Yutong Shi, Ran Mo, Yutong Chen, Zhouji Ma, Bo Wen, Qian Tan
{"title":"肢体非转移性黑色素瘤预后提名图的建立与验证--基于 SEER 的研究。","authors":"Yutong Shi, Ran Mo, Yutong Chen, Zhouji Ma, Bo Wen, Qian Tan","doi":"10.1080/08941939.2024.2401125","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Malignant melanoma, a highly aggressive skin cancer, has remarkable incidence and mortality nowadays. This study aims to explore prognostic factors associated with nonmetastatic cutaneous melanoma of the limbs and to develop nomograms for predicting overall survival (OS) and cancer-specific survival (CSS).</p><p><strong>Methods: </strong>The study cohort was derived from the Surveillance, Epidemiology, and End Results database. Univariate Cox regression, Lasso regression, and multivariate Cox regression analyses were conducted to identify prognostic factors and construct nomograms. The receiver operating characteristic (ROC) curve, time-dependent C-index, calibration curve, decision curve analysis (DCA) and Kaplan-Meier method were used to evaluate the accuracy and clinical applicability of the nomograms.</p><p><strong>Results: </strong>A total of 15,606 patients were enrolled. Multivariate analysis identified several prognostic factors for OS and CSS including age, sex, histologic type, N stage, tumor thickness, depth of invasion, mitotic rate, ulceration, surgery of primary site, systemic therapy, race, and number of lymph nodes examined. A nomogram incorporating 12 independent predictors for OS was developed, with a C-index of 0.866 (95% confidence interval [CI]: 0.858-0.874) in the training cohort and 0.853 (95% CI: 0.839-0.867) in validation. For CSS, 10 independent predictors and one related factor were included, yielding a C-index of 0.913 (95% CI: 0.903-0.923) in the training cohort and 0.922 (95% CI: 0.908-0.936) in validation. The ROC curve, time-dependent C-index, calibration curve, DCA, and K-M plot demonstrated favorable discrimination, calibration, and clinical utility.</p><p><strong>Conclusion: </strong>The developed nomograms provide a precise and personalized predictive tool for risk management of patients with nonmetastatic limb melanoma.</p>","PeriodicalId":16200,"journal":{"name":"Journal of Investigative Surgery","volume":"37 1","pages":"2401125"},"PeriodicalIF":2.1000,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Establishment and Validation of Prognostic Nomograms for Nonmetastatic Melanoma of the Limbs-A SEER-Based Study.\",\"authors\":\"Yutong Shi, Ran Mo, Yutong Chen, Zhouji Ma, Bo Wen, Qian Tan\",\"doi\":\"10.1080/08941939.2024.2401125\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Malignant melanoma, a highly aggressive skin cancer, has remarkable incidence and mortality nowadays. This study aims to explore prognostic factors associated with nonmetastatic cutaneous melanoma of the limbs and to develop nomograms for predicting overall survival (OS) and cancer-specific survival (CSS).</p><p><strong>Methods: </strong>The study cohort was derived from the Surveillance, Epidemiology, and End Results database. Univariate Cox regression, Lasso regression, and multivariate Cox regression analyses were conducted to identify prognostic factors and construct nomograms. The receiver operating characteristic (ROC) curve, time-dependent C-index, calibration curve, decision curve analysis (DCA) and Kaplan-Meier method were used to evaluate the accuracy and clinical applicability of the nomograms.</p><p><strong>Results: </strong>A total of 15,606 patients were enrolled. Multivariate analysis identified several prognostic factors for OS and CSS including age, sex, histologic type, N stage, tumor thickness, depth of invasion, mitotic rate, ulceration, surgery of primary site, systemic therapy, race, and number of lymph nodes examined. A nomogram incorporating 12 independent predictors for OS was developed, with a C-index of 0.866 (95% confidence interval [CI]: 0.858-0.874) in the training cohort and 0.853 (95% CI: 0.839-0.867) in validation. For CSS, 10 independent predictors and one related factor were included, yielding a C-index of 0.913 (95% CI: 0.903-0.923) in the training cohort and 0.922 (95% CI: 0.908-0.936) in validation. The ROC curve, time-dependent C-index, calibration curve, DCA, and K-M plot demonstrated favorable discrimination, calibration, and clinical utility.</p><p><strong>Conclusion: </strong>The developed nomograms provide a precise and personalized predictive tool for risk management of patients with nonmetastatic limb melanoma.</p>\",\"PeriodicalId\":16200,\"journal\":{\"name\":\"Journal of Investigative Surgery\",\"volume\":\"37 1\",\"pages\":\"2401125\"},\"PeriodicalIF\":2.1000,\"publicationDate\":\"2024-12-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Investigative Surgery\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1080/08941939.2024.2401125\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2024/10/6 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q2\",\"JCRName\":\"SURGERY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Investigative Surgery","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1080/08941939.2024.2401125","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/10/6 0:00:00","PubModel":"Epub","JCR":"Q2","JCRName":"SURGERY","Score":null,"Total":0}
引用次数: 0
摘要
背景:恶性黑色素瘤是一种侵袭性很强的皮肤癌,目前发病率和死亡率都很高。本研究旨在探讨与四肢非转移性皮肤黑色素瘤相关的预后因素,并制定预测总生存期(OS)和癌症特异性生存期(CSS)的提名图:研究队列来自监测、流行病学和最终结果数据库。进行了单变量 Cox 回归、Lasso 回归和多变量 Cox 回归分析,以确定预后因素并构建提名图。采用接收者操作特征曲线(ROC)、随时间变化的C指数、校准曲线、决策曲线分析(DCA)和卡普兰-梅耶法评估提名图的准确性和临床适用性:共有 15,606 名患者入选。多变量分析确定了几个影响OS和CSS的预后因素,包括年龄、性别、组织学类型、N分期、肿瘤厚度、浸润深度、有丝分裂率、溃疡、原发部位手术、全身治疗、种族和检查的淋巴结数量。研究人员绘制了一个包含 12 个独立的 OS 预测因子的提名图,训练队列的 C 指数为 0.866(95% 置信区间 [CI]:0.858-0.874),验证队列的 C 指数为 0.853(95% 置信区间 [CI]:0.839-0.867)。对于 CSS,纳入了 10 个独立预测因子和 1 个相关因子,得出的 C 指数在训练队列中为 0.913(95% CI:0.903-0.923),在验证中为 0.922(95% CI:0.908-0.936)。ROC曲线、随时间变化的C指数、校准曲线、DCA和K-M图均显示出良好的区分度、校准性和临床实用性:所开发的提名图为非转移性肢端黑色素瘤患者的风险管理提供了精确的个性化预测工具。
Establishment and Validation of Prognostic Nomograms for Nonmetastatic Melanoma of the Limbs-A SEER-Based Study.
Background: Malignant melanoma, a highly aggressive skin cancer, has remarkable incidence and mortality nowadays. This study aims to explore prognostic factors associated with nonmetastatic cutaneous melanoma of the limbs and to develop nomograms for predicting overall survival (OS) and cancer-specific survival (CSS).
Methods: The study cohort was derived from the Surveillance, Epidemiology, and End Results database. Univariate Cox regression, Lasso regression, and multivariate Cox regression analyses were conducted to identify prognostic factors and construct nomograms. The receiver operating characteristic (ROC) curve, time-dependent C-index, calibration curve, decision curve analysis (DCA) and Kaplan-Meier method were used to evaluate the accuracy and clinical applicability of the nomograms.
Results: A total of 15,606 patients were enrolled. Multivariate analysis identified several prognostic factors for OS and CSS including age, sex, histologic type, N stage, tumor thickness, depth of invasion, mitotic rate, ulceration, surgery of primary site, systemic therapy, race, and number of lymph nodes examined. A nomogram incorporating 12 independent predictors for OS was developed, with a C-index of 0.866 (95% confidence interval [CI]: 0.858-0.874) in the training cohort and 0.853 (95% CI: 0.839-0.867) in validation. For CSS, 10 independent predictors and one related factor were included, yielding a C-index of 0.913 (95% CI: 0.903-0.923) in the training cohort and 0.922 (95% CI: 0.908-0.936) in validation. The ROC curve, time-dependent C-index, calibration curve, DCA, and K-M plot demonstrated favorable discrimination, calibration, and clinical utility.
Conclusion: The developed nomograms provide a precise and personalized predictive tool for risk management of patients with nonmetastatic limb melanoma.
期刊介绍:
Journal of Investigative Surgery publishes peer-reviewed scientific articles for the advancement of surgery, to the ultimate benefit of patient care and rehabilitation. It is the only journal that encompasses the individual and collaborative efforts of scientists in human and veterinary medicine, dentistry, basic and applied sciences, engineering, and law and ethics. The journal is dedicated to the publication of outstanding articles of interest to the surgical research community.