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The C-indices of the radiomic nomogram and TNM staging system were 0.780 (95 % CI 0.734-0.847) and 0.738 (0.687-0.784) respectively. The radiomic signature-based nomogram demonstrated good fitness (shown by calibration curves) and clinical usefulness (shown by decision curve analysis). A radiomic signature derived from MDCT images can effectively predict DFS in patients with stage II and III colon cancer and could be used as a supplement for risk stratification. A radiomic signature derived from MDCT images can effectively predict DFS in