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| Prognostic value of patient - generated subjective global assessment for colorectal cancer patients and construction of
a nomogram |
| Zhao Dong, Xu Jianhua, Ji Peidong, Ming Zhixiang |
| Department of General Surgery Nantong Affiliated Hospital of Nanjing University of Chinese Medicine Nantong 226007
Jiangsu China |
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Abstract Objective To investigate the prognostic value of patient - generated subjective global assessment PG - SGA for
colorectal cancer patients and construct a nutrition - related nomogram integrated with nutritional status with clinicopathologic
parameters for survival prediction. Method A retrospective analysis was conducted on 202 colorectal cancer patients who underwent
curative resection in Nantong Affiliated Hospital of Nanjing University of Chinese Medicine from January 2016 to January 2020.
Preoperative nutritional status was evaluated by PG-SGA and its impact on overall survival OS of colorectal cancer patients was
analyzed. The univariate and multivariate Cox regression analysis was used to determine independent prognostic factors. A nomogram
model was constructed and its predictive performance was tested by the consistency index C-index and calibration plots. Result
According to the PG-SGA 33. 7% of patients had moderate malnutrition and 26. 7% were severely malnourished. Patients with severe
malnutrition had a larger tumor diameter P = 0. 044 and a lower proportion of adjuvant chemotherapy following the surgery P =
0. 029 than other patients. The 5-year OS rates of patients with well nutrition moderate malnutrition and severe malnutrition were
81. 6% 63. 2% and 46. 5% respectively. There were significant survival differences between the groups P< 0. 05 . Tumor size
P= 0. 046 pT stage P= 0. 002 lymph node metastasis P = 0. 001 vascular invasion P<0. 001 and PG-SGA P<0. 001
were independent prognostic factors for colorectal cancer patients. A nomogram model was developed according to the above prognostic
parameters and its C-index was 0. 781 95% CI = 0. 671 - 0. 890 . The calibration plots showed a good consistency between the
predicted survival probability and actual survival probability. Conclusion PG-SGA is a useful tool for survival prediction of colorectal
cancer patients and it might further optimize the prognostic risk stratification of patients along with clinicopathologic parameters.
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