Nomogram predicting the cardiovascular disease mortality for the older patients with colorectal cancer: a population-based study reflecting the real world

AbstractIntroduction: Cardio-oncology has received more and more attention in the older patients with colorectal cancer(CRC). We aimed to identify the prognostic factors and construct a nomogram-based model to predict the cardiovascular disease(CVD) mortality for the older patients with CRC.Materials and Methods: The data on the older patients diagnosed with CRC were retrieved from the SEER database from 2004 to 2015. The prognostic factors and a nomogram-based model predicting the CVD-specific mortality was performed by the Least absolute shrinkage and selection operator (LASSO) and Cox regression.Results: A total of 141251 eligible patients with CRC were enrolled, of which 41459 patients died of CRC and 12651 patients died of CVD. The age at diagnosis, sex, marital status, the year of diagnosis, surgery and chemotherapy were independent prognostic factors associated with CVD-specific mortality in the older patients with CRC. And we used these variables to develop the model predicting the CVD-specific mortality. The calibration curves for CVD-specific mortality probabilities showed that the model was in good agreement with actual observations. The C-index value of the model in the training cohort and testing cohort for predicting CVD-specific mortality was 0.728 and 0.734, respectively.Discussion: The proposed nomogram-based model of the CVD-specific mortality could be used to predict the accurate prognosis for the older patients with CRC. This model could be a useful tool for clinicians to identify high-risk patients and develop personalized treatment plans. The derived nomogram-based model could be adopted to assistant clinicians including oncologists and cardiologists to providing screening recommendations and choosing an optimum treatment regimen.