title: Validation of nomogram for disease free survival for colon cancer in UK population: A prospective cohort study.
abstract: OBJECTIVE
  To externally validate the MSKCC nomogram in a UK population, and determine if it could be used in our practice here in the UK.
  
  
  METHODS
  The colon cancer database from a district general hospital in England was used to extract all patients who had a curative colon cancer resection. Inclusion criteria were all patients who had curative elective colon cancer resection between 01/01/1998 and 31/12/2003. Patients were followed up for up to ten years. Five and ten year predictions were calculated for each patient, and plotted against the actual recurrence using a ROC curve, and AUC was calculated for both the five and ten year nomogram.
  
  
  RESULTS
  138 patients were included in the study. Overall five year recurrence rate was 26.8% with a mean follow up of 60.24 months (SD = 38.6). 118 patients were included in the five year nomogram validation, and 102 patients were included in the ten year nomogram validation. A ROC curve was plotted for both the five and ten year nomogram and AUC was calculated. For the five year nomogram AUC was 0.673, and for the ten year nomogram AUC was 0.687. Two cut off points were identified for each nomogram and this divided the cohort into low, medium and high risk groups for recurrence. Cox regression showed there was significant difference between all groups for both nomograms.
  
  
  CONCLUSIONS
  The MSKCC colon cancer nomogram was validated in our cohort, but it is recommended to be used in conjunction with AJCC TNM staging system.
authors.affiliation: Surgery and Cancer Division, Leighton Hospital, Middlewich Road, Crewe CW1 4QJ, UK. Electronic address: mhdalikazem@hotmail.com.
authors.forename: M A
authors.initials: MA
authors.lastname: Kazem
authors.affiliation: Surgery and Cancer Division, Leighton Hospital, Middlewich Road, Crewe CW1 4QJ, UK.
authors.forename: A U
authors.initials: AU
authors.lastname: Khan
authors.affiliation: Department of Surgery, The Christie NHS Foundation Trust, Manchester, M20 4BX, UK.
authors.forename: C R
authors.initials: CR
authors.lastname: Selvasekar
mesh_terms: D000368:Aged; D019540:Area Under Curve; D003082:Colectomy / Q000706:statistics & numerical data*; D003110:Colonic Neoplasms / Q000473:pathology* / Q000601:surgery; D018572:Disease-Free Survival; D004739:England; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000209:etiology; D009367:Neoplasm Staging; D049451:Nomograms; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012372:ROC Curve; D012044:Regression Analysis; D018570:Risk Assessment / Q000379:methods
keywords: Colon cancer; Nomogram; Predictive model; Survival