{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T22:45:43Z","timestamp":1791585943720,"version":"4.3.4"},"reference-count":37,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2024,5,31]],"date-time":"2024-05-31T00:00:00Z","timestamp":1717113600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100003392","name":"Natural Science Foundation of Fujian Province","doi-asserted-by":"publisher","award":["2023J011819"],"award-info":[{"award-number":["2023J011819"]}],"id":[{"id":"10.13039\/501100003392","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer Medicine"],"published-print":{"date-parts":[[2024,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aim<\/jats:title><jats:p>To explore the clinical factors associated with pathologic complete response (pCR) for locally advanced rectal cancer (LARC) patients treated with neoadjuvant chemoradiotherapy (nCRT) and develop a web\u2010based dynamic nomogram.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Retrospective analysis of patients with examination confirmed LARC from 2011 to 2022. Patients from the Union Hospital of Fujian Medical University were included as the training cohort (<jats:italic>n<\/jats:italic>\u2009=\u20091579) and Zhangzhou Hospital of Fujian Medical University as the external validation cohort (<jats:italic>n<\/jats:italic>\u2009=\u2009246).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In the training cohort, after nCRT, 350 (22.2%) patients achieved pCR. More stomas were avoided in pCR patients (73.9% vs. 69.7%, <jats:italic>p<\/jats:italic>\u2009=\u20090.043). After a median follow\u2010up time of 47.7\u2009months (IQR 2\u2013145) shown OS (5\u2010year: 93.7% vs. 81.0%, HR\u2009=\u20090.310, 95%CI: 0.189\u20130.510, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001) and DFS (5\u2010year: 91.2% vs. 75.0%, HR\u2009=\u20090.204, 95%CI: 0.216\u20130.484, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001) were significantly better among patients with pCR than non\u2010pCR. Multivariable Logistic analysis shown pCR was significantly associated with Pre\u2010CRT CEA (HR\u2009=\u20090.944, 95%CI: 0.921\u20130.968; <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001), histopathology (HR\u2009=\u20094.608, 95%CI: 2.625\u20138.089; <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001), Pre\u2010CRT T stage (HR\u2009=\u20090.793, 95%CI: 0.634\u20130.993; <jats:italic>p<\/jats:italic>\u2009=\u20090.043), Pre\u2010CRT N stage (HR\u2009=\u20090.727, 95%CI: 0.606\u20130.873; <jats:italic>p<\/jats:italic>\u2009=\u20090.001), Pre\u2010CRT MRI EMVI (HR\u2009=\u20090.352, 95%CI: 0.262\u20130.473; <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001), total neoadjuvant therapy (HR\u2009=\u20092.264, 95%CI: 1.280\u20134.004; <jats:italic>p<\/jats:italic>\u2009=\u20090.005). Meanwhile, the online version of the nomogram established in this study was publicized on an open\u2010access website (URL: <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"https:\/\/pcrpredict.shinyapps.io\/LARC2\/\">https:\/\/pcrpredict.shinyapps.io\/LARC2\/<\/jats:ext-link>). The model predicted accuracy with a C\u2010index of 0.73 (95% CI: 0.70\u20130.75), with an average C\u2010index of 0.73 for the internal cross validation and 0.78 (95% CI: 0.72\u20130.83) for the external validation cohort, showing excellent model accuracy. Delong test results showed the model has an important gain value for clinical characteristics to predict pCR in rectal cancer.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Patients with pCR had a better prognosis, including OS and DFS, and were independently associated with Pre\u2010CRT CEA, histopathology, Pre\u2010CRT T\/N stage, Pre\u2010CRT MRI EMVI, and TNT. A web\u2010based dynamic nomogram was successfully established for clinical use at any time.<\/jats:p><\/jats:sec>","DOI":"10.1002\/cam4.7251","type":"journal-article","created":{"date-parts":[[2024,5,31]],"date-time":"2024-05-31T14:51:59Z","timestamp":1717167119000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["A dynamic nomogram for predicting pathologic complete response to neoadjuvant chemotherapy in locally advanced rectal cancer"],"prefix":"10.1002","volume":"13","author":[{"given":"Guancong","family":"Wang","sequence":"first","affiliation":[{"name":"Department of Colorectal and Anal Surgery Zhangzhou Affiliated Hospital of Fujian Medical University  Zhangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiasen","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Interventional Radiology ZhangZhou Affiliated Hospital of Fujian Medical University  Zhangzhou 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