{"title":"Prognostic Nomograms for Patients with Primary Sarcomatoid Carcinoma of The Urinary Bladder: Based on The SEER Database.","authors":"Chengyun Xu, Bing Xiong","doi":"10.22037/uj.v20i.7595","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>The present study aimed to develop nomograms based on the SEER database to predict the prognosis for patients with primary sarcomatoid carcinoma of the urinary bladder (SCUB).</p><p><strong>Materials and methods: </strong>Patients with primary SCUB were identified in the Surveillance, Epidemiology, and End Results (SEER) database, between 1975 and 2017. Univariate and multivariable Cox analysis were conducted to identify the independent prognostic factors for developing the overall survival (OS) and cancer-specific survival (CSS) nomograms. Then, concordance index (C-index), receiver operating characteristic (ROC) curve and calibration curve were used to evaluate the accuracy of the nomogram model. In addition, the model was further compared with TNM staging system.</p><p><strong>Results: </strong>A total of 238 eligible patients with primary SCUB were selected from the SEER database. As suggested by Cox-analysis, age, sex, T stage, M stage, tumor size, and surgery type of primary site were identified as the independent factors for predicting both OS and CSS. We developed OS and CSS nomograms with a favorable C-index by using these prognostic factors. The C-indexes of the OS and CSS nomogram in the present study were 0.738 (0.701-0.775) and 0.763 (0.724-0.802), which were superior to those of the AJCC TNM staging with 0.621 (0.576-0.666) and 0.637 (0.588-0.686) respectively, showing better discriminatory ability. Subsequently, the ROC curves showed that the 1-, 3- and 5-year AUCs (area under the curve) of OS nomogram (i.e., 0.793, 0.807 and 0.793) were higher than those of the TNM stage((i.e., 0.659, 0.676, 0.659). Similarly, as for CSS model, them ((i.e., 0.823, 0.804 and 0.804) were aslo exceed those of TNM stage((i.e., 0.683, 0.682, 0.682). Furthermore, the calibration curves indicated a good consistency between the predictive survival and the actual survival. Finally, patients were stratified by risk, and Kaplan-Meier survival curve suggested that the prognosis of the low-risk group was significantly better than that of the high-risk group.</p><p><strong>Conclusion: </strong>We developed nomograms with the SEER database, which could help predict the prognosis of SCUB individuals more accurately.</p>","PeriodicalId":23416,"journal":{"name":"Urology Journal","volume":" ","pages":"87-97"},"PeriodicalIF":1.5000,"publicationDate":"2024-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Urology Journal","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.22037/uj.v20i.7595","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"UROLOGY & NEPHROLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Purpose: The present study aimed to develop nomograms based on the SEER database to predict the prognosis for patients with primary sarcomatoid carcinoma of the urinary bladder (SCUB).
Materials and methods: Patients with primary SCUB were identified in the Surveillance, Epidemiology, and End Results (SEER) database, between 1975 and 2017. Univariate and multivariable Cox analysis were conducted to identify the independent prognostic factors for developing the overall survival (OS) and cancer-specific survival (CSS) nomograms. Then, concordance index (C-index), receiver operating characteristic (ROC) curve and calibration curve were used to evaluate the accuracy of the nomogram model. In addition, the model was further compared with TNM staging system.
Results: A total of 238 eligible patients with primary SCUB were selected from the SEER database. As suggested by Cox-analysis, age, sex, T stage, M stage, tumor size, and surgery type of primary site were identified as the independent factors for predicting both OS and CSS. We developed OS and CSS nomograms with a favorable C-index by using these prognostic factors. The C-indexes of the OS and CSS nomogram in the present study were 0.738 (0.701-0.775) and 0.763 (0.724-0.802), which were superior to those of the AJCC TNM staging with 0.621 (0.576-0.666) and 0.637 (0.588-0.686) respectively, showing better discriminatory ability. Subsequently, the ROC curves showed that the 1-, 3- and 5-year AUCs (area under the curve) of OS nomogram (i.e., 0.793, 0.807 and 0.793) were higher than those of the TNM stage((i.e., 0.659, 0.676, 0.659). Similarly, as for CSS model, them ((i.e., 0.823, 0.804 and 0.804) were aslo exceed those of TNM stage((i.e., 0.683, 0.682, 0.682). Furthermore, the calibration curves indicated a good consistency between the predictive survival and the actual survival. Finally, patients were stratified by risk, and Kaplan-Meier survival curve suggested that the prognosis of the low-risk group was significantly better than that of the high-risk group.
Conclusion: We developed nomograms with the SEER database, which could help predict the prognosis of SCUB individuals more accurately.
期刊介绍:
As the official journal of the Urology and Nephrology Research Center (UNRC) and the Iranian Urological Association (IUA), Urology Journal is a comprehensive digest of useful information on modern urology. Emphasis is on practical information that reflects the latest diagnostic and treatment techniques. Our objectives are to provide an exceptional source of current and clinically relevant research in the discipline of urology, to reflect the scientific work and progress of our colleagues, and to present the articles in a logical, timely, and concise format that meets the diverse needs of today’s urologist.
Urology Journal publishes manuscripts on urology and kidney transplantation, all of which undergo extensive peer review by recognized authorities in the field prior to their acceptance for publication. Accordingly, original articles, case reports, and letters to editor are encouraged.