu Dist., Kaohsiung City, 840203, Taiwan (R.O.C.). jimmyee0901@gmail.com.ORCID http://orcid.org/0000-0002-5311-6889

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objective and rationaleEarly-onset locally advanced rectal cancer presents unique challenges in treatment and prognosis. This study aimed to develop and validate a prognostic nomogram for patients aged 18-50 years with locally advanced rectal cancer treated with neoadjuvant chemoradiotherapy, addressing the lack of tailored prognostic tools for this growing patient population.

methodsUsing the Surveillance, Epidemiology, and End Results (SEER) database, we analyzed 2,853 patients who received neoadjuvant chemoradiotherapy between 2010 and 2020. Patients were divided into training (n = 1,990) and validation (n = 863) cohorts. Cox proportional hazard regression models identified prognostic factors for overall survival (OS) and cancer-specific survival (CSS). Nomograms were constructed and validated using Harrell's C-index and receiver operating characteristic (ROC) curve analysis.

resultsIndependent predictors of poor OS and CSS included male sex, unmarried status (particularly divorced/separated/widowed), non-Hispanic black and American Indian/Alaskan native races, advanced T stage, increased positive regional nodes, and positive carcinoembryonic antigen (CEA). The nomogram demonstrated good discriminative ability in the validation cohort, with area under the curve (AUC) values of 0.767 and 0.742 for 3-year OS and CSS, respectively, and 0.705 and 0.697 for 5-year OS and CSS, respectively.

conclusionsThe developed nomogram and identified prognostic factors provide valuable tools for individualized risk stratification and treatment optimization in young patients with locally advanced rectal cancer. These findings can aid in clinical decision-making and patient counseling. However, further external validation and prospective evaluations are necessary to confirm the clinical utility of this prognostic model in diverse healthcare settings.

Indexed as

Early-onset rectal cancerNomogramRisk stratificationSurvival prediction

Identifiers

PMID42888297

DOI10.3390/cancers14194799

What OpenQuestion holds

Textmetadata

Read underepoch 390

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 OpenQuestion graph.