Kristel Lourdault, Arthur W Cowman, Douglas Hanes, Anthony J Scholer, Tyler Aguilar, Richard Essner
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引用次数: 0
Abstract
Background and objectives: Clinical nomograms have been developed to predict sentinel lymph node (SLN) status in early-stage melanoma patients, but the clinical utility of these tools remains debatable. We created and validated a nomogram using data from a randomized clinical trial and assessed its accuracy against the well-validated Melanoma Institute Australia (MIA) nomogram.
Methods: We developed our model to predict SLN status using logistic regression on clinicopathological patient data from the Multicenter Selective Lymphadenectomy Trial-I. The model was externally validated using the National Cancer Database (NCDB) data set, and its performance was compared to that of the MIA nomogram.
Results: Our model had good discrimination between positive and negative SLNs, with a training set area under the curve (AUC) of 0.706 (0.661-0.751). Our model achieved an AUC of 0.715 (0.706-0.724) compared to 0.723 (0.715-0.731) with the MIA model, using the NCDB set.
Conclusion: Our model performed similarly to the MIA model, confirming that despite using different clinical features and data sets, no clinical nomogram is currently accurate enough for clinical use.
背景和目的:已有临床提名图用于预测早期黑色素瘤患者的前哨淋巴结(SLN)状态,但这些工具的临床实用性仍有待商榷。我们利用一项随机临床试验的数据创建并验证了一个提名图,并对照经过充分验证的澳大利亚黑色素瘤研究所(MIA)提名图评估了其准确性:我们根据多中心选择性淋巴腺切除术试验 I 的临床病理患者数据,利用逻辑回归建立了预测 SLN 状态的模型。我们使用国家癌症数据库(NCDB)数据集对该模型进行了外部验证,并将其性能与 MIA 提名图进行了比较:结果:我们的模型对阳性和阴性 SLN 有很好的区分度,训练集的曲线下面积 (AUC) 为 0.706(0.661-0.751)。我们的模型的AUC为0.715(0.706-0.724),而使用NCDB集的MIA模型的AUC为0.723(0.715-0.731):我们的模型与 MIA 模型表现相似,这证实了尽管使用了不同的临床特征和数据集,但目前还没有一种临床提名图足够准确,可用于临床。
期刊介绍:
The Journal of Surgical Oncology offers peer-reviewed, original papers in the field of surgical oncology and broadly related surgical sciences, including reports on experimental and laboratory studies. As an international journal, the editors encourage participation from leading surgeons around the world. The JSO is the representative journal for the World Federation of Surgical Oncology Societies. Publishing 16 issues in 2 volumes each year, the journal accepts Research Articles, in-depth Reviews of timely interest, Letters to the Editor, and invited Editorials. Guest Editors from the JSO Editorial Board oversee multiple special Seminars issues each year. These Seminars include multifaceted Reviews on a particular topic or current issue in surgical oncology, which are invited from experts in the field.