Fig. 5

DCA analyzed clinical utility of the nomogram in the training (A), internal validation (B) and external validation sets (C). The y-axis represents net benefits and the x-axis measures threshold probability (Pt). The horizontal solid line indicates the advantage for patients not receiving NAT, the oblique solid line represents the advantage for patients receiving NAT and the diagonal dotted line (nomogram) indicates survival on the basis of nomogram scores to resolve whether a patient should receive NAT. A treatment strategy was superior if it had the highest value compared to other models, including two simple strategies, such as performing NAT for all patients (sloping solid line) or performing primary surgery first (horizontal solid line)