European Spine Journal

, Volume 28, Issue 6, pp 1491–1501 | Cite as

Development of a novel model for predicting survival of patients with spine metastasis from colorectal cancer

  • Yujie Liu
  • Minglei Yang
  • Bo Li
  • Kehan Xu
  • Xin Gao
  • Jialin Li
  • Haifeng Wei
  • Quan HuangEmail author
  • Wei XuEmail author
  • Jianru XiaoEmail author
Original Article



To develop a novel nomogram for predicting survival of patients with spine metastasis from colorectal cancer (SMCRC) based on the clinical characteristics and prognostic factors.


Included in this study were 93 SMCRC patients who received treatments in our institute between 2006 and 2017, whose clinical data were analyzed retrospectively by univariate and multivariate analysis to identify independent variables that could predict prognosis. A nomogram for survival prediction was established on the basis of preoperative independent factors, and then subjected to bootstrap re-samples for internal validation. The discrimination was measured by concordance index (C-index). We used ROC analysis with the corresponding AUROC to compare the prediction accuracy of Changzheng Nomogram with three existing prognostic systems (Tomita, Tokuhashi and Bauer).


The high and median degrees of primary tumor differentiation, primary tumor surgery, carcinoembryonic antigen ≤ 5 ng/ml, no visceral metastases and ECOG-PS (0–2) were favorable prognostic factors for CRC metastases in the spine. These five preoperative independent factors were identified and entered into the nomogram with the C-index of 0.786 (0.739–0.833). The calibration curves for probability of 12- and 24-month overall survival (OS) showed good agreement between the predictive risk and the actual risk, and calibration was assessed. Compared with the previous prognostic systems, Changzheng Nomogram reported in this study showed higher accuracy in predicting OS of patients with SMCRC spinal metastases (p < 0.05).


By using this novel predictive model, clinicians could more precisely estimate the survival outcome of individual patients by evaluating clinical characteristics and identify subgroups of patients who are in need of a specific individual treatment strategy.

Graphical abstract

These slides can be retrieved under Electronic Supplementary Material.


Colorectal cancer Spine metastasis Nomogram Prognostic factor 



This study was supported by the National Key Research and Development Project of China (2016YFC0902100), National Natural Science Foundation of China (81702888) and Shanghai Youth doctor assistance program (QNYS09).

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interests.

Supplementary material

586_2019_5879_MOESM1_ESM.pptx (458 kb)
Supplementary material 1 (PPTX 458 kb)


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of Orthopedic Oncology, Changzheng HospitalSecond Military Medical UniversityShanghaiChina

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