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. 2026 Sep 28;16:1849274. doi: 10.3389/fonc.2026.1849274

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Copyright © 2026 Wu, Zhang, Shi, Xu, Fan, Zhang and Wang.

This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

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Panel A displays a grouped bar chart comparing predicted risk and observed frequency across eight risk groups, showing close alignment between predictions and observations as risk group increases. Panel B presents a line graph of standardized net benefit versus high risk threshold for five models: pTNM stage, histologic grade, risk model, full model, plus 'All' and 'None' strategies, with the full model showing the highest net benefit across most thresholds. — Further evaluation of the nomogram. (A) Predicted risk and observed frequency across different risk groups. (B) Decision curve analysis (DCA) comparing tumor stage, pathological grade, and risk group alone with the nomogram incorporating clinical features.