Journal of oncology · 2022
Development and Validation of Nomogram-Based Prognosis Tools for Patients with Extremity Osteosarcoma: A SEER Population Study.
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Huang Yingtao, Wang Chenchen, Tang Dadong, Chen Bing, Jiang Zhongchao
Аннотация
OBJECTIVE: Osteosarcoma, usually occurring in the extremities, is the most common malignant bone tumour. The purpose of this study is to develop and validate nomogram-based prognosis tools for survival (OS) and cancer special survival (CSS) of patients with osteosarcoma of the extremities via the application of survival analysis.
MATERIALS AND METHODS: A total of 1427 patients diagnosed with osteosarcoma of the extremities during 2004-2015 were selected from the National Cancer Institute's (NCI) Surveillance, Epidemiology, and End Results- (SEER-) Medicare database. The samples were randomly assigned to either the training set (n = 856) or the validation cohort (n = 571). Kaplan-Meier (K-M) survival analysis was conducted to calculate patients' 1-, 3-, and 5-year OS and CSS rates. Cox proportional hazard ratio (HR) regression models were employed to identify and examine the factors that have a significant impact on OS and CSS with data from the training cohort.
RESULTS: The results of univariate and multivariate analyses performed in the training cohort indicated that older age, increased tumour size, higher grade, distant tumour extension, amputation, or no surgery (all HR > 1, P < 0.05) were risk predictors of poor OS and CSS. Subsequently, the independent prognosis signatures were utilised to construct nomograms. The concordance index (C-index), calibration plot, and decision curve analysis (DCA) were simultaneously used to validate the nomograms. The internally validated C-index values of the OS and CSS prediction models for the training set were 0.752 (95% confidence interval [CI]: 0.738-0.765) and 0.754 [95% CI: 0.740-0.768], respectively. Then, the models were validated in the validation cohort population, which also demonstrated the models had good reliability for prognostication.
CONCLUSIONS: The SEER cohort of patients with osteosarcoma of the extremities can be employed to produce effective tools that can assist in prognosis modelling.
MATERIALS AND METHODS: A total of 1427 patients diagnosed with osteosarcoma of the extremities during 2004-2015 were selected from the National Cancer Institute's (NCI) Surveillance, Epidemiology, and End Results- (SEER-) Medicare database. The samples were randomly assigned to either the training set (n = 856) or the validation cohort (n = 571). Kaplan-Meier (K-M) survival analysis was conducted to calculate patients' 1-, 3-, and 5-year OS and CSS rates. Cox proportional hazard ratio (HR) regression models were employed to identify and examine the factors that have a significant impact on OS and CSS with data from the training cohort.
RESULTS: The results of univariate and multivariate analyses performed in the training cohort indicated that older age, increased tumour size, higher grade, distant tumour extension, amputation, or no surgery (all HR > 1, P < 0.05) were risk predictors of poor OS and CSS. Subsequently, the independent prognosis signatures were utilised to construct nomograms. The concordance index (C-index), calibration plot, and decision curve analysis (DCA) were simultaneously used to validate the nomograms. The internally validated C-index values of the OS and CSS prediction models for the training set were 0.752 (95% confidence interval [CI]: 0.738-0.765) and 0.754 [95% CI: 0.740-0.768], respectively. Then, the models were validated in the validation cohort population, which also demonstrated the models had good reliability for prognostication.
CONCLUSIONS: The SEER cohort of patients with osteosarcoma of the extremities can be employed to produce effective tools that can assist in prognosis modelling.