Prognostic factors and nomogram development for survival in renal cell carcinoma patients with multiple primary cancers: a retrospective study.

IF 1.9 3区 医学 Q4 ANDROLOGY
Translational andrology and urology Pub Date : 2025-03-30 Epub Date: 2025-03-26 DOI:10.21037/tau-24-509
Man Tian, Jing Shen, Meng Liu, Xue-Fen Chen, Tie-Jun Wang, Yong-Sheng Sun
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引用次数: 0

Abstract

Background: Patients with renal cell cancer have an increased risk of developing multiple primary cancers (MPCs) due to improved survival rates. The purpose of this study was to evaluate the clinicopathological features of MPCs and to generate a useful tool for predicting cancer-specific survival (CSS) in these patients.

Methods: A retrospective analysis was conducted on data from renal cell carcinoma (RCC) who were diagnosed with MPCs between 2001 and 2021 from the Surveillance, Epidemiology, and End Results (SEER) database. Patients with RCC meeting the criteria were selected for Kaplan-Meier (KM) survival analysis. The main outcome of this study was CSS, defined as the time from the initial diagnosis to either death due to cancer or the last follow-up. The Cox regression model was used to analyze the CSS factors of MPCs, the results of the multivariate analysis were displayed in a forest map, and the significant variables identified in the multivariate Cox analysis were used to construct the nomogram. Area under the curve (AUC) and calibration plots were used to evaluate the predictive performance of the nomogram.

Results: A total of 2,078 cases of renal cancer with MPCs diagnosed between 2001 and 2021 were included. Age and grade were determined through both univariate and multivariate analyses to be independent prognostic factors affecting CSS. Based on clinical practice, the final nomogram was constructed using the variables: sex, age, grade, summary stage, tumor-node-metastasis (TNM) stage and tumor size to predict CSS at 60, 120, and 180 months. The concordance index (C-index) for the CSS nomogram was 0.670 [95% confidence interval (CI): 0.642-0.698]. The model demonstrated a good predictive performance. To assess the consistency between observed and predicted values, a calibration curve was developed.

Conclusions: This study identified risk factors for CSS in patients with clear cell RCC (ccRCC) with MPCs and developed a nomogram to predict CSS in these patients. The model demonstrates strong clinical applicability and can serve as a valuable clinical decision-making tool for physicians and patients.

肾细胞癌合并多原发癌患者的预后因素和nomogram发展:一项回顾性研究。
背景:由于生存率的提高,肾细胞癌患者发生多发性原发癌(MPCs)的风险增加。本研究的目的是评估MPCs的临床病理特征,并为预测这些患者的癌症特异性生存(CSS)提供一个有用的工具。方法:回顾性分析来自监测、流行病学和最终结果(SEER)数据库的2001年至2021年间诊断为MPCs的肾细胞癌(RCC)的数据。选择符合标准的RCC患者进行Kaplan-Meier (KM)生存分析。本研究的主要结局是CSS,定义为从最初诊断到因癌症死亡或最后一次随访的时间。采用Cox回归模型对MPCs的CSS因子进行分析,将多变量分析结果显示在森林图中,并利用多变量Cox分析中识别的显著变量构建正态图。使用曲线下面积(AUC)和校准图来评估nomogram预测性能。结果:共纳入2001年至2021年间诊断的2078例肾癌伴MPCs。通过单因素和多因素分析确定年龄和分级为影响CSS的独立预后因素。根据临床实践,构建最终的nomogram (nomogram),使用变量:性别、年龄、分级、总分期、肿瘤-淋巴结-转移(TNM)分期和肿瘤大小来预测60、120和180个月时的CSS。CSS模态图的一致性指数(C-index)为0.670[95%可信区间(CI): 0.642-0.698]。该模型具有良好的预测性能。为了评估观测值与预测值之间的一致性,绘制了校准曲线。结论:本研究确定了透明细胞RCC (ccRCC)合并MPCs患者发生CSS的危险因素,并建立了预测这些患者发生CSS的nomogram。该模型具有较强的临床适用性,可以作为医生和患者有价值的临床决策工具。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
4.10
自引率
5.00%
发文量
80
期刊介绍: ranslational Andrology and Urology (Print ISSN 2223-4683; Online ISSN 2223-4691; Transl Androl Urol; TAU) is an open access, peer-reviewed, bi-monthly journal (quarterly published from Mar.2012 - Dec. 2014). The main focus of the journal is to describe new findings in the field of translational research of Andrology and Urology, provides current and practical information on basic research and clinical investigations of Andrology and Urology. Specific areas of interest include, but not limited to, molecular study, pathology, biology and technical advances related to andrology and urology. Topics cover range from evaluation, prevention, diagnosis, therapy, prognosis, rehabilitation and future challenges to urology and andrology. Contributions pertinent to urology and andrology are also included from related fields such as public health, basic sciences, education, sociology, and nursing.
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