Sloan-Kettering - Prediction Tools: Colorectal Cancer

Colorectal Cancer Nomogram

This tool can be used to calculate the probability of being disease-free after surgery

This tool, known as a nomogram, can be used to predict the probability of being disease-free from colon cancer five to ten years following complete resection (surgical removal of all cancerous tissue). It is designed to help patients and physicians make decisions on further treatment and plan long-term follow-up.

The colorectal cancer nomogram is based on a database of 1,320 patients with nonmetastatic colon cancer treated at Memorial Sloan-Kettering Cancer Center. It provides a more accurate picture of the five- or ten-year risk of recurrence than older assessment tools, such as the staging system of the American Joint Committee on Cancer (AJCC).

This predictive tool may also be used by researchers to help design and evaluate clinical trials.

Supporting Publication

Visit PubMed to view the journal articles that support this nomogram

Who Is This Tool For?

This tool can be used to predict probability of being disease-free from colon cancer after surgery, assuming that all of the primary cancer was completely removed during the original surgery. The nomogram is for patients who have localized colon cancer that shows no evidence of metastasis, or spread beyond the colon, before or at the time of surgery. This means that only patients with tumors found in the colon -- between the pouch that forms the first part of the large intestine (known as the cecum) and the S-shaped section of the colon that connects to the rectum (the rectosigmoid, or sigmoid, colon) -- should use this tool. Patients using this nomogram may or may not have had chemotherapy.

The tool should be used by physicians. Patients should use this tool only in consultation with their physicians.

What Information Will I Need?

In order to use the colorectal cancer nomogram, you will need to have specific information on hand, some of which you will have to obtain from your doctor. See below for details on what you will need to know in order to use the nomogram.

Needed Information	Parameters/Further Explanation
Age	Patient's age at the time of the surgery
Preoperative CEA level	Carcinoembryonic antigen (CEA), which is a tumor marker for colorectal cancer
Tumor location	This nomogram is only for patients with tumors localized in the colon, found between the cecum and rectosigmoid (greater than 18 cm from the anal verge).
Tumor differentiation	Whether tumor is poor, moderate, or well differentiated
Lymphovascular invasion	Whether the presence of one or more tumor cells was found in the lymphatic or vascular structure
Perineural invasion	Whether the presence of one or more tumor cells was found in or around the nerves
Number of positive and negative lymph nodes	Value between 0 and 50
Depth of tumor penetration into the colon wall (T-Stage)	The stage of the tumor, based upon the TNM anatomic staging system
Whether or not the patient received adjuvant chemotherapy	Whether the patient received chemotherapy after surgery

How to Access the Tool

To use the online version of this prediction tool, click here or on "open calculator" in the box at the top of the page. The calculator will open in a pop-up window.

Contact Us

If you have questions or comments, please do not hesitate to contact us at nomograms@mskcc.org.