构建骨盆骨肉瘤预测提名图：基于 SEER 数据库和中国队列的回顾性研究

IF 1 4区医学 Q3 MEDICINE, GENERAL & INTERNAL

British journal of hospital medicine Pub Date : 2024-08-30 DOI:10.12968/hmed.2024.0339

Yefeng Xu, Qingying Yan, Jiewen Yang, Miao Cheng, Jialu Chen, Yongwei Yao, Yunxia Liu

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A nomogram was constructed using data gleaned from the SEER cohort and verified using the receiver operating characteristic (ROC) curve and calibration plot in the Chinese cohort. Results Kaplan-Meier analysis revealed that individuals of other races (Asians) (hazard ratio (HR) = 0.24, 95% confidence interval (CI): 0.1-0.57, p = 0.001), aged ≤51 years old (HR = 0.4, 95% CI: 0.22-0.73, p = 0.003), and with tumor size ≤160 mm (HR = 0.37, 95% CI: 0.2-0.71, p = 0.03) had better survival outcomes. Conversely, factors such as no primary surgery (HR = 3.6, 95% CI: 1.81-7.15, p < 0.001), lung metastasis (HR = 1.96, 95% CI: 1.17-3.28, p = 0.010), and radiotherapy (HR = 1.89, 95% CI: 1.10-3.25, p = 0.021) were associated with poorer survival. Multivariate Cox analysis indicated that lung metastasis (HR = 2.57, 95% CI: 1.29-5.13, p = 0.008), other races (Asians) (HR = 0.23, 95% CI: 0.07-0.75, p = 0.015), tumor size (HR = 0.28, 95% CI: 0.13-0.62, p = 0.001) and age (HR = 0.3, 95% CI: 0.16-0.59, p < 0.001) were independent prognostic factors for pelvic osteosarcoma. Univariate and multivariate Cox regression models identified three independent variables in the training cohort: age, lung metastasis, and tumor size. A predictive nomogram was developed based on the data from the SEER cohort and validated in the Chinese cohort. The areas under the curves (AUCs) that are used to predict 1-year, 2-year, and 3-year survival rates were 0.81 (95% CI: 0.68-0.94), 0.75 (95% CI: 0.63-0.86), and 0.80 (95% CI: 0.70-0.89) in the training cohort, and 0.67 (95% CI: 0.30-1.04), 0.66 (95% CI: 0.43-0.90) and 0.71 (95% CI: 0.50-0.93) in the validation cohort. 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引用次数: 0

摘要

目的/背景一般来说，骨盆骨肉瘤的预后比肢体骨肉瘤差。本研究旨在创建并验证一种新的预测骨盆骨肉瘤预后的提名图。方法收集了来自监测、流行病学和最终结果（SEER）数据库的 62 名患者和 31 名确诊为骨盆骨肉瘤的中国患者的临床数据。采用卡普兰-米尔生存分析法计算所有变量的中位生存时间。采用单变量和多变量 Cox 回归模型确定骨盆骨肉瘤的预后因素。利用从 SEER 队列中收集的数据构建了一个提名图，并在中国队列中利用接收器操作特征曲线（ROC）和校准图进行了验证。结果 Kaplan-Meier 分析显示，其他种族（亚洲人）（危险比 (HR) = 0.24，95% 置信区间 (CI)：0.1-0.57，p = 0.001）、年龄≤51 岁（HR = 0.4，95% CI：0.22-0.73，p = 0.003）、肿瘤大小≤160 毫米（HR = 0.37，95% CI：0.2-0.71，p = 0.03）的患者生存率更高。相反，未进行初次手术（HR = 3.6，95% CI：1.81-7.15，p <0.001）、肺转移（HR = 1.96，95% CI：1.17-3.28，p = 0.010）和放疗（HR = 1.89，95% CI：1.10-3.25，p = 0.021）等因素与较差的生存率相关。多变量 Cox 分析表明，肺转移（HR = 2.57，95% CI：1.29-5.13，p = 0.008）、其他种族（亚洲人）（HR = 0.23，95% CI：0.07-0.75，p = 0.015）、肿瘤大小（HR = 0.28，95% CI：0.13-0.62，p = 0.001）和年龄（HR = 0.3，95% CI：0.16-0.59，p < 0.001）是盆腔骨肉瘤的独立预后因素。单变量和多变量考克斯回归模型确定了训练队列中的三个独立变量：年龄、肺转移和肿瘤大小。根据SEER队列的数据绘制了预测提名图，并在中国队列中进行了验证。用于预测 1 年、2 年和 3 年生存率的曲线下面积（AUC）分别为 0.81（95% CI：0.68-0.94）、0.75（95% CI：0.63-0.86）和 0.在训练队列中分别为 0.81（95% CI：0.68-0.94）、0.75（95% CI：0.63-0.86）和 0.80（95% CI：0.70-0.89），在验证队列中分别为 0.67（95% CI：0.30-1.04）、0.66（95% CI：0.43-0.90）和 0.71（95% CI：0.50-0.93）。结论本研究构建的预测提名图有助于准确、有效地预测骨盆骨肉瘤患者的总生存期，有助于提高临床决策过程。

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Constructing a Nomogram for Predicting Pelvic Osteosarcoma: A Retrospective Study Based on the SEER Database and a Chinese Cohort.

Aims/Background Generally, pelvic osteosarcoma has a worse prognosis compared with limb osteosarcoma. This study aims to create and validate a new nomogram for predicting the prognosis of pelvic osteosarcoma. Methods Clinical data of 62 patients derived from the Surveillance, Epidemiology, and End Results (SEER) database and 31 Chinese patients diagnosed with pelvic osteosarcoma were gathered. Kaplan-Meier survival analysis was utilized to calculate the median survival time for all variables. Univariate and multivariate Cox regression models were employed to identify the prognostic factors of pelvic osteosarcoma. A nomogram was constructed using data gleaned from the SEER cohort and verified using the receiver operating characteristic (ROC) curve and calibration plot in the Chinese cohort. Results Kaplan-Meier analysis revealed that individuals of other races (Asians) (hazard ratio (HR) = 0.24, 95% confidence interval (CI): 0.1-0.57, p = 0.001), aged ≤51 years old (HR = 0.4, 95% CI: 0.22-0.73, p = 0.003), and with tumor size ≤160 mm (HR = 0.37, 95% CI: 0.2-0.71, p = 0.03) had better survival outcomes. Conversely, factors such as no primary surgery (HR = 3.6, 95% CI: 1.81-7.15, p < 0.001), lung metastasis (HR = 1.96, 95% CI: 1.17-3.28, p = 0.010), and radiotherapy (HR = 1.89, 95% CI: 1.10-3.25, p = 0.021) were associated with poorer survival. Multivariate Cox analysis indicated that lung metastasis (HR = 2.57, 95% CI: 1.29-5.13, p = 0.008), other races (Asians) (HR = 0.23, 95% CI: 0.07-0.75, p = 0.015), tumor size (HR = 0.28, 95% CI: 0.13-0.62, p = 0.001) and age (HR = 0.3, 95% CI: 0.16-0.59, p < 0.001) were independent prognostic factors for pelvic osteosarcoma. Univariate and multivariate Cox regression models identified three independent variables in the training cohort: age, lung metastasis, and tumor size. A predictive nomogram was developed based on the data from the SEER cohort and validated in the Chinese cohort. The areas under the curves (AUCs) that are used to predict 1-year, 2-year, and 3-year survival rates were 0.81 (95% CI: 0.68-0.94), 0.75 (95% CI: 0.63-0.86), and 0.80 (95% CI: 0.70-0.89) in the training cohort, and 0.67 (95% CI: 0.30-1.04), 0.66 (95% CI: 0.43-0.90) and 0.71 (95% CI: 0.50-0.93) in the validation cohort. Conclusion The predictive nomogram constructed in this study facilitates accurate and effective prediction of the overall survival of patients with pelvic osteosarcoma and helps enhance the clinical decision-making process.

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来源期刊

British journal of hospital medicine 医学-医学：内科

CiteScore

1.50

自引率

0.00%

发文量

176

审稿时长

4-8 weeks

期刊介绍： British Journal of Hospital Medicine was established in 1966, and is still true to its origins: a monthly, peer-reviewed, multidisciplinary review journal for hospital doctors and doctors in training. The journal publishes an authoritative mix of clinical reviews, education and training updates, quality improvement projects and case reports, and book reviews from recognized leaders in the profession. The Core Training for Doctors section provides clinical information in an easily accessible format for doctors in training. British Journal of Hospital Medicine is an invaluable resource for hospital doctors at all stages of their career. The journal is indexed on Medline, CINAHL, the Sociedad Iberoamericana de Información Científica and Scopus.