{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,27]],"date-time":"2026-02-27T04:13:42Z","timestamp":1772165622352,"version":"3.50.1"},"reference-count":27,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2023,5,18]],"date-time":"2023-05-18T00:00:00Z","timestamp":1684368000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2023,5,18]],"date-time":"2023-05-18T00:00:00Z","timestamp":1684368000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Jiang xi Youth Science Fundation","award":["20161BAB215250"],"award-info":[{"award-number":["20161BAB215250"]}]},{"name":"Youth Fundation of Second Affiliated Hospital of Nanchang University","award":["2016YNQN12029"],"award-info":[{"award-number":["2016YNQN12029"]}]},{"name":"Jiangxi Provincial Health Fund for Traditional Chinese Medicine","award":["2019A027"],"award-info":[{"award-number":["2019A027"]}]},{"name":"Jiangxi Health and Family Planning Commission Fundation","award":["202130387"],"award-info":[{"award-number":["202130387"]}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Gastroenterol"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>The definition of rectosigmoid junction (RSJ) is still in debate. The treatment and prognosis of patients with rectosigmoid junction cancer (RSJC) and positive lymph nodes (PLN-RSJCs) are mostly based on the American Joint Committee on Cancer (AJCC) staging system. Our study aims to assist clinicians in creating a more intuitive and accurate nomogram model for PLN-RSJCs for the prediction of patient overall survival (OS) after surgery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Based on the Surveillance, Epidemiology, and End Results (SEER) database, we extracted 3384 patients with PLN-RSJCs and randomly divided them into development (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20092344) and validation (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20091004) cohorts at a ratio of 7:3. Using univariate and multivariate COX regression analysis, we identified independent risk factors associated with OS in PLN-RSJCs in the development cohort, which were further used to establish a nomogram model. To verify the accuracy of the model, the concordance index (C-index), receiver operating characteristic (ROC) curves, calibration curves, and an internal validation cohort have been employed. Decision curve analysis (DCA) was used to assess the clinical applicability and benefits of the generated model. Survival curves of the low- and high-risk groups were calculated using the Kaplan\u2013Meier method together with the log-rank test.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Age, marital, chemotherapy, AJCC stage, T and N stage of TNM system, tumor size, and regional lymph nodes were selected as independent risk factors and included in the nomogram model. The C-index of this nomogram in the development (0.751;0.737\u20130.765) and validation cohorts (0.750;0.764\u20130.736) were more significant than that of the AJCC 7th staging system (0.681; 0.665\u20130.697). The ROC curve with the calculated area under the curve (AUC) in the development cohort was 0.845,0.808 and 0.800 for 1-year, 3-year and 5-year OS, AUC in the validation cohort was 0.815,0.833 and 0.814 for 1-year, 3-year and 5-year, respectively. The calibration plots of both cohorts for 1-year,3-year and 5-year OS all demonstrated good agreement between actual clinical observations and predicted outcomes. In the development cohort, the DCA showed that the nomogram prediction model is more advantageous for clinical application than the AJCC 7th staging system. Kaplan\u2013Meier curves in the low and high groups showed significant difference in patient OS.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>We established an accurate nomogram model for PLN-RSJCs, intended to support clinicians in the treatment and follow-up of patients.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12876-023-02810-7","type":"journal-article","created":{"date-parts":[[2023,5,18]],"date-time":"2023-05-18T07:03:43Z","timestamp":1684393423000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["A postsurgical prognostic nomogram for patients with lymph node positive rectosigmoid junction adenocarcinoma"],"prefix":"10.1186","volume":"23","author":[{"given":"Wu","family":"Yanlong","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wu","family":"Yunxiao","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wang","family":"Yibing","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2023,5,18]]},"reference":[{"issue":"1","key":"2810_CR1","doi-asserted-by":"publisher","first-page":"7","DOI":"10.3322\/caac.21708","volume":"72","author":"RL Siegel","year":"2022","unstructured":"Siegel RL, et al. Cancer statistics, 2022. CA Cancer J Clin. 2022;72(1):7\u201333.","journal-title":"CA Cancer J Clin"},{"issue":"3","key":"2810_CR2","doi-asserted-by":"publisher","first-page":"521","DOI":"10.1016\/j.suronc.2018.06.005","volume":"27","author":"N D'Souza","year":"2018","unstructured":"D\u2019Souza N, et al. The rectosigmoid problem. Surg Oncol. 2018;27(3):521\u20135.","journal-title":"Surg Oncol"},{"issue":"5","key":"2810_CR3","first-page":"410","volume":"111","author":"J Luna-Abanto","year":"2019","unstructured":"Luna-Abanto J. The rectosigmoid junction: are limits important? Rev Esp Enferm Dig. 2019;111(5):410.","journal-title":"Rev Esp Enferm Dig"},{"issue":"4","key":"2810_CR4","doi-asserted-by":"publisher","first-page":"431","DOI":"10.1007\/s00276-017-1954-4","volume":"40","author":"D Massalou","year":"2018","unstructured":"Massalou D, et al. Is it possible to give a single definition of the rectosigmoid junction? Surg Radiol Anat. 2018;40(4):431\u20138.","journal-title":"Surg Radiol Anat"},{"key":"2810_CR5","doi-asserted-by":"publisher","first-page":"237","DOI":"10.1007\/s003840050217","volume":"14","author":"A Shafik","year":"1999","unstructured":"Shafik A. Rectosigmoid junction anatomical, histological, and radiological studies with special reference to a sphincteric function.pdf. Int J Colorectal Dis. 1999;14:237\u201344.","journal-title":"Int J Colorectal Dis"},{"issue":"3","key":"2810_CR6","first-page":"737","volume":"26","author":"M Mukai","year":"2011","unstructured":"Mukai M, et al. Stage II\/III cancer of the rectosigmoid junction: an independent tumor type? Oncol Rep. 2011;26(3):737\u201341.","journal-title":"Oncol Rep"},{"issue":"6","key":"2810_CR7","doi-asserted-by":"publisher","first-page":"1454","DOI":"10.1245\/s10434-018-6462-1","volume":"25","author":"MR Weiser","year":"2018","unstructured":"Weiser MR. AJCC 8th Edition: Colorectal Cancer. Ann Surg Oncol. 2018;25(6):1454\u20135.","journal-title":"Ann Surg Oncol"},{"issue":"4","key":"2810_CR8","doi-asserted-by":"publisher","first-page":"1793","DOI":"10.1016\/j.jtcvs.2017.12.107","volume":"155","author":"SY Park","year":"2018","unstructured":"Park SY. Nomogram: An analogue tool to deliver digital knowledge. J Thorac Cardiovasc Surg. 2018;155(4):1793.","journal-title":"J Thorac Cardiovasc Surg"},{"issue":"22","key":"2810_CR9","doi-asserted-by":"publisher","first-page":"641","DOI":"10.21037\/atm.2019.10.77","volume":"7","author":"C Yu","year":"2019","unstructured":"Yu C, Zhang Y. Development and validation of prognostic nomogram for young patients with gastric cancer. Ann Transl Med. 2019;7(22):641.","journal-title":"Ann Transl Med"},{"issue":"7","key":"2810_CR10","doi-asserted-by":"publisher","first-page":"301","DOI":"10.1002\/cac2.12067","volume":"40","author":"J Wu","year":"2020","unstructured":"Wu J, et al. A nomogram for predicting overall survival in patients with low-grade endometrial stromal sarcoma: A population-based analysis. Cancer Commun (Lond). 2020;40(7):301\u201312.","journal-title":"Cancer Commun (Lond)"},{"issue":"8","key":"2810_CR11","doi-asserted-by":"publisher","first-page":"1364","DOI":"10.1200\/JCO.2007.12.9791","volume":"26","author":"A Iasonos","year":"2008","unstructured":"Iasonos A, et al. How to build and interpret a nomogram for cancer prognosis. J Clin Oncol. 2008;26(8):1364\u201370.","journal-title":"J Clin Oncol"},{"key":"2810_CR12","doi-asserted-by":"publisher","first-page":"772482","DOI":"10.3389\/fonc.2021.772482","volume":"11","author":"C Zhang","year":"2021","unstructured":"Zhang C, Zhao S, Wang X. A Postsurgical Prognostic Nomogram for Locally Advanced Rectosigmoid Cancer to Assist in Patient Selection for Adjuvant Chemotherapy. Front Oncol. 2021;11:772482.","journal-title":"Front Oncol"},{"issue":"1","key":"2810_CR13","doi-asserted-by":"publisher","first-page":"61","DOI":"10.1055\/s-0038-1673355","volume":"32","author":"MC Daly","year":"2019","unstructured":"Daly MC, Paquette IM. Surveillance, Epidemiology, and End Results (SEER) and SEER-Medicare Databases: Use in Clinical Research for Improving Colorectal Cancer Outcomes. Clin Colon Rectal Surg. 2019;32(1):61\u20138.","journal-title":"Clin Colon Rectal Surg"},{"key":"2810_CR14","first-page":"1196","volume":"15","author":"CMM Alves","year":"2021","unstructured":"Alves CMM, de Oliveira Prado PC, Bastos RR. Net survival for colorectal cancer in Cuiaba and Varzea Grande (state of Mato Grosso) Brazil. Ecancermedicalscience. 2021;15:1196.","journal-title":"Ecancermedicalscience"},{"issue":"11","key":"2810_CR15","doi-asserted-by":"publisher","first-page":"2037","DOI":"10.1016\/j.ejso.2019.06.024","volume":"45","author":"C Falch","year":"2019","unstructured":"Falch C, et al. Oncological outcome of carcinomas in the rectosigmoid junction compared to the upper rectum or sigmoid colon - A retrospective cohort study. Eur J Surg Oncol. 2019;45(11):2037\u201344.","journal-title":"Eur J Surg Oncol"},{"issue":"11","key":"2810_CR16","doi-asserted-by":"publisher","first-page":"1875","DOI":"10.1038\/bjc.2012.189","volume":"106","author":"O Majek","year":"2012","unstructured":"Majek O, et al. Survival from colorectal cancer in Germany in the early 21st century. Br J Cancer. 2012;106(11):1875\u201380.","journal-title":"Br J Cancer"},{"issue":"3","key":"2810_CR17","doi-asserted-by":"publisher","first-page":"971","DOI":"10.1002\/cam4.2779","volume":"9","author":"W Cai","year":"2020","unstructured":"Cai W, et al. Rectal NETs and rectosigmoid junction NETs may need to be treated differently. Cancer Med. 2020;9(3):971\u20139.","journal-title":"Cancer Med"},{"issue":"2","key":"2810_CR18","doi-asserted-by":"publisher","first-page":"148","DOI":"10.1097\/DCR.0000000000002323","volume":"65","author":"JD Vogel","year":"2022","unstructured":"Vogel JD, et al. The American Society of Colon and Rectal Surgeons Clinical Practice Guidelines for the Management of Colon Cancer. Dis Colon Rectum. 2022;65(2):148\u201377.","journal-title":"Dis Colon Rectum"},{"issue":"9","key":"2810_CR19","doi-asserted-by":"publisher","first-page":"1191","DOI":"10.1097\/DCR.0000000000001762","volume":"63","author":"YN You","year":"2020","unstructured":"You YN, et al. The American Society of Colon and Rectal Surgeons Clinical Practice Guidelines for the Management of Rectal Cancer. Dis Colon Rectum. 2020;63(9):1191\u2013222.","journal-title":"Dis Colon Rectum"},{"issue":"1","key":"2810_CR20","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1007\/s10147-017-1101-6","volume":"23","author":"T Watanabe","year":"2018","unstructured":"Watanabe T, et al. Japanese Society for Cancer of the Colon and Rectum (JSCCR) guidelines 2016 for the treatment of colorectal cancer. Int J Clin Oncol. 2018;23(1):1\u201334.","journal-title":"Int J Clin Oncol"},{"issue":"1","key":"2810_CR21","doi-asserted-by":"publisher","first-page":"347","DOI":"10.1186\/s12876-020-01464-z","volume":"20","author":"C Yu","year":"2020","unstructured":"Yu C, Zhang Y. Establishment of prognostic nomogram for elderly colorectal cancer patients: a SEER database analysis. BMC Gastroenterol. 2020;20(1):347.","journal-title":"BMC Gastroenterol"},{"issue":"18","key":"2810_CR22","doi-asserted-by":"publisher","first-page":"2157","DOI":"10.1200\/JCO.2015.65.9128","volume":"34","author":"YQ Huang","year":"2016","unstructured":"Huang YQ, et al. Development and Validation of a Radiomics Nomogram for Preoperative Prediction of Lymph Node Metastasis in Colorectal Cancer. J Clin Oncol. 2016;34(18):2157\u201364.","journal-title":"J Clin Oncol"},{"issue":"1","key":"2810_CR23","doi-asserted-by":"publisher","first-page":"337","DOI":"10.1186\/s12957-021-02445-6","volume":"19","author":"J Lv","year":"2021","unstructured":"Lv J, et al. A nomogram model for predicting prognosis of obstructive colorectal cancer. World J Surg Oncol. 2021;19(1):337.","journal-title":"World J Surg Oncol"},{"issue":"6","key":"2810_CR24","doi-asserted-by":"publisher","first-page":"675","DOI":"10.1007\/s00423-014-1243-1","volume":"400","author":"SA Kaser","year":"2015","unstructured":"Kaser SA, et al. Adenocarcinomas of the upper third of the rectum and the rectosigmoid junction seem to have similar prognosis as colon cancers even without radiotherapy, SAKK 40\/87. Langenbecks Arch Surg. 2015;400(6):675\u201382.","journal-title":"Langenbecks Arch Surg"},{"key":"2810_CR25","first-page":"1648","volume":"45","author":"S Yamamoto","year":"2002","unstructured":"Yamamoto S. Prospective evaluation of laparoscopic surgery for rectosigmoidal and rectal carcinoma.pdf. Laparosc Surg Rectal Carcinoma. 2002;45:1648\u201354.","journal-title":"Laparosc Surg Rectal Carcinoma"},{"issue":"4","key":"2810_CR26","doi-asserted-by":"publisher","first-page":"345","DOI":"10.1016\/j.ejso.2009.12.006","volume":"36","author":"B Morcos","year":"2010","unstructured":"Morcos B, et al. Lymph node yield in rectal cancer surgery: Effect of preoperative chemoradiotherapy. Eur J Surg Oncol (EJSO). 2010;36(4):345\u20139.","journal-title":"Eur J Surg Oncol (EJSO)"},{"issue":"15","key":"2810_CR27","doi-asserted-by":"publisher","first-page":"308","DOI":"10.21037\/atm.2018.07.02","volume":"6","author":"Z Zhang","year":"2018","unstructured":"Zhang Z, et al. Decision curve analysis: a technical note. Ann Transl Med. 2018;6(15):308.","journal-title":"Ann Transl Med"}],"container-title":["BMC Gastroenterology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12876-023-02810-7.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12876-023-02810-7\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12876-023-02810-7.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,5,18]],"date-time":"2023-05-18T07:06:10Z","timestamp":1684393570000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmcgastroenterol.biomedcentral.com\/articles\/10.1186\/s12876-023-02810-7"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,5,18]]},"references-count":27,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2023,12]]}},"alternative-id":["2810"],"URL":"https:\/\/doi.org\/10.1186\/s12876-023-02810-7","relation":{"has-preprint":[{"id-type":"doi","id":"10.21203\/rs.3.rs-2006874\/v1","asserted-by":"object"}]},"ISSN":["1471-230X"],"issn-type":[{"value":"1471-230X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,5,18]]},"assertion":[{"value":"28 August 2022","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"9 May 2023","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"18 May 2023","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"All methods were carried out in accordance with relevant guidelines and regulations. Ethical approval for study was obtained from second Affiliated Hospital of Nanchang University Medical Research Ethics Committee. Informed consent was obtained from all the participants.We declare that none of the work contained in this manuscript is published in any language or currently under consideration at any other journal, and there are no conflicts of interest to declare. All authors have contributed to read and approved this submitted manuscript in its current form.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"No applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"159"}}