构建和验证直肠癌术前放疗患者肿瘤特异性生存的预后预测图

IF 2.1 4区 医学 Q2 SURGERY Journal of Investigative Surgery Pub Date : 2022-05-26 DOI:10.1080/08941939.2022.2078021
Yunjie Shi, Xinxing Li, Xukun Zhang, Shengyun Wang, Jun Pu, Lihua Zhang, Zhiqian Hu
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引用次数: 0

摘要

摘要背景需要一种预测工具来确定选择术前放疗的癌症(RC)直肠患者的癌症特异性生存率。方法选择一个包含2000-2004年接受手术的RC患者的监测、流行病学和最终结果(SEER)记录数据的数据库。所有患者均接受新辅助放射治疗。使用卡方检验分析临床病理参数的相关性,并使用Cox比例风险分析(单变量和多变量)分析生存风险因素。最后,根据队列的筛选变量,开发并验证了列线图,以直观地表示3年和5年癌症特异性生存(CSS)概率的准确预测。结果纳入队列的癌症患者11499例。根据相等的比例(1:1),将患者的记录随机分配到开发或验证队列中。在发育队列中结合这些变量进行多变量Cox回归分析,确定了11个独立的预后因素。使用对数秩检验记录了亚组之间的统计学显著差异,这证实了因素分层的适当性和可接受性。然后,构建列线图,评估其在发展队列(0.720)和验证队列(0.717)中的一致性指数(C指数)值高于AJCC阶段(分别为0.631和0.633)(P<0.05)。此外,在开发队列(0.746 vs.0.631)和验证队列(0.745 vs.0.640)中,该列线图的3年AUC值均高于AJCC分期。使用DCA曲线,目前开发的列线图预测潜力优于传统AJCC分期系统。结论列线图模型可作为准确预测癌症术前放疗患者预后的可靠工具。
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Constructing and Validating a Prognosis Predictive Nomogram for Cancer-Specific Survival in Rectal Cancer Patients Receiving Preoperative Radiotherapy
Abstract Background A predictive tool is required to identify the cancer-specific survival in rectal cancer (RC) patients who have opted to receive preoperative radiotherapy. Methods A database containing the data on RC patients’ records of Surveillance, Epidemiology, and End Results (SEER) receiving surgery during 2000–2014 was selected. All patients received neoadjuvant radiotherapy (NR). The correlation of clinicopathological parameters was analyzed using the Chi-square test and the survival risk factors were analyzed using the Cox proportional hazards analysis (univariate and multivariate). Finally, the nomogram was developed and validated to visually represent an accurate prediction of the probability of 3- and 5-year cancer-specific survival (CSS) based on the screened variables of the cohort. Results 11,499 rectal cancer patients were included in our cohort. Patients’ records were randomly allocated to either the development or validation cohorts based on an equal ratio (1:1). Performing the multivariate Cox regression analysis incorporating these variables in the development cohort determined 11 independent prognostic factors. Statistically significant differences were recorded among subgroups using log-rank tests, which confirmed the appropriateness and acceptability of factor stratifications. Then, the nomogram was constructed and its concordance index (C-index) values in the development cohort (0.720) and validation cohort (0.717) were evaluated to be higher (P<0.05) than those of the AJCC stage (0.631 and 0.633 respectively). Also, the 3-year AUC values of this nomogram were higher than those of the AJCC stage in both the development cohort (0.746 vs. 0.631) and the validation cohort (0.745 vs. 0.640). Using DCA curves, the predictive potential of the currently developed nomogram outperformed the conventional AJCC staging system. Conclusion The nomogram model might be a more reliable tool to predict prognosis accurately in rectal cancer patients receiving preoperative radiotherapy.
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来源期刊
CiteScore
4.20
自引率
0.00%
发文量
114
审稿时长
6-12 weeks
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.
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