Log Odds of Positive Lymph Node- (LODDS-) Based Competing-Risk Nomogram for Predicting Prognosis of Resected Rectal Cancer: A Development and Validation Study

IF 2 4区 医学 Q3 GASTROENTEROLOGY & HEPATOLOGY Gastroenterology Research and Practice Pub Date : 2020-11-19 DOI:10.1155/2020/9706732
Rui-zhe Zheng, Jiang Xie, Shui Zhang, Wen Li, Bo Dong, Yin-wei Cong, Zhi-qiang Wang
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Abstract

Background and Aims. Cancer-specific survival (CSS) of rectal cancer (RC) is associated with several factors. We aimed to build an efficient competing-risk nomogram based on log odds of positive lymph nodes (LODDS) to predict RC survival. Methods. Medical records of 8754 patients were collected from the Surveillance, Epidemiology, and End Results (SEER) database, of 4895 patients from SEER during 2011–2014 and of 478 patients from an Eastern center as a development cohort, validation cohort, and test cohort, respectively. Univariate and multivariate competing-risk analyses were performed to build competing-risk nomogram for predicting the CSS of RC patients. Prediction efficacy was evaluated and compared with reference to the 8th TNM classification using the factor areas under the receiver operating characteristic curve (AUC) and Brier score. Results. The competing-risk nomogram was based on 6 variables: size, M stage, LODDS, T stage, grade, and age. The competing-risk nomogram showed a higher AUC value in predicting the 5-year death rate due to RC than the 8th TNM stage in the development cohort (0.81 vs. 0.76), validation cohort (0.85 vs. 0.82), and test cohort (0.71 vs. 0.66). The competing-risk nomogram also showed a higher Brier score in predicting the 5-year death rate due to RC than the 8th TNM stage in the development cohort (0.120 vs. 0.127), validation cohort (0.123 vs. 0.128), and test cohort (0.202 vs. 0.226). Conclusion. We developed and validated a competing-risk nomogram for RC death, which could provide the probability of survival averting competing risk to facilitate clinical decision-making.
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基于正淋巴结对数比值(LODDS-)的竞争风险诺模图预测癌症切除预后的发展与验证研究
背景和目的。直肠癌症(RC)的癌症特异性生存率(CSS)与几个因素有关。我们旨在建立一个基于阳性淋巴结对数比值(LODS)的有效竞争风险列线图来预测RC生存率。方法。从监测、流行病学和最终结果(SEER)数据库中收集了8754名患者的医疗记录,2011-2014年期间从SEER中收集了4895名患者,从东部中心收集了478名患者,分别作为开发队列、验证队列和测试队列。进行单变量和多变量竞争风险分析,建立竞争风险列线图,用于预测RC患者的CSS。使用受试者工作特征曲线下的因子面积(AUC)和Brier评分,参考第8次TNM分类对预测功效进行评估和比较。后果竞争风险列线图基于6个变量:大小、M分期、LODS、T分期、等级和年龄。竞争风险列线图在预测RC导致的5年死亡率方面显示出比发展队列中的第8个TNM阶段(0.81对0.76)、验证队列(0.85对0.82)和第8个阶段更高的AUC值,和测试队列(0.71对0.66)。在开发队列(0.120对0.127)、验证队列(0.123对0.128)和测试队列中(0.202对0.226),竞争风险列线图在预测RC 5年死亡率方面也显示出比第8 TNM阶段更高的Brier评分。结论。我们开发并验证了RC死亡的竞争风险列线图,该列线图可以提供避免竞争风险的生存概率,以便于临床决策。
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来源期刊
Gastroenterology Research and Practice
Gastroenterology Research and Practice GASTROENTEROLOGY & HEPATOLOGY-
CiteScore
4.40
自引率
0.00%
发文量
91
审稿时长
1 months
期刊介绍: Gastroenterology Research and Practice is a peer-reviewed, Open Access journal which publishes original research articles, review articles and clinical studies based on all areas of gastroenterology, hepatology, pancreas and biliary, and related cancers. The journal welcomes submissions on the physiology, pathophysiology, etiology, diagnosis and therapy of gastrointestinal diseases. The aim of the journal is to provide cutting edge research related to the field of gastroenterology, as well as digestive diseases and disorders. Topics of interest include: Management of pancreatic diseases Third space endoscopy Endoscopic resection Therapeutic endoscopy Therapeutic endosonography.
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