A predictive model for early death in elderly colorectal cancer patients: A population-based study

Purpose: The purpose of the present study was to investigate independent risk factors for early death in elderly colorectal cancer patients (ECRC) and to develop prediction model. Methods: Patients diagnosed with ECRC in Surveillance, Epidemiology, and End Result datasets (SEER) between 2010 and 2015 were included in this retrospective cohort study. For external validation, a data set from the Chinese population was gathered. Logistic regression analyses were used to identify independent risk factors for early death and to establish nomograms. Internal and external validation was performed to evaluate the nomograms using the receiver operating characteristic curve (ROC), calibration curve, and decision curve analysis (DCA). Results: A total of 28111 patients in the SEER cohort and 222 patients in the Chinese cohort were included. Patients from the SEER database were randomly divided into the training cohort (n = 19,679) and internal validation cohort (n = 8,432). Patients in the Chinese cohort were selected for the external validation cohort. Overall, 3579(12.73%) patients experienced early death in the SEER cohort and 31(13.96%) in the Chinese cohort. Two reliable nomograms were constructed on the basis of some significant risk factors. Internal validation and external validation of the nomograms showed high accuracy in predicting early death. Conclusion: These nomograms were considered practical tool to predict the risk of early death in ECRC patients. It was no doubt that it would aid in clinical decision-making and the development of tailored treatment strategies for this group.