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Liang GZ, Li XS, Hu ZH, Xu QJ, Wu F, Wu XL, Lei HK. Development and validation of a nomogram model for predicting overall survival in patients with gastric carcinoma. World J Gastrointest Oncol 2025; 17:95423. [PMID: 39958550 PMCID: PMC11755997 DOI: 10.4251/wjgo.v17.i2.95423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2024] [Revised: 10/01/2024] [Accepted: 11/06/2024] [Indexed: 01/18/2025] Open
Abstract
BACKGROUND The prevalence and mortality rates of gastric carcinoma are disproportionately elevated in China, with the disease's intricate and varied characteristics further amplifying its health impact. Precise forecasting of overall survival (OS) is of paramount importance for the clinical management of individuals afflicted with this malignancy. AIM To develop and validate a nomogram model that provides precise gastric cancer prevention and treatment guidance and more accurate survival outcome prediction for patients with gastric carcinoma. METHODS Data analysis was conducted on samples collected from hospitalized gastric cancer patients between 2018 and 2020. Least absolute shrinkage and selection operator, univariate, and multivariate Cox regression analyses were employed to identify independent prognostic factors. A nomogram model was developed to predict gastric cancer patient outcomes. The model's predictability and discriminative ability were evaluated via receiver operating characteristic curves. To evaluate the clinical utility of the model, Kaplan-Meier and decision curve analyses were performed. RESULTS A total of ten independent prognostic factors were identified, including body mass index, tumor-node-metastasis (TNM) stage, radiation, chemotherapy, surgery, albumin, globulin, neutrophil count, lactate dehydrogenase, and platelet-to-lymphocyte ratio. The area under the curve (AUC) values for the 1-, 3-, and 5-year survival prediction in the training set were 0.843, 0.850, and 0.821, respectively. The AUC values were 0.864, 0.820, and 0.786 for the 1-, 3-, and 5-year survival prediction in the validation set, respectively. The model exhibited strong discriminative ability, with both the time AUC and time C-index exceeding 0.75. Compared with TNM staging, the model demonstrated superior clinical utility. Ultimately, a nomogram was developed via a web-based interface. CONCLUSION This study established and validated a novel nomogram model for predicting the OS of gastric cancer patients, which demonstrated strong predictive ability. Based on these findings, this model can aid clinicians in implementing personalized interventions for patients with gastric cancer.
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Affiliation(s)
- Guan-Zhong Liang
- Chongqing Key Laboratory of Translational Research for Cancer Metastasis and Individualized Treatment, Chongqing University Cancer Hospital, Chongqing 400030, China
| | - Xiao-Sheng Li
- Chongqing Cancer Multi-omics Big Data Application Engineering Research Center, Chongqing University Cancer Hospital, Chongqing 400030, China
| | - Zu-Hai Hu
- Department of Health Statistics, School of Public Health, Chongqing Medical University, Chongqing 400016, China
| | - Qian-Jie Xu
- Department of Health Statistics, School of Public Health, Chongqing Medical University, Chongqing 400016, China
| | - Fang Wu
- Research Center for Medicine and Social Development, School of Public Health, Chongqing Medical University, Chongqing 400016, China
| | - Xiang-Lin Wu
- Chongqing Key Laboratory of Translational Research for Cancer Metastasis and Individualized Treatment, Chongqing University Cancer Hospital, Chongqing 400030, China
| | - Hai-Ke Lei
- The Research Center of Big Data, Chongqing University Cancer Hospital, Chongqing 400030, China
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Yang Y, Xu P, Zhang C. Construction of the survival nomograms for colon cancer patients of different ages based on the SEER database. J Cancer Res Clin Oncol 2023; 149:15395-15406. [PMID: 37639008 PMCID: PMC10620318 DOI: 10.1007/s00432-023-05323-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2023] [Accepted: 08/18/2023] [Indexed: 08/29/2023]
Abstract
INTRODUCTION Three nomograms for predicting the outcomes of early- and late-onset colon cancer (COCA) among patients not stratified by age were constructed using data in the Epidemiology and End Results (SEER) database (1975-2019). The accuracy of the nomogram was then assessed. METHOD Clinical data of 6107 patients with COCA were obtained from the SEER database. The patients were randomly divided into training and validation cohorts in a ratio of 7:3. Univariate and multivariate COX analyses of factors that could independently impact the prognosis of COCA were performed, and the corresponding nomograms for early-onset and late-onset COCA were constructed. Calibration curves, ROC curves, and C-index were used to determine the predictive accuracy. The discriminatory ability of the nomograms to assess their clinical utility, which was compared with the TNM staging system of the 8th edition of AJCC, was verified using survival analysis. RESULT Tumor primary site, ethnicity, and serum carcinoembryonic antigen (CEA) level significantly impacted the prognosis of colon cancer. Race, brain metastasis, and CEA were independent factors for predicting COCA prognosis. C-index, ROC, and calibration curves demonstrated that the three nomograms were accurate and superior to the traditional TNM staging system. Among the three nomograms, the early-onset COCA nomogram had the highest predictive accuracy, followed by that of colon cancer not stratified by age. CONCLUSION Three nomograms for patients not stratified by age, early-onset colon cancer, and late-onset colon cancer were constructed. The accuracies of the nomograms were good and were all superior to the conventional TNM staging system. The early- and late-onset COCA nomograms are useful for clinical management and individualized treatment of COCA patients at different ages.
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Affiliation(s)
- Yuzhou Yang
- Department of General Surgery, General Hospital of Northern Theater Command (General Hospital of Shenyang Military Command), Shenyang, Liaoning Province, China
- Jinzhou Medical University, Jinzhou, Liaoning Province, China
| | - Peng Xu
- Department of General Surgery, General Hospital of Northern Theater Command (General Hospital of Shenyang Military Command), Shenyang, Liaoning Province, China.
| | - Cheng Zhang
- Department of General Surgery, General Hospital of Northern Theater Command (General Hospital of Shenyang Military Command), Shenyang, Liaoning Province, China.
- Jinzhou Medical University, Jinzhou, Liaoning Province, China.
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Yu Y, Wang S, Liu J, Ge J, Guan H. Development and validation of a nomogram to predict long-term cancer-specific survival for patients with osteosarcoma. Sci Rep 2023; 13:10230. [PMID: 37353555 PMCID: PMC10290059 DOI: 10.1038/s41598-023-37391-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2022] [Accepted: 06/21/2023] [Indexed: 06/25/2023] Open
Abstract
The present work aimed to establish a new model to accurately estimate overall survival (OS) as well as cancer-specific survival (CSS) of osteosarcoma. Osteosarcoma cases were collected from the Surveillance, Epidemiology, and End Results (SEER) database between 2004 and 2017 and randomized as training or validation sets. Then, the OS- and CSS-related variables were discovered through multivariate Cox regression analysis to develop new nomograms to predict the 1-, 3- and 5-year OS and CSS. Besides, consistency index (C-index), decision curve analysis (DCA), along with calibration curve were adopted for assessing the predicting ability of our constructed nomograms after calibrating for 1-, 3- and 5-year OS and CSS. Altogether, 1727 osteosarcoma cases were enrolled in the present study and randomly divided as training (n = 1149, 70%) or validation (n = 576, 30%) set. As shown by univariate as well as multivariate Cox regression analyses, age, grade, T stage, M stage, surgery, chemotherapy, and histological type were identified to be the adverse factors to independently predict OS and CSS among the osteosarcoma cases. Besides, based on results of multivariate Cox regression analysis, we constructed the OS and CSS prediction nomograms. The C-index in training set was 0.806 (95% CI 0.769-0.836) for OS nomogram and 0.807 (95% CI 0.769-0.836) for CSS nomogram. In the meantime, C-index value in validation set was 0.818 (95% CI 0.789-0.847) for OS nomogram, while 0.804 (95% CI 0.773-0.835) for CSS nomogram. Besides, those calibration curves regarding the 3- and 5-year CSS of our constructed nomogram were highly consistent between the predicted values and the measurements in the training set as well as the external validation set. Our constructed nomogram outperformed the TNM stage in prediction. Our constructed nomogram is facile, creditable, and feasible; it efficiently predicts OS and CSS for osteosarcoma cases and can assist clinicians in assessing the prognosis for individuals and making decisions.
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Affiliation(s)
- Yali Yu
- Department of Clinical Laboratory, Zhengzhou Orthopaedics Hospital, Zhengzhou, 450000, Henan, China
| | - Shaohua Wang
- Department of Joint Surgery, Zhengzhou Orthopaedics Hospital, Zhengzhou, 450000, Henan, China
| | - Jia Liu
- Department of Translational Medicine Center, Zhengzhou Central Hospital Affiliated to Zhengzhou University, Zhengzhou, 450007, Henan, People's Republic of China
| | - Jiejie Ge
- Department of Clinical Laboratory, Zhengzhou Central Hospital Affiliated to Zhengzhou University, Zhengzhou, 450007, Henan, China
| | - Hongya Guan
- Department of Translational Medicine Center, Zhengzhou Central Hospital Affiliated to Zhengzhou University, Zhengzhou, 450007, Henan, People's Republic of China.
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Development and Validation of Nomograms Predicting the 5- and 8-Year Overall and Cancer-Specific Survival of Bladder Cancer Patients Based on SEER Program. J Clin Med 2023; 12:jcm12041314. [PMID: 36835849 PMCID: PMC9962885 DOI: 10.3390/jcm12041314] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Revised: 01/16/2023] [Accepted: 01/30/2023] [Indexed: 02/10/2023] Open
Abstract
BACKGROUND Bladder cancer is often prone to recurrence and metastasis. We sought to construct nomogram models to predict the overall survival (OS) and cancer-specific survival (CSS) of bladder cancer patients. METHODS A reliable random split-sample approach was used to divide patients into two groups: modeling and validation cohorts. Uni-variate and multivariate survival analyses were used to obtain the independent prognostic risk factors based on the modeling cohort. A nomogram was constructed using the R package, "rms". Harrell's concordance index (C-index), calibration curves and receiver operating characteristic (ROC) curves were applied to evaluate the discrimination, sensitivity and specificity of the nomograms using the R packages "hmisc", "rms" and "timeROC". A decision curve analysis (DCA) was used to evaluate the clinical value of the nomograms via R package "stdca.R". RESULTS 10,478 and 10,379 patients were assigned into nomogram modeling and validation cohorts, respectively (split ratio ≈ 1:1). For OS and CSS, the C-index values for internal validation were 0.738 and 0.780, respectively, and the C-index values for external validation were 0.739 and 0.784, respectively. The area under the ROC curve (AUC) values for 5- and 8-year OS and CSS were all greater than 0.7. The calibration curves show that the predicted probability values of 5- and 8-year OS and CSS are close to the actual OS and CSS. The decision curve analysis revealed that the two nomograms have a positive clinical benefit. CONCLUSION We successfully constructed two nomograms to forecast OS and CSS for bladder cancer patients. This information can help clinicians conduct prognostic evaluations in an individualized manner and tailor personalized treatment plans.
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Lopes C, Chaves J, Ortigão R, Dinis‐Ribeiro M, Pereira C. Gastric cancer detection by non-blood-based liquid biopsies: A systematic review looking into the last decade of research. United European Gastroenterol J 2022; 11:114-130. [PMID: 36461757 PMCID: PMC9892482 DOI: 10.1002/ueg2.12328] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Accepted: 09/21/2022] [Indexed: 12/04/2022] Open
Abstract
Gastric cancer (GC) screening is arguable in most Western countries. Liquid biopsies are a great promise to answer the unmet need for less invasive diagnostic biomarkers in GC. Thus, we aimed at systematically reviewing the current knowledge on liquid biopsy-based biomarkers in GC screening. A systematic search on PubMed/MEDLINE and Scopus databases was performed on published articles reporting the use of non-blood specimen (saliva, gastric juice [GJ], urine and stool) on GC diagnosis. 3208 records were retrieved by June 2022. After removal of duplicate records, 2379 abstracts were screened, and 84 full texts included in this systematic review. More than 90% of studies were reported on Asian populations. Overall, 9 studies explored stool-, 12 saliva-, and 29 urine-derived biomarkers for GC detection. Additionally, 37 studies, representing the majority, analyzed GJ, focusing on nucleic acid molecules. Several miRNAs and lncRNA molecules have been associated with GC risk, particularly miR-21 (area under the curve [AUC] = 0.97, 95% CI: 0.94-1.00). Considering salivary biomarkers, the best described model in validation sets included the soybean agglutinin and Vicia villosa agglutinin lectins (AUC = 0.89, 95% CI: 0.80-0.99). Most studies in urine carried out metabolomic approaches, with two discriminatory models presenting AUC values superior to 0.97. This systematic review emphasizes the potential role of non-blood-based biomarkers, although further validation, particularly in Western countries, is mandatory, namely for non-invasive screening and/or monitoring, as well as the use of GJ as a tool to enhance upper gastrointestinal endoscopy accuracy.
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Affiliation(s)
- Catarina Lopes
- Precancerous Lesions and Early Cancer Management GroupResearch Center of IPO Porto (CI‐IPOP)/Rise@CI‐IPOP (Health Research Group)Portuguese Institute of Oncology of Porto (IPO Porto)/Porto Comprehensive Cancer Center (Porto.CCC)PortoPortugal,CINTESIS – Center for Health Technology and Services ResearchUniversity of PortoPortoPortugal,ICBAS‐UP – Institute of Biomedical Sciences Abel SalazarUniversity of PortoPortoPortugal
| | - Jéssica Chaves
- Precancerous Lesions and Early Cancer Management GroupResearch Center of IPO Porto (CI‐IPOP)/Rise@CI‐IPOP (Health Research Group)Portuguese Institute of Oncology of Porto (IPO Porto)/Porto Comprehensive Cancer Center (Porto.CCC)PortoPortugal,Department of GastroenterologyPortuguese Oncology Institute of PortoPortoPortugal
| | - Raquel Ortigão
- Precancerous Lesions and Early Cancer Management GroupResearch Center of IPO Porto (CI‐IPOP)/Rise@CI‐IPOP (Health Research Group)Portuguese Institute of Oncology of Porto (IPO Porto)/Porto Comprehensive Cancer Center (Porto.CCC)PortoPortugal,Department of GastroenterologyPortuguese Oncology Institute of PortoPortoPortugal
| | - Mário Dinis‐Ribeiro
- Precancerous Lesions and Early Cancer Management GroupResearch Center of IPO Porto (CI‐IPOP)/Rise@CI‐IPOP (Health Research Group)Portuguese Institute of Oncology of Porto (IPO Porto)/Porto Comprehensive Cancer Center (Porto.CCC)PortoPortugal,Department of GastroenterologyPortuguese Oncology Institute of PortoPortoPortugal
| | - Carina Pereira
- Precancerous Lesions and Early Cancer Management GroupResearch Center of IPO Porto (CI‐IPOP)/Rise@CI‐IPOP (Health Research Group)Portuguese Institute of Oncology of Porto (IPO Porto)/Porto Comprehensive Cancer Center (Porto.CCC)PortoPortugal,CINTESIS – Center for Health Technology and Services ResearchUniversity of PortoPortoPortugal
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Zhong J, Liao X, Peng S, Cao J, Liu Y, Liu C, Qiu J, Guan X, Zhang Y, Liu X, Peng S. A Visualized Dynamic Prediction Model for Overall Survival in Elderly Patients With Pancreatic Cancer for Smart Medical Services. Front Public Health 2022; 10:885624. [PMID: 35685764 PMCID: PMC9171143 DOI: 10.3389/fpubh.2022.885624] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Accepted: 04/06/2022] [Indexed: 11/13/2022] Open
Abstract
Background Pancreatic cancer (PC) is a highly malignant tumor of the digestive system. The number of elderly patients with PC is increasing, and older age is related to a worse prognosis. Accurate prognostication is crucial in treatment decisions made for people diagnosed with PC. However, an accurate predictive model for the prognosis of these patients is still lacking. We aimed to construct nomograms for predicting the overall survival (OS) of elderly patients with PC. Methods Patients with PC, older than 65 years old from 2010 to 2015 in the Surveillance, Epidemiology, and End Results database, were selected and randomly divided into training cohort (n = 4,586) and validation cohort (n = 1,966). Data of patients in 2016-2018 (n = 1,761) were used for external validation. Univariable and forward stepwise multivariable Cox analysis was used to determine the independent prognostic factors. We used significant variables in the training set to construct nomograms predicting prognosis. The performance of the models was evaluated for their discrimination and calibration power based on the concordance index (C-index), calibration curve, and the decision curve analysis (DCA). Results Age, insurance, grade, surgery, radiation, chemotherapy, T, N, and American Joint Commission on Cancer were independent predictors for OS and thus were included in our nomogram. In the training cohort and validation cohort, the C-indices of our nomogram were 0.725 (95%CI: 0.715-0.735) and 0.711 (95%CI: 0.695-0.727), respectively. The 1-, 3-, and 5-year areas under receiver operating characteristic curves showed similar results. The calibration curves showed a high consensus between observations and predictions. In the external validation cohort, C-index (0.797, 95%CI: 0.778-0.816) and calibration curves also revealed high consistency between observations and predictions. The nomogram-related DCA curves showed better clinical utility compared to tumor-node-metastasis staging. In addition, we have developed an online prediction tool for OS. Conclusions A web-based prediction model for OS in elderly patients with PC was constructed and validated, which may be useful for prognostic assessment, treatment strategy selection, and follow-up management of these patients.
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Affiliation(s)
- Jiang Zhong
- College of Computer Science, Chongqing University, Chongqing, China
| | - XingShu Liao
- College of Computer Science, Chongqing University, Chongqing, China
| | - Shuang Peng
- General Affairs Section, The People's Hospital of Tongnan District, Chongqing, China
| | - Junyi Cao
- Department of Medical Quality Control, First People's Hospital of Zigong City, Zigong, China
| | - Yue Liu
- Department of Pediatrics, First People's Hospital of Zigong City, Zigong, China
| | - Chunyang Liu
- Scientific Research Department, First People's Hospital of Zigong City, Zigong, China
| | - Ju Qiu
- Scientific Research Department, First People's Hospital of Zigong City, Zigong, China
| | - Xiaoyan Guan
- Department of Pediatrics, First People's Hospital of Zigong City, Zigong, China
| | - Yang Zhang
- College of Medical Information, Chongqing Medical University, Chongqing, China
| | - Xiaozhu Liu
- Department of Cardiology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Shengxian Peng
- Scientific Research Department, First People's Hospital of Zigong City, Zigong, China
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Cheng M, Zhan X, Xu Y, Wang S, Zhang H, Fang L, Jin H, Chen W. DNA methylation of RNA-binding protein for multiple splicing 2 functions as diagnosis biomarker in gastric cancer pathogenesis and its potential clinical significance. Bioengineered 2022; 13:4347-4360. [PMID: 35137653 PMCID: PMC8973754 DOI: 10.1080/21655979.2022.2032965] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Higher methylation levels of RNA-binding protein for multiple splicing 2 (RBPMS2) was reported to be related with unfavorable outcome in gastric cancer (GC). However, molecular function and diagnostic significance of DNA methylation of RBPMS2 remains indistinct. Here we aimed to whether DNA methylation of RBPMS2 acts as a diagnosis biomarker in GC pathogenesis and its potential clinical significance. Western blot and immunochemistry assays were carried out to explore the level of RBPMS2. GC malignancy behaviors were determined by cell counting kit-8, Transwell, flow cytometry analysis and terminal-deoxynucleoitidyl transferase mediated nick end labeling staining. The inflammatory cell infiltration in xenograft model was observed by hematoxylin and eosin staining. CpG Islands was predicted by MethPrimer and the DNA methylation of RBPMS2 was evaluated by methylation-specific polymerase chain reaction. The results showed that RBPMS2 was downregulated in GC specimens. Poor survival rates were associated with low RBPMS2 expression. Overexpression of RBPMS2 inhibited GC growth while facilitated apoptosis in GC cells. In addition, level of DNA methylation of RBPMS2 in GC tissues was increased and DNA methylation of RBPMS2 was strongly associated with tumor invasion, Borrmann classification and TNM stage. We also observed that DNA methylation inhibitors counteracted the role of RBPMS2 in restraining GC development and tumorigenesis. To sum, our data demonstrated that DNA methylation of RBPMS2 was responsible for its downregulation in GC and promoted tumor progression, indicating DNA methylation of RBPMS2 might serve as a valuable potential parameter in GC pathogenesis.
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Affiliation(s)
- Ming Cheng
- Department of Gastroenterology, Zhejiang Jinhua Guangfu Tumor Hospital, Jinhua, Zhejiang, China
| | - Xiaoan Zhan
- Department of Gastrointestinal Surgery, Zhejiang Jinhua Guangfu Tumor Hospital, Jinhua, Zhejiang, China
| | - Yi Xu
- Department of Gastroenterology, Zhejiang Jinhua Guangfu Tumor Hospital, Jinhua, Zhejiang, China
| | - Saishan Wang
- Department of Gastroenterology, Zhejiang Jinhua Guangfu Tumor Hospital, Jinhua, Zhejiang, China
| | - Hongcheng Zhang
- Department of Gastroenterology, Zhejiang Jinhua Guangfu Tumor Hospital, Jinhua, Zhejiang, China
| | - Limin Fang
- Department of Gastroenterology, Zhejiang Jinhua Guangfu Tumor Hospital, Jinhua, Zhejiang, China
| | - Hao Jin
- Department of Gastroenterology, Zhejiang Jinhua Guangfu Tumor Hospital, Jinhua, Zhejiang, China
| | - Wei Chen
- Department of Cardiology, Jinhua Fifth Hospital, Jinhua, Zhejiang, China
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Capelli G, Tonello AS, Chiminazzo V, Lorenzoni G, Bao QR, Marchet A, Gregori D, Pawlik TM, Pucciarelli S, Spolverato G. Validation of a Nomogram to Predict Long Term Outcomes After Curative Surgery for Gastric Cancer in an Italian Cohort of Patients. J Visc Surg 2021; 159:471-479. [PMID: 34794901 DOI: 10.1016/j.jviscsurg.2021.09.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
AIM OF THE STUDY Nomograms have been proposed to assess prognosis following curative surgery for gastric cancer. The objective of the current study was to evaluate the performance of the Gastric Cancer Collaborative Group nomograms developed in 2014 by Kim et al., using a cohort of patients from a 10-year single institution experience in gastric cancer management. PATIENTS AND METHODS We retrospectively reviewed patients who underwent curative-intent surgery for histologically confirmed gastric cancer at First Surgical Clinic of Padua University Hospital (Italy) from January 2010 to May 2020. Univariable and multivariable Cox proportional hazard models were employed to assess the effect of the variables of interest on mortality and recurrence. Multivariable analysis was performed by considering the variables included in the Gastric Cancer Collaborative Group nomograms in order to validate them. The performance of the nomograms was evaluated using Harrell's C-index and calibration plots. RESULTS Overall, 168 patients were included, with a median follow-up of 20.1 months. On multivariable analysis, tumor location, lymph node ratio, and pathological T stage were associated with recurrence; age, tumor location, lymph node ratio, and pT stage were associated with OS (overall survival). The nomograms had good discriminatory capability to classify both OS (C-index: 0.75) and DFS (disease-free survival) (C-index 0.72). The corrected C-Index for DFS based on the AJCC staging system revealed better prediction (C-Index 0.75), while the corrected C-Index for OS had worse discrimination ability compared with the current nomogram (C-Index 0.72). CONCLUSIONS The Gastric Cancer Collaborative Group nomograms demonstrated good performances in terms of prediction of both OS and DFS on external validation. The two nomograms are easy to apply, and variables included are widely available to most facilities.
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Affiliation(s)
- G Capelli
- Department of Surgical, Oncological and Gastroenterological Sciences (DiSCOG), First Surgical Clinic, University of Padua, Padua, Italy
| | - A S Tonello
- Department of Surgical, Oncological and Gastroenterological Sciences (DiSCOG), First Surgical Clinic, University of Padua, Padua, Italy
| | - V Chiminazzo
- Unit of Biostatistics, Epidemiology, and Public Health, Department of Cardiac, Thoracic, and Vascular Sciences, University of Padua, Padua, Italy
| | - G Lorenzoni
- Unit of Biostatistics, Epidemiology, and Public Health, Department of Cardiac, Thoracic, and Vascular Sciences, University of Padua, Padua, Italy
| | - Q R Bao
- Department of Surgical, Oncological and Gastroenterological Sciences (DiSCOG), First Surgical Clinic, University of Padua, Padua, Italy
| | - A Marchet
- Department of Surgical, Oncological and Gastroenterological Sciences (DiSCOG), First Surgical Clinic, University of Padua, Padua, Italy
| | - D Gregori
- Unit of Biostatistics, Epidemiology, and Public Health, Department of Cardiac, Thoracic, and Vascular Sciences, University of Padua, Padua, Italy
| | - T M Pawlik
- Department of Surgical Oncology, The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - S Pucciarelli
- Department of Surgical, Oncological and Gastroenterological Sciences (DiSCOG), First Surgical Clinic, University of Padua, Padua, Italy
| | - G Spolverato
- Department of Surgical, Oncological and Gastroenterological Sciences (DiSCOG), First Surgical Clinic, University of Padua, Padua, Italy.
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Xu Y, Luo L, Feng X, Zheng Y, Chen T, Zhou R, Li Y, Li G, Wang W, Xiong W. Nomogram for Predicting Risk of Esophagogastric Junction (EGJ) Resection During Laparoscopic Resection of Gastrointestinal Stromal Tumors in EGJ: A Retrospective Multicenter Study. Front Surg 2021; 8:712984. [PMID: 34708070 PMCID: PMC8544638 DOI: 10.3389/fsurg.2021.712984] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Accepted: 09/06/2021] [Indexed: 11/13/2022] Open
Abstract
Background: The established criteria for determining whether to excise the cardia during laparoscopic surgery for gastrointestinal stromal tumors in the esophagogastric junction (EGJ-GISTs) remain controversial. This retrospective multicenter study was conducted to develop a nomogram for predicting the risk of the cardia excision during laparoscopic surgery for EGJ-GISTs. Material and Methods: We reviewed data from 2,127 gastric-GISTs (g-GISTs) patients without distant metastases in four hospital between June 2012 and June 2020. Of those, according to the including criteria, 184 patients [Guangdong Provincial Hospital of Chinese Medicine (n = 81), Nanfang Hospital of Southern Medical University (n = 60), Guangdong General Hospital (n = 34), and The Third Affiliated Hospital of Southern Medical University (n = 9)] with EGJ-GISTs were identified and included in this study. Factors contributing to risk of cardia excision were identified and used to create a nomogram. Nomogram performance was assessed using a bootstrapped concordance index (c-index) and calibration plots. Results: According to the multivariate analysis, the distance from the margin of the tumor to the esophagogastric line (EG-line) (cm) (OR = 0.001, 95% CI: 0.00001~0.056, P = 0.001) and tumor size (cm) (OR = 14.969, 95% CI: 1.876~119.410, P = 0.011) were significantly related to likelihood of cardia structure excision in laparoscopic surgery for EGJ-GISTs. These two factors were used to generate a nomogram for predicting risk of cardia excision using a logistic regression model; a bootstrapped C-index of 0.988 (calibrated C-index = 0.987) indicated strong predictive ability, with broad calibration. Conclusions: This nomogram based on distance from tumor margin to EG-line and tumor size may serve as a tool for predicting risk of cardia damage during laparoscopic removal of EGJ-GISTs to aid in selection of surgical methods and preoperative neoadjuvant therapy.
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Affiliation(s)
- Yuting Xu
- The Affiliated Zhongshan Hospital of Guangzhou University of Chinese Medicine, Zhongshan, China
| | - Lijie Luo
- Guangdong Provincial Hospital of Chinese Medicine, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Xingyu Feng
- Guangdong General Hospital, Guangdong Academy of Medical Science, Guangzhou, China
| | - Yensheng Zheng
- Guangdong Provincial Hospital of Chinese Medicine, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Tao Chen
- Department of General Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Rui Zhou
- The Third Affiliated Hospital of Southern Medical University, Guangzhou, China
| | - Yong Li
- Guangdong General Hospital, Guangdong Academy of Medical Science, Guangzhou, China
| | - Guoxin Li
- Department of General Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Wei Wang
- Guangdong Provincial Hospital of Chinese Medicine, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Wenjun Xiong
- Guangdong Provincial Hospital of Chinese Medicine, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
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Spolverato G, Capelli G, Lorenzoni G, Gregori D, Squires MH, Poultsides GA, Fields RC, Bloomston MP, Weber SM, Votanopoulos KI, Acher AW, Jin LX, Hawkins WG, Schmidt CR, Kooby DA, Worhunsky DJ, Saunders ND, Levine EA, Cho CS, Maithel SK, Pucciarelli S, Pawlik TM. Development of a Prognostic Nomogram and Nomogram Software Application Tool to Predict Overall Survival and Disease-Free Survival After Curative-Intent Gastrectomy for Gastric Cancer. Ann Surg Oncol 2021; 29:1220-1229. [PMID: 34523000 DOI: 10.1245/s10434-021-10768-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Accepted: 08/21/2021] [Indexed: 11/18/2022]
Abstract
BACKGROUND We sought to derive and validate a prediction model of survival and recurrence among Western patients undergoing resection of gastric cancer. METHODS Patients who underwent curative-intent surgery for gastric cancer at seven US institutions and a major Italian center from 2000 to 2020 were included. Variables included in the multivariable Cox models were identified using an automated model selection procedure based on an algorithm. Best models were selected using the Bayesian information criterion (BIC). The performance of the models was internally cross-validated via the bootstrap resampling procedure. Discrimination was evaluated using the Harrell's Concordance Index and accuracy was evaluated using calibration plots. Nomograms were made available as online tools. RESULTS Overall, 895 patients met inclusion criteria. Age (hazard ratio [HR] 1.47, 95% confidence interval [CI] 1.17-1.84), presence of preoperative comorbidities (HR 1.66, 95% CI 1.14-2.41), lymph node ratio (LNR; HR 1.72, 95% CI 1.42-2.01), and lymphovascular invasion (HR 1.81, 95% CI 1.33-2.45) were associated with overall survival (OS; all p < 0.01), whereas tumor location (HR 1.93, 95% CI 1.23-3.02), T category (Tis-T1 vs. T3: HR 0.31, 95% CI 0.14-0.66), LNR (HR 1.82, 95% CI 1.45-2.28), and lymphovascular invasion (HR 1.49; 95% CI 1.01-2.22) were associated with disease-free survival (DFS; all p < 0.05) The models demonstrated good discrimination on internal validation relative to OS (C-index 0.70) and DFS (C-index 0.74). CONCLUSIONS A web-based nomograms to predict OS and DFS among gastric cancer patients following resection demonstrated good accuracy and discrimination and good performance on internal validation.
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Affiliation(s)
- Gaya Spolverato
- First Surgical Clinic, Department of Surgical, Oncological and Gastroenterological Sciences (DiSCOG), University of Padua, Padua, Italy
| | - Giulia Capelli
- First Surgical Clinic, Department of Surgical, Oncological and Gastroenterological Sciences (DiSCOG), University of Padua, Padua, Italy
| | - Giulia Lorenzoni
- Unit of Biostatistics, Epidemiology, and Public Health, Department of Cardiac, Vascular Sciences and Public Health, University of Padua, ThoracicPadua, Italy
| | - Dario Gregori
- Unit of Biostatistics, Epidemiology, and Public Health, Department of Cardiac, Vascular Sciences and Public Health, University of Padua, ThoracicPadua, Italy
| | - Malcolm H Squires
- Division of Surgical Oncology, Department of Surgery, Levine Cancer Institute, Atrium Health, Charlotte, NC, USA
| | | | - Ryan C Fields
- Department of Surgery, Washington University School of Medicine, Saint Louis, MO, USA
| | - Mark P Bloomston
- Department of Surgery, The Ohio State University, Columbus, OH, USA
| | - Sharon M Weber
- Division of Surgical Oncology, Department of Surgery, University of Wisconsin, Madison, WI, USA
| | | | - Alexandra W Acher
- Division of Surgical Oncology, Department of Surgery, University of Wisconsin, Madison, WI, USA
| | - Linda X Jin
- Department of Surgery, Washington University School of Medicine, Saint Louis, MO, USA
| | - William G Hawkins
- Department of Surgery, Washington University School of Medicine, Saint Louis, MO, USA
| | - Carl R Schmidt
- Department of Surgery, West Virginia University, Morgantown, WV, USA
| | - David A Kooby
- Department of Surgery, Emory University School of Medicine, Atlanta, GA, USA
| | | | - Neil D Saunders
- Department of Surgery, Emory University School of Medicine, Atlanta, GA, USA
| | - Edward A Levine
- Department of Surgery, Wake Forest University, Winston-Salem, NC, USA
| | - Clifford S Cho
- Department of Surgery, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Shishir K Maithel
- Department of Surgery, Emory University School of Medicine, Atlanta, GA, USA
| | - Salvatore Pucciarelli
- First Surgical Clinic, Department of Surgical, Oncological and Gastroenterological Sciences (DiSCOG), University of Padua, Padua, Italy
| | - Timothy M Pawlik
- Department of Surgery, The Ohio State University, Columbus, OH, USA.
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11
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Saenthaveesuk P, Yang L, Zeng B, Xu M, Young S, Liao G, Liang Y. Development and validation of multiparametric MRI-based nomogram for predicting occult metastasis risk in early tongue squamous cell carcinoma. BMC Cancer 2021; 21:408. [PMID: 33858377 PMCID: PMC8048044 DOI: 10.1186/s12885-021-08135-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2020] [Accepted: 11/11/2020] [Indexed: 12/21/2022] Open
Abstract
Background Nomograms are currently used in predicting individualized outcomes in clinical oncology of several cancers. However, nomograms for evaluating occult nodal metastasis of patients with squamous cell carcinoma of lateral tongue (SCCLT) have not been widely investigated for their functionality. This retrospective cohort study was designed to address this question. Methods This study was divided into primary and validation cohorts. The primary cohort comprised 120 patients diagnosed between 2012 and 2017, whereas the validation cohort included 41 patients diagnosed thereafter. The diagnostic value of multiparametric MRI, including radiologic tumor thickness threshold (rTTT) in three-dimensions, paralingual distance, and sublingual distance were investigated. A nomogram was developed based on stepwise logistic regression of potential predictors associated with nodal metastasis in the primary cohort and then tested for predictive accuracy in the validation cohort using area under the curve (AUC) and goodness-of-fit tests. Results Multivariate analysis, tumor size (odd ratio [OR] 15.175, 95% confidence interval [CI] 1.436–160.329, P = 0.024), rTTT (OR 11.528, 95% CI 2.483–53.530, P = 0.002), paralingual distance (OR 11.976, 95% CI 1.981–72.413, P = 0.005), and tumor location (OR 6.311, 95% CI 1.514–26.304, P = 0.011) were included in the nomogram to predict the likelihood of having cervical metastasis. A nomogram cutoff value of 210 points (sensitivity 93.8%, specificity 87.5%) was significantly different to classify the patients metastasis risk group (P < 0.001). Nomogram showed predictive accuracy with AUC 0.881 (95% CI 0.779–0.983, P < 0.001) and good calibration after the validation. Conclusions A preoperative nomogram incorporating multiparametric MRI demonstrated good prediction and performed adequately in our study. Three-dimensional assessment of occult metastasis risk value obtained from this nomogram can assist in preoperative decision making for individual patients with early-stage SCCLT. The probability of nodal metastasis tended to be greater than 20% in patients with high metastasis risk or nomogram total score > 210 points.
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Affiliation(s)
- Pensiri Saenthaveesuk
- Department of Oral and Maxillofacial Surgery, Guanghua School of Stomatology, Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University, 56 West Lingyuan Road, Guangzhou, 510055, Guangdong, China.,Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Khon Kaen University, Khon Kaen, Thailand
| | - Le Yang
- Department of Oral and Maxillofacial Surgery, Guanghua School of Stomatology, Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University, 56 West Lingyuan Road, Guangzhou, 510055, Guangdong, China
| | - Bin Zeng
- Department of Oral and Maxillofacial Surgery, Guanghua School of Stomatology, Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University, 56 West Lingyuan Road, Guangzhou, 510055, Guangdong, China
| | - Meng Xu
- Department of Oral Pathology, Guanghua School of Stomatology, Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Simon Young
- Department of Oral and Maxillofacial Surgery, The University of Texas Health Science Center at Houston, School of Dentistry, Houston, TX, USA
| | - Guiqing Liao
- Department of Oral and Maxillofacial Surgery, Guanghua School of Stomatology, Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University, 56 West Lingyuan Road, Guangzhou, 510055, Guangdong, China
| | - Yujie Liang
- Department of Oral and Maxillofacial Surgery, Guanghua School of Stomatology, Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University, 56 West Lingyuan Road, Guangzhou, 510055, Guangdong, China.
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12
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Shin HJ, Choi YO, Roh CK, Son SY, Hur H, Han SU. Prediction of Survival Outcomes Based on Preoperative Clinical Parameters in Gastric Cancer. Ann Surg Oncol 2021; 28:7027-7037. [PMID: 33825079 DOI: 10.1245/s10434-021-09754-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Accepted: 02/05/2021] [Indexed: 12/24/2022]
Abstract
BACKGROUND Few current preoperative risk assessment tools provide essential, optimized treatment for gastric cancer. The purpose of this study was to develop and validate a nomogram that uses preoperative data to predict survival and risk assessments. METHODS A survival prediction model was constructed using data from a developmental cohort of 1251 patients with stage I to III gastric cancer who underwent curative resection between January 2005 and December 2008 at Ajou University Hospital, Korea. The model was internally validated for discrimination and calibrated using bootstrap resampling. To externally validate the model, data from a validation cohort of 2012 patients with stage I to III gastric cancer who underwent surgery at multiple centers in Korea between January 2001 and June 2006 were analyzed. Analyses included the model's discrimination index (C-index), calibration plots, and decision curve that predict overall survival. RESULTS Eight independent predictors, including age, sex, clinical tumor size, macroscopic features, body mass index, histology, clinical stages, and tumor location, were considered for developing the nomogram. The discrimination index was 0.816 (adjusted C-index) in the developmental cohort and 0.781 (adjusted C-index) in the external validation cohort. Additionally, in both the developmental and validation datasets, age and tumor size were significantly correlated with each other and were independent indicators for survival (P < 0.05). CONCLUSIONS We developed a new nomogram by using the most common and significant preoperative parameters that can help to identify high-risk patients before treatment and help clinicians to make appropriate decisions for patients with stage I to III gastric cancer.
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Affiliation(s)
- Ho-Jung Shin
- Department of Surgery, Ajou University School of Medicine, Suwon, Korea.,Division of Acute and Critical care Surgery, Ajou University School of Medicine, Suwon, Korea
| | - Yong-Ok Choi
- School of Economics, Chung-Ang University, Seoul, Korea
| | - Chul-Kyu Roh
- Department of Surgery, Ajou University School of Medicine, Suwon, Korea.,Gastric Cancer Center, Ajou University School of Medicine, Suwon, Korea
| | - Sang-Yong Son
- Department of Surgery, Ajou University School of Medicine, Suwon, Korea.,Gastric Cancer Center, Ajou University School of Medicine, Suwon, Korea
| | - Hoon Hur
- Department of Surgery, Ajou University School of Medicine, Suwon, Korea.,Gastric Cancer Center, Ajou University School of Medicine, Suwon, Korea
| | - Sang-Uk Han
- Department of Surgery, Ajou University School of Medicine, Suwon, Korea. .,Gastric Cancer Center, Ajou University School of Medicine, Suwon, Korea.
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13
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Alabi RO, Mäkitie AA, Pirinen M, Elmusrati M, Leivo I, Almangush A. Comparison of nomogram with machine learning techniques for prediction of overall survival in patients with tongue cancer. Int J Med Inform 2020; 145:104313. [PMID: 33142259 DOI: 10.1016/j.ijmedinf.2020.104313] [Citation(s) in RCA: 41] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Revised: 10/04/2020] [Accepted: 10/20/2020] [Indexed: 01/15/2023]
Abstract
BACKGROUND The prediction of overall survival in tongue cancer is important for planning of personalized care and patient counselling. OBJECTIVES This study compares the performance of a nomogram with a machine learning model to predict overall survival in tongue cancer. The nomogram and machine learning model were built using a large data set from the Surveillance, Epidemiology, and End Results (SEER) program database. The comparison is necessary to provide the clinicians with a comprehensive, practical, and most accurate assistive system to predict overall survival of this patient population. METHODS The data set used included the records of 7596 tongue cancer patients. The considered machine learning algorithms were logistic regression, support vector machine, Bayes point machine, boosted decision tree, decision forest, and decision jungle. These algorithms were mainly evaluated in terms of the areas under the receiver-operating characteristic (ROC) curve (AUC) and accuracy values. The performance of the algorithm that produced the best result was compared with a nomogram to predict overall survival in tongue cancer patients. RESULTS The boosted decision-tree algorithm outperformed other algorithms. When compared with a nomogram using external validation data, the boosted decision tree produced an accuracy of 88.7% while the nomogram showed an accuracy of 60.4%. In addition, it was found that age of patient, T stage, radiotherapy, and the surgical resection were the most prominent features with significant influence on the machine learning model's performance to predict overall survival. CONCLUSION The machine learning model provides more personalized and reliable prognostic information of tongue cancer than the nomogram. However, the level of transparency offered by the nomogram in estimating patients' outcomes seems more confident and strengthened the principle of shared decision making between the patient and clinician. Therefore, a combination of a nomogram - machine learning (NomoML) predictive model may help to improve care, provides information to patients, and facilitates the clinicians in making tongue cancer management-related decisions.
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Affiliation(s)
- Rasheed Omobolaji Alabi
- Department of Industrial Digitalization, School of Technology and Innovations, University of Vaasa, Vaasa, Finland.
| | - Antti A Mäkitie
- Research Program in Systems Oncology, Faculty of Medicine, University of Helsinki, Helsinki, Finland; Department of Otorhinolaryngology - Head and Neck Surgery, University of Helsinki and Helsinki University Hospital, Helsinki, Finland; Division of Ear, Nose and Throat Diseases, Department of Clinical Sciences, Intervention and Technology, Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden
| | - Matti Pirinen
- Institute for Molecular Medicine Finland (FIMM), University of Helsinki, Helsinki, Finland; Department of Public Health, University of Helsinki, Helsinki, Finland; Department of Mathematics and Statistics, University of Helsinki, Helsinki, Finland
| | - Mohammed Elmusrati
- Department of Industrial Digitalization, School of Technology and Innovations, University of Vaasa, Vaasa, Finland
| | - Ilmo Leivo
- University of Turku, Institute of Biomedicine, Pathology, Turku, Finland
| | - Alhadi Almangush
- Research Program in Systems Oncology, Faculty of Medicine, University of Helsinki, Helsinki, Finland; University of Turku, Institute of Biomedicine, Pathology, Turku, Finland; Department of Pathology, University of Helsinki, Helsinki, Finland; Faculty of Dentistry, University of Misurata, Misurata, Libya
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14
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Cao J, Chen J, Zhang Q, Wu J, Wang W, Zhang X, Zhao D, Zhang Q, Yang W, Chen Z. Ethnic disparities in demographic, clinicopathologic and biological behaviours and prognosis of gastric cancer in northwest China. Cancer Med 2020; 9:9353-9364. [PMID: 33084161 PMCID: PMC7774720 DOI: 10.1002/cam4.3551] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2020] [Revised: 09/11/2020] [Accepted: 10/01/2020] [Indexed: 12/24/2022] Open
Abstract
This retrospective study aimed to investigate ethnic disparities in demographic, clinicopathologic, and biological behaviours of gastric cancer (GC) in a high GC incidence area of China. There were 5022 GC patients, including 3987 Han (79.4%) and 987 Hui (14.4%) patients from Northwest China. All patient data were retrieved from 2009 to 2017. Median survival was estimated using the Kaplan‐Meier method and compared using the log‐rank test. A Cox proportional hazards model was used to assess the impact of covariates. Similarly, low 5‐year OS rates were observed in both the Hui and Han groups (23.8% and 24.2% respectively). Hui patients with stage T1 or N0 or with tumours <5 cm had 2.144‐fold, 1.426‐fold and 1.305‐fold increased risks of poor prognosis compared with Han patients with these characteristics respectively (all p < 0.05). Further, Hui patients had 1.265‐fold, 1.364‐fold and 1.401‐fold increased risks of poor prognosis compared with Han patients among those with high expression of Ki67, EGFR and VEGF respectively (all p < 0.05). There are ethnic disparities in the prognosis of GC patients in Northwest China. Understanding the effects of ethnicity on GC will guide reasonable evaluations of prognosis and future interventions to equalise access to high‐quality care for GC patients of different ethnicities in China.
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Affiliation(s)
- Juan Cao
- Medical Research Center, Union Shenzhen Hospital, Huazhong University of Science and Technology, Shenzhen, China.,Key Laboratory of Fertility Preservation and Maintenance (Ministry of Education), Ningxia Medical University, Yinchuan, China
| | - Jing Chen
- Key Laboratory of Fertility Preservation and Maintenance (Ministry of Education), Ningxia Medical University, Yinchuan, China
| | - Qinghua Zhang
- Department of Neurosurgery, Union Shenzhen Hospital, Huazhong University of Science and Technology, Shenzhen, China
| | - Jing Wu
- Key Laboratory of Fertility Preservation and Maintenance (Ministry of Education), Ningxia Medical University, Yinchuan, China
| | - Wenfan Wang
- Department of Gastroenterology, the General Hospital, Ningxia Medical University, Yinchuan, China
| | - Xiaoxu Zhang
- Department of Gastroenterology, the General Hospital, Ningxia Medical University, Yinchuan, China
| | - Dan Zhao
- Department of Gastroenterology, the General Hospital, Ningxia Medical University, Yinchuan, China
| | - Qian Zhang
- Key Laboratory of Fertility Preservation and Maintenance (Ministry of Education), Ningxia Medical University, Yinchuan, China
| | - Wenjun Yang
- Medical Research Center, Union Shenzhen Hospital, Huazhong University of Science and Technology, Shenzhen, China.,Key Laboratory of Fertility Preservation and Maintenance (Ministry of Education), Ningxia Medical University, Yinchuan, China
| | - Zhiqiang Chen
- Department of Radiology, the General Hospital, Ningxia Medical University, Yinchuan, China
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15
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Wang F, Wen J, Yang X, Jia T, Du F, Wei J. Applying nomograms based on the surveillance, epidemiology and end results database to predict long-term overall survival and cancer-specific survival in patients with oropharyngeal squamous cell carcinomas: A case-control research. Medicine (Baltimore) 2020; 99:e20703. [PMID: 32791664 PMCID: PMC7386992 DOI: 10.1097/md.0000000000020703] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Few models regarding to the individualized prognosis assessment of oropharyngeal squamous cell carcinoma (OPSCC) patients were documented. The purpose of this study was to establish nomogram model to predict the long-term overall survival (OS) and cancer-specific survival (CSS) of OPSCC patients. The detailed clinical data for the 10,980 OPSCC patients were collected from the surveillance, epidemiology and end results (SEER) database. Furthermore, we applied a popular and reasonable random split-sample method to divide the total 10,980 patients into 2 groups, including 9881 (90%) patients in the modeling cohort and 1099 (10%) patients in the external validation cohort. Among the modeling cohort, 3084 (31.2%) patients were deceased at the last follow-up date. Of those patients, 2188 (22.1%) patients died due to OPSCC. In addition, 896 (9.1%) patients died due to other causes. The median follow-up period was 45 months (1-119 months). We developed 2 nomograms to predict 5- and 8- year OS and CSS using Cox Proportional Hazards model. The nomograms' accuracy was evaluated through the concordance index (C-index) and calibration curves by internal and external validation. The C-indexes of internal validation on the 5- and 8-year OS and CSS were 0.742 and 0.765, respectively. Moreover, the C-indexes of external validation were 0.740 and 0.759, accordingly. Based on a retrospective cohort from the SEER database, we succeeded in constructing 2 nomograms to predict long-term OS and CSS for OPSCC patients, which provides reference for surgeons to develop a treatment plan and individual prognostic evaluations.
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Affiliation(s)
- Fengze Wang
- State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi Clinical Research Center for Oral Diseases, Department of Oral and Maxillofacial Surgery School of Stomatology, The Fourth Military Medical University, Xi’an, China
- Department of Stomatology, The eighth medical center of Chinese PLA General Hospital, Beijing, China
| | - Jiao Wen
- State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi Engineering Research Center for Dental Materials and Advanced Manufacture, Department of Anesthesiology, School of Stomatology, The Fourth Military Medical University, Xi’an
| | - Xinjie Yang
- State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi Clinical Research Center for Oral Diseases, Department of Oral and Maxillofacial Surgery School of Stomatology, The Fourth Military Medical University, Xi’an, China
| | - Tingting Jia
- Department of Stomatology, The Chinese PLA General Hospital, Haidian District, Beijing, China
| | - Fangchong Du
- Department of Stomatology, The eighth medical center of Chinese PLA General Hospital, Beijing, China
| | - Jianhua Wei
- State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi Clinical Research Center for Oral Diseases, Department of Oral and Maxillofacial Surgery School of Stomatology, The Fourth Military Medical University, Xi’an, China
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16
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Zhu Y, Fang X, Wang L, Zhang T, Yu D. A Predictive Nomogram for Early Death of Metastatic Gastric Cancer: A Retrospective Study in the SEER Database and China. J Cancer 2020; 11:5527-5535. [PMID: 32742500 PMCID: PMC7391207 DOI: 10.7150/jca.46563] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Accepted: 07/05/2020] [Indexed: 12/15/2022] Open
Abstract
Background: To identify associated risk factors and develop a predictive nomogram for the early death of metastatic gastric cancer patients. Methods: A total of 4575 patients in the SEER cohort and 220 patients in the Chinese cohort diagnosed with metastatic gastric cancer in our Cancer Center were obtained. Univariate and multivariate logistic regression models were used to identify independent risk variables for early death. A predictive nomogram and a web-based probability calculator were developed and then validated by receiver operating characteristics (ROCs) curve and calibration plot in a Chinese cohort. Results: Eight independent variables, including race, grade, surgery, chemotherapy, and metastases of bone, brain, liver, lung were recognized by using univariate and multivariate logistic regression models for identifying independent risk variables of early death about metastatic gastric cancer patients. By comprising these variables, a predictive nomogram and a web-based probability calculator were constructed in the SEER cohort. Then, it could be validated well in the Chinese cohort by receiver operating characteristics (ROCs) curve and calibration plot. Conclusion: Using this nomogram model provided an insightful and applicable tool to distinguish the early death of metastatic gastric cancer patients.
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Affiliation(s)
- Ying Zhu
- Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
| | - Xiongfeng Fang
- School of Electrical and Electronic Engineering, Huazhong University of Science and Technology, Wuhan 430074, China
| | - Lanqing Wang
- Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
| | - Tao Zhang
- Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
| | - Dandan Yu
- Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
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17
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Liao F, Guo X, Lu X, Dong W. A validated survival nomogram for early-onset diffuse gastric cancer. Aging (Albany NY) 2020; 12:13160-13171. [PMID: 32639946 PMCID: PMC7377898 DOI: 10.18632/aging.103406] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2020] [Accepted: 05/25/2020] [Indexed: 12/15/2022]
Abstract
This study aimed to establish and independently validate a prognostic nomogram for individual risk prediction in patients with early-onset diffuse gastric cancer (EODGC). Data for 794 patients with EODGC from the SEER database were randomly assigned to training (N=558) and internal validation (N=236) sets, and data for 82 patients from the Renmin Hospital of Wuhan University (RMHWHU) were used as an independent validation cohort. Our LASSO regression analyses of the training set yielded five clinicopathological features (race, AJCC stage, surgery for primary site, chemotherapy and tumor size), which were used to create a survival nomogram. Our survival nomogram achieved better predictive performance than the AJCC staging system, the current standard. Additionally, the calibration curves of the prognostic nomogram revealed good agreement between the predicted survival probabilities and the ground truth values. Indeed, our nomogram, which estimates individualized survival probabilities for patients with EODGC, shows good predictive accuracy and calibration ability for both the SEER and RMHWHU cohorts. These results suggest that a survival nomogram may be better at predicting OS for EODGC patients than the AJCC staging system.
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Affiliation(s)
- Fei Liao
- Department of Gastroenterology, Renmin Hospital of Wuhan University, Wuhan 430061, Hubei Province, China
| | - Xufeng Guo
- Department of Oncology, Renmin Hospital of Wuhan University, Wuhan 430061, Hubei Province, China
| | - Xiaohong Lu
- Department of Gastroenterology, Renmin Hospital of Wuhan University, Wuhan 430061, Hubei Province, China
| | - Weiguo Dong
- Department of Gastroenterology, Renmin Hospital of Wuhan University, Wuhan 430061, Hubei Province, China
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18
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Li Z, Cen H. Construction of a nomogram for the prediction of prognosis in patients with resectable gastric cancer undergoing fewer than sixteen lymph node biopsies. Onco Targets Ther 2019; 12:7415-7428. [PMID: 31686848 PMCID: PMC6752044 DOI: 10.2147/ott.s216086] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2019] [Accepted: 08/08/2019] [Indexed: 12/17/2022] Open
Abstract
Background Lymph node metastases evaluation is important for assessing gastric cancer prognosis. In patients not undergoing adequate lymph node biopsy, lymph node stage migration occurs with the use of the existing staging system. This study established a prediction model to improve prognostication in patients undergoing fewer than 16 lymph nodes biopsy. Patients and methods In total, 3036 eligible patients from the Surveillance, Epidemiology, and End Results Program database were evaluated. They were randomized into development and validation sets in a 1:1 ratio (n=1520 and 1516, respectively). To avoid model overfitting and loss of important factors, prognostic factors related to overall survival (OS) were screened according to the Akaike information criterion. The nomogram was assessed using discrimination and consistency tests in the development and validation sets; the concordance index (C-index), calibration curves, and receiver operating characteristic (ROC) curves were also evaluated. Comparison with the 7th American Joint Committee on Cancer (AJCC) staging system was based on Kaplan–Meier curves, ROC, risk stratification, and decision curve analysis (DCA). Results Age, race, degree of differentiation, invasion depth, chemotherapy, radiotherapy, and lymph node ratio were independent prognostic factors in OS. C-indices of the development and validation sets were 0.759 (95% CI: 0.741–0.777) and 0.742 (95% CI: 0.713–0.771), respectively; calibration curves were approximately 45° diagonal, indicating good predictive ability of the nomogram. In contrast to the 7th AJCC staging system, the Kaplan–Meier curves and risk stratification of the nomogram had better discrimination ability, the ROC curves of the nomogram achieved more predictive accuracy, and the DCA indicated that the nomogram conferred higher net benefit. Conclusion Our constructed nomogram predicts the prognosis of patients with resectable gastric cancer undergoing biopsy of fewer than 16 lymph nodes more precisely and has better clinical applicability than the 7th AJCC staging system.
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Affiliation(s)
- Zhe Li
- Department of Chemotherapy, Guangxi Medical University, Cancer Hospital, Nanning, Guangxi, People's Republic of China
| | - Hong Cen
- Department of Chemotherapy, Guangxi Medical University, Cancer Hospital, Nanning, Guangxi, People's Republic of China
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19
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Zhao R, Jia T, Qiao B, Liang J, Qu S, Zhu L, Feng H, Xing L, Ren Y, Wang F, Zhang H. Nomogram predicting long-term overall survival and cancer-specific survival of lip carcinoma patients based on the SEER database: A retrospective case-control study. Medicine (Baltimore) 2019; 98:e16727. [PMID: 31415366 PMCID: PMC6831112 DOI: 10.1097/md.0000000000016727] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Our study was designed to construct nomograms to predict the overall survival (OS) and cancer-specific survival (CSS) of lip carcinoma patients.A search of the Surveillance, Epidemiology, and End Results (SEER) database provided us with detailed clinical data of the 1780 lip carcinoma patients. On the basis of the credible random split-sample method, the 1780 patients were placed into 2 groups, with 890 patients in the modeling group and 890 patients in the counterpart's group (proportion = 1:1). By employing Kaplan-Meier univariate and Cox multivariate survival analyses based on the modeling cohort, the nomograms were developed and then used to divide the modeling cohort into low-risk cohort and high-risk cohort. The survival rates of the 2 groups were calculated. Internal and external evaluation of nomogram accuracy was performed by the concordance index (C-index) and calibration curves.With regard to 5- and 8-year OS and CSS, the C-indexes of internal validation were 0.762 and 0.787, whereas those of external validation reached 0.772 and 0.818, respectively. All the C-indexes were higher than 0.7. The survival curves of the low-risk cohort were obviously better than those of the high-risk cohort.Credible nomograms have been established based on the SEER large-sample population research. We believe these nomograms can contribute to the design of treatment plans and evaluations of individual prognosis.
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Affiliation(s)
- Rui Zhao
- Oral and Maxillofacial Surgery Department, The Chinese PLA General Hospital
| | - Tingting Jia
- Oral and Maxillofacial Surgery Department, The Chinese PLA General Hospital
| | - Bo Qiao
- Oral and Maxillofacial Surgery Department, The Chinese PLA General Hospital
| | - Jiawu Liang
- Oral and Maxillofacial Surgery Department, The Chinese PLA General Hospital
| | - Shuang Qu
- Oral and Maxillofacial Surgery Department, The Chinese PLA General Hospital
| | - Liang Zhu
- Oral and Maxillofacial Surgery Department, The Chinese PLA General Hospital
| | - Hang Feng
- Oral and Maxillofacial Surgery Department, The Chinese PLA General Hospital
| | - Lejun Xing
- Oral and Maxillofacial Surgery Department, The Chinese PLA General Hospital
| | - Yipeng Ren
- Oral and Maxillofacial Surgery Department, The Chinese PLA General Hospital
| | - Fengze Wang
- Department of Stomatology, The 316th Hospital of Chinese People's Liberation Army, Xiangshan Road, Haidian District, Beijing, China
| | - Haizhong Zhang
- Oral and Maxillofacial Surgery Department, The Chinese PLA General Hospital
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Li J, Liu L. Overall survival in patients over 40 years old with surgically resected pancreatic carcinoma: a SEER-based nomogram analysis. BMC Cancer 2019; 19:726. [PMID: 31337369 PMCID: PMC6651947 DOI: 10.1186/s12885-019-5958-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2019] [Accepted: 07/18/2019] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND The aim of this study was to identify the determinants of overall survival (OS) within patients over 40 years old with surgically resected pancreatic carcinoma (PC), and to develop a nomogram with the intention of OS predicting. METHODS A total of 6341 patients of 40 years of age or later with surgically resected PC between 2010 and 2015 were enrolled from the Surveillance, Epidemiology, and End Results (SEER) program and randomly assigned into training set (4242 cases) and validation set (2099 cases). A nomogram was constructed for predicting 1-, 2- and 3-years OS based on univairate and multivariate Cox regression. The C-index and calibration plot were adopted to assess the nomogram performance. RESULTS Our analysis showed that age, location of carcinoma in pancreas, tumor grade, TNM stage, size of carcinoma together with lymph node ratio (LNR) were considered to be independent overall survival predictors. A nomogram based on these six factors was developed with C-index being 0.680 (95%CI: 0.667-0.693). All calibration curves of OS fitted well. The OS curves stratified by nomogram-predicted probability score (≥20, 10-19 and < 10) demonstrated statistically significant difference not only within training set but also in validation set. CONCLUSIONS The present nomogram for OS predicting can serve as the efficacious survival-predicting model and assist in accurate decision-making for patients over 40 years old with surgically resected PC.
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Affiliation(s)
- Jian Li
- Clinical Research Center, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, 197 Ruijin Er Road, Huangpu District, Shanghai, 200025 China
| | - Leshan Liu
- Clinical Research Center, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, 197 Ruijin Er Road, Huangpu District, Shanghai, 200025 China
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Development and validation of a prognostic nomogram for early-onset colon cancer. Biosci Rep 2019; 39:BSR20181781. [PMID: 31142625 PMCID: PMC6617053 DOI: 10.1042/bsr20181781] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2018] [Revised: 05/03/2019] [Accepted: 05/13/2019] [Indexed: 12/18/2022] Open
Abstract
The present study was to develop a prognostic nomogram to predict overall survival (OS) and cancer-specific survival (CSS) in early-onset colon cancer (COCA, age < 50). Patients diagnosed as COCA between 2004 and 2015 were retrieved from the surveillance, epidemiology, and end results (SEER) database. All included patients were assigned into training and validation sets. Univariate and multivariate analysis were used to identify independent prognostic variables for the construction of nomogram. The discrimination and calibration plots were used to measure the accuracy of the nomogram. A total of 11220 patients were included from the SEER database. The nomograms were established based on the variables significantly associated with OS and CSS using cox regression models. Calibration plots indicated that both nomograms in OS and CSS exhibited high correlation to actual observed results. The nomograms also displayed improved discrimination power than tumor-node-metastasis (TNM) stage and SEER stage both in the training and validation sets. The monograms established in the present study provided an alternative tool to both OS and CSS prognostic prediction compared with TNM and SEER stages.
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Abstract
The aim of this study was to develop nomograms to predict long-term overall survival and cancer-specific survival of patients with osteosarcoma.We carried out univariate and multivariate analyses and set up nomograms predicting survival outcome using osteosarcoma patient data collected from the Surveillance, Epidemiology and End Results (SEER) program of the National Cancer Institute (2004-2011, n = 1426). The patients were divided into a training cohort (2004-2008, n = 863) and a validation cohort (2009-2011, n = 563), and the mean follow-up was 55 months.In the training cohort, 304 patients (35.2%) died from osteosarcoma and 91 (10.5%) died from other causes. In the validation cohort, 155 patients (27.5%) died from osteosarcoma and (12.3%) died from other causes. Nomograms predicting overall survival (OS) and cancer-specific survival (CSS) were developed according to 6 clinicopathologic factors (age, tumor site, historic grade, surgery, AJCC T/N, and M), with concordance indexes (C-index) of 0.725 (OS) and 0.718 (CSS), respectively. The validation C-indexes were 0.775 and 0.742 for OS and CSS, respectively.Our results suggest that we have successfully developed highly accurate nomograms for predicting 5-year OS and CSS for osteosarcoma patients. These nomograms will help surgeons customize treatment and monitoring strategies for osteosarcoma patients.
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Affiliation(s)
- Wenhao Chen
- Affiliated Union Hospital, Fujian Medical University, Department of Orthopedics
| | - Yuxiang Lin
- Affiliated Union Hospital, Fujian Medical University, Department of Breast Surgery, Fuzhou, China
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Hu CY, Pan ZY, Yang J, Chu XH, Zhang J, Tao XJ, Chen WM, Li YJ, Lyu J. Nomograms for predicting long-term overall survival and cancer-specific survival in lip squamous cell carcinoma: A population-based study. Cancer Med 2019; 8:4032-4042. [PMID: 31112373 PMCID: PMC6639254 DOI: 10.1002/cam4.2260] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2019] [Revised: 03/30/2019] [Accepted: 05/06/2019] [Indexed: 12/25/2022] Open
Abstract
Background The goal of this study was to establish and validate two nomograms for predicting the long‐term overall survival (OS) and cancer‐specific survival (CSS) in lip squamous cell carcinoma (LSCC). Methods This study selected 4175 patients who were diagnosed with LSCC between 2004 and 2015 in the SEER (Surveillance, Epidemiology, and End Results) database. The patients were allocated randomly to a training cohort and validation cohort. Variables were selected using a backward stepwise method in a Cox regression model. Based on the predictive model with the identified prognostic factors, nomograms were established to predict the 3‐, 5‐, and 8‐year survival OS and CSS rates of LSCC patients. The accuracy of the nomograms was evaluated based on the consistency index (C‐index), while their prediction accuracy was evaluated using calibration plots. Decision curve analyses (DCAs) were used to evaluate the performance of our survival model. Results The multivariate analyses demonstrated that age at diagnosis, marital status, sex, race, American Joint Committee on Cancer stage, surgery status, and radiotherapy status were risk factors for both OS and CSS. The C‐index, area under the time‐dependent receiver operating characteristic curve, and calibration plots demonstrated the good performance of the nomograms. DCAs of both nomograms further showed that they exhibited good 3‐, 5‐, and 8‐year net benefits. Conclusions We have developed and validated LSCC prognosis nomograms for OS and CSS for the first time. These nomograms can be valuable tools for clinical practice when clinicians are helping patients to understand their survival risk for the next 3, 5, and 8 years.
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Affiliation(s)
- Chuan-Yu Hu
- Clinical Research Center, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.,Stomatology Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Zhen-Yu Pan
- Clinical Research Center, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.,School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, China.,Department of Pharmacy, The Affiliated Children Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Jin Yang
- Clinical Research Center, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.,School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, China
| | - Xiu-Hong Chu
- Department of Nursing, Yeda Hospital, Yantai, China
| | - Jun Zhang
- Clinical Research Center, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.,School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, China.,Department of Orthopaedics, Baoji Municipal Central Hospital, Baoji, China
| | - Xue-Jin Tao
- Stomatology Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Wei-Min Chen
- Stomatology Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yuan-Jie Li
- Department of Human Anatomy, Histology and Embryology, School of Basic Medical Sciences, Xi'an Jiaotong University Health Science Center, Xi'an, China
| | - Jun Lyu
- Clinical Research Center, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.,School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, China
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Xie K, Liu S, Liu J. Nomogram predicts survival benefit for non- metastatic esophageal cancer patients who underwent preoperative radiotherapy. Cancer Manag Res 2018; 10:3657-3668. [PMID: 30271214 PMCID: PMC6152601 DOI: 10.2147/cmar.s165168] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Background A prognostic model to predict the individual disease-specific survival (DSS) rates of non-metastatic esophageal cancer (nMEC) patients after preoperative radiotherapy (pRT) has not been established. In the current study, we aimed to establish a survival nomogram for nMEC patients after pRT. Methods We identified 2,424 nMEC patients who underwent pRT from the Surveillance, Epidemiology, and End Results database. Approximately, 80% (n=1,948) of the included patients were randomly selected and designated as training data set, and the remaining patients (n=476) were defined as external validation set. Nomogram was established by the training set and validated by the validation set. Results According to the results of the multivariate analysis, a nomogram combined with age at diagnosis, sex, tumor location, yp-T stage, yp metastatic lymph node ratio stage (yp-mLNRS), and grade was developed. The C-index of the model was significantly higher than that of yp-TNM staging system (0.62, 95% CI, 0.58 to 0.66 vs 0.55, 95% CI, 0.51 to 0.60; p<0.001). Calibration plots of the nomogram showed that the probability of DSS rates optimally corresponded to the survival rates were observed. Conclusion The proposed nomogram resulted in more reliable DSS prediction for nMEC patients in general population, regardless of the patient’s histological type. Upon validation, it will aid in individualized survival prediction and prove useful in clinical decision making in nMECs after pRT.
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Affiliation(s)
- Kenan Xie
- Department of Cardiothoracic Surgery, Traditional Chinese Medicine Hospital of Taihe County, Taihe, China,
| | - Song Liu
- Department of Head - Neck and Thoracic Surgery, The First Affiliated Hospital of University of Science and Technology of China, Anhui Provincial Cancer Hospital, Hefei, China,
| | - Jianjun Liu
- Department of Head - Neck and Thoracic Surgery, The First Affiliated Hospital of University of Science and Technology of China, Anhui Provincial Cancer Hospital, Hefei, China,
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Song W, Lv CG, Miao DL, Zhu ZG, Wu Q, Wang YG, Chen L. Development and validation of a nomogram for predicting survival in patients with gastrointestinal stromal tumours. Eur J Surg Oncol 2018; 44:1657-1665. [PMID: 30082175 DOI: 10.1016/j.ejso.2018.07.004] [Citation(s) in RCA: 45] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2018] [Revised: 07/04/2018] [Accepted: 07/08/2018] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND This study aimed to develop and validate nomograms for predicting long-term overall survival (OS) and cancer-specific survival (CSS) in gastrointestinal stromal tumours (GISTs). METHODS Patients diagnosed with GISTs between 2004 and 2015 were selected for the study from the Surveillance, Epidemiology, and End Results (SEER) database. Patients were randomly separated into the training set and the validation set. Multivariate analysis was used on the training set to obtain independent prognostic factors to build nomograms for predicting 3- and 5-year OS and CSS. The discrimination and calibration plots were used to evaluate the predictive accuracy of the nomograms. RESULTS Data for a total of 5622 patients with GISTs were collected from the SEER database. Nomograms were established based on variables that were significantly associated with OS and CSS identified by the Cox regression model. The nomograms for predicting OS and CSS displayed better discrimination power than did the SEER stage and Tumour-Node-Metastasis (TNM) staging systems (7th edition) in the training set and validation set. Calibration plots of the nomograms indicated that OS and CSS closely corresponded to actual observation. CONCLUSIONS The nomograms were able to more accurately predict 3- and 5-year OS and CSS of patients with GISTs than were existing models.
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Affiliation(s)
- Wei Song
- Department of Intervention and Vascular Surgery, Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Suzhou Cancer Medical Center, Suzhou, Jiangsu, 215001, China
| | - Chang-Guang Lv
- Department of Intervention and Vascular Surgery, Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Suzhou Cancer Medical Center, Suzhou, Jiangsu, 215001, China
| | - Dong-Liu Miao
- Department of Intervention and Vascular Surgery, Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Suzhou Cancer Medical Center, Suzhou, Jiangsu, 215001, China
| | - Zhi-Gang Zhu
- Department of Intervention and Vascular Surgery, Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Suzhou Cancer Medical Center, Suzhou, Jiangsu, 215001, China
| | - Qiong Wu
- Department of Intervention and Vascular Surgery, Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Suzhou Cancer Medical Center, Suzhou, Jiangsu, 215001, China
| | - Yong-Gang Wang
- Department of Intervention and Vascular Surgery, Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Suzhou Cancer Medical Center, Suzhou, Jiangsu, 215001, China
| | - Lei Chen
- Department of Intervention and Vascular Surgery, Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Suzhou Cancer Medical Center, Suzhou, Jiangsu, 215001, China.
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Miao DL, Song W, Qian J, Zhu ZG, Wu Q, Lv CG, Chen L. Development and Validation of a Nomogram for Predicting Overall Survival in Pancreatic NeuroendocrineTumors. Transl Oncol 2018; 11:1097-1103. [PMID: 30015262 PMCID: PMC6070700 DOI: 10.1016/j.tranon.2018.06.012] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2018] [Revised: 06/28/2018] [Accepted: 06/28/2018] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND: The objective of current study was to develop and validate a nomogram to predict overall survival in pancreatic neuroendocrine tumors (PNETs). METHODS: The Surveillance, Epidemiology, and End Results (SEER) database was queried for patients with PNETs between 2004 and 2015. Patients were randomly separated into the training set and the validation set. Cox regression model was used in training set to obtain independent prognostic factors to develop a nomogram for predicting overall survival (OS). The discrimination and calibration plots were used to evaluate the predictive accuracy of the nomogram. RESULTS: A total of 3142 patients with PNETs were collected from the SEER database. Sex, age, marital status, primary site, TNM stage, tumor grade, and therapy were associated with OS in the multivariate models. A nomogram was constructed based on these variables. The nomogram for predicting OS displayed better discrimination power than the Tumor-Node-Metastasis (TNM) stage systems 7th edition in the training set and validation set. The calibration curve indicated that the nomogram was able to accurately predict 3- and 5-year OS. CONCLUSIONS: The nomogram which could predict 3- and 5-year OS were established in this study. Our nomogram showed a good performance, suggesting that it could be served as an effective tool for prognostic evaluation of patients with PNETs.
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Affiliation(s)
- Dong-Liu Miao
- Department of Intervention and Vascular Surgery, Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Suzhou Cancer Medical Center, Suzhou, Jiangsu, 215001, China
| | - Wei Song
- Department of Intervention and Vascular Surgery, Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Suzhou Cancer Medical Center, Suzhou, Jiangsu, 215001, China
| | - Jun Qian
- Department of Oncology, Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Suzhou Cancer Medical Center, Suzhou, Jiangsu, 215001, China
| | - Zhi-Gang Zhu
- Department of Intervention and Vascular Surgery, Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Suzhou Cancer Medical Center, Suzhou, Jiangsu, 215001, China
| | - Qiong Wu
- Department of Intervention and Vascular Surgery, Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Suzhou Cancer Medical Center, Suzhou, Jiangsu, 215001, China
| | - Chang-Guang Lv
- Department of Intervention and Vascular Surgery, Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Suzhou Cancer Medical Center, Suzhou, Jiangsu, 215001, China
| | - Lei Chen
- Department of Intervention and Vascular Surgery, Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Suzhou Cancer Medical Center, Suzhou, Jiangsu, 215001, China.
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Song W, Zhu ZG, Wu Q, Lv CG, Wang YG, Chen L, Miao DL. A nomogram to predict overall survival for biliary tract cancer. Cancer Manag Res 2018; 10:1535-1541. [PMID: 29942155 PMCID: PMC6005298 DOI: 10.2147/cmar.s163291] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Background The aim of the study was to develop and validate a nomogram to predict overall survival (OS) in biliary tract cancer (BTC). Patients and methods Patients diagnosed with BTC between 2004 and 2014 were selected for the study from the Surveillance, Epidemiology, and End Results (SEER) database. All patients were randomly allocated to 2 sets, the training set (n = 8,869) and the validation set (n = 8,766), for the purposes of validation. The prognostic effects of each variable were examined using univariate and multivariate analyses. Cox regression models and a nomogram were developed based on significant prognostic factors. The predictive and discriminatory capacity of the nomogram was evaluated by Harrell’s concordance index (C-index) and calibration plots. Results Data of 17,635 patients with BTC were collected from the SEER database. Age; race; tumor site; tumor grade; T, N, and M stage; marital status; and therapy were associated with survival in the multivariate models. All these factors were integrated to construct the nomogram. The nomogram for predicting OS displayed better discrimination power than the tumor-node-metastasis (TNM) stage system 6th edition in the training set and validation set. The calibration curve indicated that the nomogram was able to accurately predict 3- and 5-year OS. Conclusion This predictive model has the potential to provide an individualized risk estimate of survival in patients with BTC.
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Affiliation(s)
- Wei Song
- Department of Intervention and Vascular Surgery, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Suzhou Cancer Medical Center, Suzhou, China
| | - Zhi-Gang Zhu
- Department of Intervention and Vascular Surgery, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Suzhou Cancer Medical Center, Suzhou, China
| | - Qiong Wu
- Department of Intervention and Vascular Surgery, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Suzhou Cancer Medical Center, Suzhou, China
| | - Chang-Guang Lv
- Department of Intervention and Vascular Surgery, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Suzhou Cancer Medical Center, Suzhou, China
| | - Yong-Gang Wang
- Department of Intervention and Vascular Surgery, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Suzhou Cancer Medical Center, Suzhou, China
| | - Lei Chen
- Department of Intervention and Vascular Surgery, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Suzhou Cancer Medical Center, Suzhou, China
| | - Dong-Liu Miao
- Department of Intervention and Vascular Surgery, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Suzhou Cancer Medical Center, Suzhou, China
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Abdel-Rahman O. Validation of the 8th AJCC staging system for gastric cancer in a population-based setting. Expert Rev Gastroenterol Hepatol 2018; 12:525-530. [PMID: 29198151 DOI: 10.1080/17474124.2018.1413348] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
BACKGROUND The aim of this analysis is to validate the prognostic value of the 8th edition of the American Joint Committee on Cancer (AJCC) staging system for gastric cancer. METHODS Through SEER*Stat program, Surveillance, epidemiology and end results database (2010-2013) was accessed and 8th AJCC stages were reconstructed. Cancer-specific survival analyses according to both 7th and 8th editions were conducted through Kaplan-Meier analysis/log-rank testing and multivariate analysis was conducted through a Cox model. RESULTS Among pathologically-staged patients, P values for pairwise comparisons among different 8th AJCC stages were significant (<0.05) for all comparisons except for stage IIIC vs. IV; while P values for pairwise comparisons among different 7th AJCC stages were significant (<0.05) for all comparisons except for stage IIIA vs. IIIB and stage IIIC vs. IV. Among clinically-staged patients and according to either the clinical 8th AJCC or the 7th AJCC, significant overlap in outcomes existed between different stages. Among pathologically-staged patients, c-statistic for the pathological 8th system was: 0.762; while for the 7th system, it was: 0.763. Among clinically-staged patients, c-statistic for the clinical 8th system was: 0.634; while for the 7th system, it was: 0.637. CONCLUSION Compared to the 7th system, the 8th system does not bring about significant prognostic improvement (for either clinically- or pathologically-staged patients).
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Affiliation(s)
- Omar Abdel-Rahman
- a Clinical Oncology department, Faculty of Medicine , Ain Shams University , Cairo , Egypt
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Liu J, Su M, Hong S, Gao H, Zheng X, Wang S. Nomogram predicts survival benefit from preoperative radiotherapy for non-metastatic breast cancer: A SEER-based study. Oncotarget 2018; 8:49861-49868. [PMID: 28591713 PMCID: PMC5564813 DOI: 10.18632/oncotarget.17991] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2017] [Accepted: 05/01/2017] [Indexed: 12/21/2022] Open
Abstract
Background To estimate survival in non-metastatic breast cancer patients who failed to achieve a pathological complete response (pCR) more effectively, we combined the clinicpathological characteristics after preoperative radiation therapy (pRT) and established a novel nomogram. Materials and Methods Using the Surveillance, Epidemiology, and End Results (SEER) database, we identified 2,545 non-metastatic breast cancer patients who underwent pRT between 1998 and 2013. Based on the registries of patients, the primary cohort divided into training set (n = 1,692) and validation set (n = 853). Nomograms were established by training set and validated by validation set. Results According to the multivariate analysis of training set, nomogram which combined age at diagnosed, marital status, location, grade, ER status, yp-T status, yp-N status and whether received breast conservation surgery (BCS) was developed. Calibration plots of the nomograms showed that the probability of DSS corresponded to actual observation closely. The C-index was 0.78 in validation set, which was significantly higher than that of yp-TNM staging system (0.75, p = 0.004). Conclusions The proposed nomogram resulted in more–reliable DSS prediction for non-metastatic breast cancer patients in general population, it would be helpful in individualized survival prediction and better treatment allocation after pRT.
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Affiliation(s)
- Jianjun Liu
- Department of Head, Neck, and Breast Surgery, Anhui Provincial Cancer Hospital, West Branch of Anhui Provincial Hospital, Hefei, China
| | - Mingxue Su
- Department of Infectious Disease Epidemiology, Lu'an People's Hospital, Lu'an, China
| | - Shikai Hong
- Department of Head, Neck, and Breast Surgery, Anhui Provincial Cancer Hospital, West Branch of Anhui Provincial Hospital, Hefei, China
| | - Hong Gao
- Department of Head, Neck, and Breast Surgery, Anhui Provincial Cancer Hospital, West Branch of Anhui Provincial Hospital, Hefei, China
| | - Xucai Zheng
- Department of Head, Neck, and Breast Surgery, Anhui Provincial Cancer Hospital, West Branch of Anhui Provincial Hospital, Hefei, China
| | - Shengying Wang
- Department of Head, Neck, and Breast Surgery, Anhui Provincial Cancer Hospital, West Branch of Anhui Provincial Hospital, Hefei, China
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Liu Y, Li Y, Fu Y, Liu T, Liu X, Zhang X, Fu J, Guan X, Chen T, Chen X, Sun Z. Quantitative prediction of oral cancer risk in patients with oral leukoplakia. Oncotarget 2018; 8:46057-46064. [PMID: 28545021 PMCID: PMC5542248 DOI: 10.18632/oncotarget.17550] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2017] [Accepted: 02/28/2017] [Indexed: 12/16/2022] Open
Abstract
Exfoliative cytology has been widely used for early diagnosis of oral squamous cell carcinoma. We have developed an oral cancer risk index using DNA index value to quantitatively assess cancer risk in patients with oral leukoplakia, but with limited success. In order to improve the performance of the risk index, we collected exfoliative cytology, histopathology, and clinical follow-up data from two independent cohorts of normal, leukoplakia and cancer subjects (training set and validation set). Peaks were defined on the basis of first derivatives with positives, and modern machine learning techniques were utilized to build statistical prediction models on the reconstructed data. Random forest was found to be the best model with high sensitivity (100%) and specificity (99.2%). Using the Peaks-Random Forest model, we constructed an index (OCRI2) as a quantitative measurement of cancer risk. Among 11 leukoplakia patients with an OCRI2 over 0.5, 4 (36.4%) developed cancer during follow-up (23 ± 20 months), whereas 3 (5.3%) of 57 leukoplakia patients with an OCRI2 less than 0.5 developed cancer (32 ± 31 months). OCRI2 is better than other methods in predicting oral squamous cell carcinoma during follow-up. In conclusion, we have developed an exfoliative cytology-based method for quantitative prediction of cancer risk in patients with oral leukoplakia.
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Affiliation(s)
- Yao Liu
- Department of Oral Medicine, Beijing Stomatological Hospital, Capital Medical University, Beijing, China
| | - Yicheng Li
- Cancer Research Program, Julius L. Chambers Biomedical Biotechnology Research Institute, North Carolina Central University, Durham, North Carolina, USA
| | - Yue Fu
- Department of Oral Medicine, Beijing Stomatological Hospital, Capital Medical University, Beijing, China
| | - Tong Liu
- Department of Oral Medicine, Beijing Stomatological Hospital, Capital Medical University, Beijing, China
| | - Xiaoyong Liu
- Department of Pathology, Beijing Stomatological Hospital, Capital Medical University, Beijing, China
| | - Xinyan Zhang
- Beijing Institute of Dental Research, School of Stomatology, Capital Medical University, Beijing, China
| | - Jie Fu
- Department of Oral Medicine, Beijing Stomatological Hospital, Capital Medical University, Beijing, China
| | - Xiaobing Guan
- Department of Oral Medicine, Beijing Stomatological Hospital, Capital Medical University, Beijing, China
| | - Tong Chen
- Division of Medical Oncology, Department of Internal Medicine, The Ohio State University, Columbus, Ohio, USA
| | - Xiaoxin Chen
- Cancer Research Program, Julius L. Chambers Biomedical Biotechnology Research Institute, North Carolina Central University, Durham, North Carolina, USA
| | - Zheng Sun
- Department of Oral Medicine, Beijing Stomatological Hospital, Capital Medical University, Beijing, China
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Chen S, Rao H, Liu J, Geng Q, Guo J, Kong P, Li S, Liu X, Sun X, Zhan Y, Xu D. Lymph nodes ratio based nomogram predicts survival of resectable gastric cancer regardless of the number of examined lymph nodes. Oncotarget 2018; 8:45585-45596. [PMID: 28489596 PMCID: PMC5542210 DOI: 10.18632/oncotarget.17276] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2017] [Accepted: 03/27/2017] [Indexed: 12/14/2022] Open
Abstract
To develop a nomogram to predict the prognosis of gastric cancer patients on the basis of metastatic lymph nodes ratio (mLNR), especially in the patients with total number of examined lymph nodes (TLN) less than 15. The nomogram was constructed based on a retrospective database that included 2,205 patients underwent curative resection in Cancer Center, Sun Yat-sen University (SYSUCC). Resectable gastric cancer (RGC) patients underwent curative resection before December 31, 2008 were assigned as the training set (n=1,470) and those between January 1, 2009 and December 31, 2012 were selected as the internal validation set (n=735). Additional external validations were also performed separately by an independent data set (n=602) from Jiangxi Provincial Cancer Hospital (JXCH) in Jiangxi, China and a data set (n=3,317) from the Surveillance, Epidemiology, and End Results (SEER) database. The Independent risk factors were identified by Multivariate Cox Regression. In the SYSUCC set, TNM (Tumor-node-metastasis) and TRM-based (Tumor-Positive Nodes Ratio-Metastasis) nomograms were constructed respectively. The TNM-based nomogram showed better discrimination than the AJCC-TNM staging system (C-index: 0.73 versus 0.69, p<0.01). When the mLNR was included in the nomogram, the C-index increased to 0.76. Furthermore, the C-index in the TRM-based nomogram was similar between TLN ≥16 (C-index: 0.77) and TLN ≤15 (C-index: 0.75). The discrimination was further ascertained by internal and external validations. We developed and validated a novel TRM-based nomogram that provided more accurate prediction of survival for gastric cancer patients who underwent curative resection, regardless of the number of examined lymph nodes.
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Affiliation(s)
- Shangxiang Chen
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China.,Department of Gastric and Pancreatic Surgery, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Huamin Rao
- Department of Abdominal Surgery, Jiangxi Cancer Hospital, Nanchang, China
| | - Jianjun Liu
- Department of Breast Surgery, Anhui Provincial Cancer Hospital, West branch of Anhui Provincial Hospital, Hefei, China
| | - Qirong Geng
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China.,Department of Hematology Oncology, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Jing Guo
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China.,Department of Gastric and Pancreatic Surgery, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Pengfei Kong
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China.,Department of Gastric and Pancreatic Surgery, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Shun Li
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China.,Department of Gastric and Pancreatic Surgery, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Xuechao Liu
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China.,Department of Gastric and Pancreatic Surgery, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Xiaowei Sun
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China.,Department of Gastric and Pancreatic Surgery, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Youqing Zhan
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China.,Department of Gastric and Pancreatic Surgery, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Dazhi Xu
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China.,Department of Gastric and Pancreatic Surgery, Sun Yat-sen University Cancer Center, Guangzhou, China
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32
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Wang F, Zhang H, Wen J, Zhou J, Liu Y, Cheng B, Chen X, Wei J. Nomograms forecasting long-term overall and cancer-specific survival of patients with oral squamous cell carcinoma. Cancer Med 2018; 7:943-952. [PMID: 29512294 PMCID: PMC5911576 DOI: 10.1002/cam4.1216] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2017] [Revised: 08/17/2017] [Accepted: 08/25/2017] [Indexed: 12/20/2022] Open
Abstract
Our aim was to establish a "nomogram" model to forecast the overall survival (OS) and cancer-specific survival (CSS) of oral squamous cell carcinoma (OSCC) patients. The clinicopathological data for the 10,533 OSCC patients were collected from the Surveillance, Epidemiology and End Results (SEER) database. We used a credible random split-sample method to divide 10,533 patients into two cohorts: 7046 patients in the modeling cohort and 3487 patients in the external validation cohort (split-ratio = 2:1). The median follow-up period was 32 months (1-119 months). We developed nomograms to predict 5- and 8-year OS and CSS of OSCC patients with a Cox proportional hazards model. The precision of the nomograms was assessed by the concordance index (C-index) and calibration curves through internal and external validation. The C-indexes of internal validation regarding 5- and 8-year OS and CSS were 0.762 and 0.783, respectively. In addition, the external validation's C-indexes were 0.772 and 0.800. Based on a large-sample analysis targeting the SEER database, we established two nomograms to predict long-term OS and CSS for OSCC patients successfully, which can assist surgeons in developing a more effective therapeutic regimen and conducting personalized prognostic evaluations.
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Affiliation(s)
- Fengze Wang
- Department of stomatologyThe 316th Hospital of Chinese People's Liberation ArmyNo. A2 Niangniangfu, Xiangshan RoadBeijingHaidian DistrictChina
- State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi Clinical Research Center for Oral DiseasesDepartment of Oral and Maxillofacial SurgerySchool of StomatologyThe Fourth Military Medical UniversityXi'anChina
| | - Hui Zhang
- State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi Engineering Research Center for Dental Materials and Advanced ManufactureDepartment of AnesthesiologySchool of StomatologyThe Fourth Military Medical UniversityXi'anChina
| | - Jiao Wen
- State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi Engineering Research Center for Dental Materials and Advanced ManufactureDepartment of AnesthesiologySchool of StomatologyThe Fourth Military Medical UniversityXi'anChina
| | - Jun Zhou
- State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi International Joint Research Center for Oral DiseasesDepartment of Oral Histology and PathologyThe Fourth Military Medical UniversityXi'anChina
| | - Yuan Liu
- State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi International Joint Research Center for Oral DiseasesDepartment of Oral Histology and PathologyThe Fourth Military Medical UniversityXi'anChina
| | - Bingkun Cheng
- Department of oral and maxillofacial surgeryThe Second Hospital of Hebei Medical UniversityShijiazhuangChina
| | - Xun Chen
- Department of stomatologyThe 316th Hospital of Chinese People's Liberation ArmyNo. A2 Niangniangfu, Xiangshan RoadBeijingHaidian DistrictChina
| | - Jianhua Wei
- State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi Clinical Research Center for Oral DiseasesDepartment of Oral and Maxillofacial SurgerySchool of StomatologyThe Fourth Military Medical UniversityXi'anChina
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33
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Zhou ML, Wang L, Wang JZ, Yang W, Hu R, Li GC, Sheng WQ, Zhang Z. Validation of the Memorial Sloan Kettering Cancer Center nomogram to predict disease-specific survival in a Chinese gastric cancer population receiving postoperative chemoradiotherapy after an R0 resection. Oncotarget 2018; 7:64757-64765. [PMID: 27588465 PMCID: PMC5323113 DOI: 10.18632/oncotarget.11665] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2016] [Accepted: 08/11/2016] [Indexed: 12/26/2022] Open
Abstract
The widely validated Memorial Sloan Kettering Cancer Center (MSKCC) nomogram for gastric carcinoma (GC) was developed based on patients who received R0 resection only. The purpose of the current study was to assess the performance of this nomogram in Chinese patients who received postoperative chemoradiotherapy (CRT) after an R0 resection for GC. From 2006 to 2015, the clinical data of 150 eligible patients were retrospectively collected from the Fudan University Shanghai Cancer Center (FUSCC) and used for external validation. The nomogram was validated by means of the concordance index (CI) and a calibration plot. The CI for the nomogram was 0.657, which was lower than the CI of the nomogram for patients who received surgery alone (0.80). In the calibration plot, the gap between the observed and the predicted survival gradually increased as the predicted 5-year disease-specific survival (DSS) decreased. Thus the MSKCC nomogram for GC significantly underestimated the survival of patients in the FUSCC cohort, especially the survival of patients whose predicted 5-year DSS was less than 50%. The current study indicates the potential for the nomogram to be developed as an ideal tool to identify target patients for postoperative CRT.
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Affiliation(s)
- Meng-Long Zhou
- Department of Radiation Oncology, Fudan University Shanghai Cancer Center, Shanghai, 200032, PR China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, PR China
| | - Lei Wang
- Department of Pathology, Fudan University Shanghai Cancer Center, Shanghai, 200032, PR China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, PR China
| | - Jia-Zhou Wang
- Department of Radiation Oncology, Fudan University Shanghai Cancer Center, Shanghai, 200032, PR China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, PR China
| | - Wang Yang
- Department of Radiation Oncology, Fudan University Shanghai Cancer Center, Shanghai, 200032, PR China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, PR China
| | - Ran Hu
- Department of Radiation Oncology, Fudan University Shanghai Cancer Center, Shanghai, 200032, PR China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, PR China
| | - Gui-Chao Li
- Department of Radiation Oncology, Fudan University Shanghai Cancer Center, Shanghai, 200032, PR China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, PR China
| | - Wei-Qi Sheng
- Department of Pathology, Fudan University Shanghai Cancer Center, Shanghai, 200032, PR China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, PR China
| | - Zhen Zhang
- Department of Radiation Oncology, Fudan University Shanghai Cancer Center, Shanghai, 200032, PR China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, PR China
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34
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van den Boorn HG, Engelhardt EG, van Kleef J, Sprangers MAG, van Oijen MGH, Abu-Hanna A, Zwinderman AH, Coupé VMH, van Laarhoven HWM. Prediction models for patients with esophageal or gastric cancer: A systematic review and meta-analysis. PLoS One 2018; 13:e0192310. [PMID: 29420636 PMCID: PMC5805284 DOI: 10.1371/journal.pone.0192310] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2017] [Accepted: 01/22/2018] [Indexed: 02/06/2023] Open
Abstract
Background Clinical prediction models are increasingly used to predict outcomes such as survival in cancer patients. The aim of this study was threefold. First, to perform a systematic review to identify available clinical prediction models for patients with esophageal and/or gastric cancer. Second, to evaluate sources of bias in the included studies. Third, to investigate the predictive performance of the prediction models using meta-analysis. Methods MEDLINE, EMBASE, PsycINFO, CINAHL, and The Cochrane Library were searched for publications from the year 2000 onwards. Studies describing models predicting survival, adverse events and/or health-related quality of life (HRQoL) for esophageal or gastric cancer patients were included. Potential sources of bias were assessed and a meta-analysis, pooled per prediction model, was performed on the discriminative abilities (c-indices). Results A total of 61 studies were included (45 development and 16 validation studies), describing 47 prediction models. Most models predicted survival after a curative resection. Nearly 75% of the studies exhibited bias in at least 3 areas and model calibration was rarely reported. The meta-analysis showed that the averaged c-index of the models is fair (0.75) and ranges from 0.65 to 0.85. Conclusion Most available prediction models only focus on survival after a curative resection, which is only relevant to a limited patient population. Few models predicted adverse events after resection, and none focused on patient’s HRQoL, despite its relevance. Generally, the quality of reporting is poor and external model validation is limited. We conclude that there is a need for prediction models that better meet patients’ information needs, and provide information on both the benefits and harms of the various treatment options in terms of survival, adverse events and HRQoL.
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Affiliation(s)
- H. G. van den Boorn
- Cancer Center Amsterdam, Amsterdam, The Netherlands
- Department of Medical Oncology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
- * E-mail:
| | - E. G. Engelhardt
- Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
- Department of Epidemiology and Biostatistics, VU University Medical Center, Amsterdam, The Netherlands
| | - J. van Kleef
- Cancer Center Amsterdam, Amsterdam, The Netherlands
- Department of Medical Oncology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - M. A. G. Sprangers
- Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
- Department of Medical Psychology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - M. G. H. van Oijen
- Cancer Center Amsterdam, Amsterdam, The Netherlands
- Department of Medical Oncology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - A. Abu-Hanna
- Department of Medical Informatics, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - A. H. Zwinderman
- Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - V. M. H. Coupé
- Department of Epidemiology and Biostatistics, VU University Medical Center, Amsterdam, The Netherlands
| | - H. W. M. van Laarhoven
- Cancer Center Amsterdam, Amsterdam, The Netherlands
- Department of Medical Oncology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
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Ju J, Wang J, Ma C, Li Y, Zhao Z, Gao T, Ni Q, Sun M. Nomograms predicting long-term overall survival and cancer-specific survival in head and neck squamous cell carcinoma patients. Oncotarget 2018; 7:51059-51068. [PMID: 27419636 PMCID: PMC5239458 DOI: 10.18632/oncotarget.10595] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2016] [Accepted: 06/13/2016] [Indexed: 12/18/2022] Open
Abstract
This study aimed to develop nomograms to predict long-term overall survival and cancer-specific survival in patients with head and neck squamous cell carcinoma (HNSCC). We conducted prognostic analyses and developed nomograms predicting survival outcome using HNSCC patient data collected from the Surveillance, Epidemiology and End Results (SEER) program of the National Cancer Institute. An external dataset of 219 patients was used to validate the nomograms. Of 36,179 HNSCC patients, 9,627 (26.6%) died from HNSCC and 4,229 (11.7%) died from other causes. Median follow-up was 28 months (1-107 months). Nomograms predicting overall survival (OS) and cancer-specific survival (CSS) were developed according to 10 clinicopathologic factors (age, race, sex, tumor site, tumor grade, surgery, radiotherapy and TNM stage), with concordance indexes (C-indexes) of 0.719 and 0.741, respectively. External validation C-indexes were 0.709 and 0.706 for OS and CSS, respectively. Our results suggest that we successfully developed nomograms predicting five- and eight-year HNSCC patient OS and CSS with high accuracy. These nomograms could help clinicians tailor surgical, adjuvant therapeutic and follow-up strategies to more effectively treat HNSCC patients.
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Affiliation(s)
- Jun Ju
- State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shanxi Clinical Research Center for Oral Diseases, Department of Oral and Maxillofacial Surgery, School of Stomatology, Fourth Military Medical University, Xincheng, Xi'an, Shaanxi, China
| | - Jia Wang
- State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shanxi Key Laboratory of Stomatology, Department of Prosthodontics, School of Stomology, Fourth Military Medical University, Xincheng, Xi'an, Shaanxi, China
| | - Chao Ma
- State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shanxi Clinical Research Center for Oral Diseases, Department of Oral and Maxillofacial Surgery, School of Stomatology, Fourth Military Medical University, Xincheng, Xi'an, Shaanxi, China
| | - Yun Li
- State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shanxi Clinical Research Center for Oral Diseases, Department of Oral and Maxillofacial Surgery, School of Stomatology, Fourth Military Medical University, Xincheng, Xi'an, Shaanxi, China
| | - Zhenyan Zhao
- State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shanxi Clinical Research Center for Oral Diseases, Department of Oral and Maxillofacial Surgery, School of Stomatology, Fourth Military Medical University, Xincheng, Xi'an, Shaanxi, China
| | - Tao Gao
- State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shanxi Clinical Research Center for Oral Diseases, Department of Oral and Maxillofacial Surgery, School of Stomatology, Fourth Military Medical University, Xincheng, Xi'an, Shaanxi, China
| | - Qianwei Ni
- State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shanxi Clinical Research Center for Oral Diseases, Department of Oral and Maxillofacial Surgery, School of Stomatology, Fourth Military Medical University, Xincheng, Xi'an, Shaanxi, China
| | - Moyi Sun
- State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shanxi Clinical Research Center for Oral Diseases, Department of Oral and Maxillofacial Surgery, School of Stomatology, Fourth Military Medical University, Xincheng, Xi'an, Shaanxi, China
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36
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Song W, Miao DL, Chen L. Nomogram for predicting survival in patients with pancreatic cancer. Onco Targets Ther 2018; 11:539-545. [PMID: 29416354 PMCID: PMC5790064 DOI: 10.2147/ott.s154599] [Citation(s) in RCA: 47] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Background The purpose of this study was to develop a nomogram to predict cancer-specific survival (CSS) in pancreatic cancer (PC). Patients and methods We used the Surveillance, Epidemiology, and End Results (SEER) database to analyze 53,028 patients diagnosed with PC from 2004 to 2014 and randomly divided them into the training (n=26,583) cohort and validation (n=26,445) cohort. Univariate and multivariate analyses were used to select independent prognostic factors. We used significant prognostic factors for constructing a nomogram based on Cox regression analyses. Validation of the nomogram was assessed by discrimination and calibration. Results According to the multivariate models of training cohort, a nomogram that combined age, race, tumor location, marital status, tumor size, TNM stage, tumor grade, and surgery was constructed for predicting CSS. The internally validated and externally validated C-indexes were 0.741 and 0.734, respectively. The calibration curves showed that the nomogram was able to predict 1-, 3-, and 5-year CSS accurately. Conclusion A nomogram effectively predicts survival in patients with PC. This prognostic model may be considered for use in clinical practice.
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Affiliation(s)
- Wei Song
- Department of Intervention and Vascular Surgery, Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Suzhou Cancer Medical Center, Suzhou, People's Republic of China
| | - Dong-Liu Miao
- Department of Intervention and Vascular Surgery, Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Suzhou Cancer Medical Center, Suzhou, People's Republic of China
| | - Lei Chen
- Department of Intervention and Vascular Surgery, Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Suzhou Cancer Medical Center, Suzhou, People's Republic of China
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37
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Woo Y, Goldner B, Son T, Song K, Noh SH, Fong Y, Hyung WJ. Western Validation of a Novel Gastric Cancer Prognosis Prediction Model in US Gastric Cancer Patients. J Am Coll Surg 2017; 226:252-258. [PMID: 29277711 DOI: 10.1016/j.jamcollsurg.2017.12.016] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2017] [Revised: 12/09/2017] [Accepted: 12/10/2017] [Indexed: 02/07/2023]
Abstract
BACKGROUND A novel prediction model for accurate determination of 5-year overall survival of gastric cancer patients was developed by an international collaborative group (G6+). This prediction model was created using a single institution's database of 11,851 Korean patients and included readily available and clinically relevant factors. Already validated using external East Asian cohorts, its applicability in the American population was yet to be determined. STUDY DESIGN Using the Surveillance, Epidemiology, and End Results (SEER) dataset, 2014 release, all patients diagnosed with gastric adenocarcinoma who underwent surgical resection between 2002 and 2012, were selected. Characteristics for analysis included: age, sex, depth of tumor invasion, number of positive lymph nodes, total lymph nodes retrieved, presence of distant metastasis, extent of resection, and histology. Concordance index (C-statistic) was assessed using the novel prediction model and compared with the prognostic index, the seventh edition of the TNM staging system. RESULTS Of the 26,019 gastric cancer patients identified from the SEER database, 15,483 had complete datasets. Validation of the novel prediction tool revealed a C-statistic of 0.762 (95% CI 0.754 to 0.769) compared with the seventh TNM staging model, C-statistic 0.683 (95% CI 0.677 to 0.689), (p < 0.001). CONCLUSIONS Our study validates a novel prediction model for gastric cancer in the American patient population. Its superior prediction of the 5-year survival of gastric cancer patients in a large Western cohort strongly supports its global applicability. Importantly, this model allows for accurate prognosis for an increasing number of gastric cancer patients worldwide, including those who received inadequate lymphadenectomy or underwent a noncurative resection.
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Affiliation(s)
- Yanghee Woo
- Department of Surgery, City of Hope National Medical Center, Duarte, CA
| | - Bryan Goldner
- Department of Surgery, City of Hope National Medical Center, Duarte, CA
| | - Taeil Son
- Department of Surgery, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Kijun Song
- Department of Biostatistics, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Sung Hoon Noh
- Department of Surgery, City of Hope National Medical Center, Duarte, CA; Department of Surgery, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Yuman Fong
- Department of Surgery, City of Hope National Medical Center, Duarte, CA
| | - Woo Jin Hyung
- Department of Surgery, Yonsei University College of Medicine, Seoul, Republic of Korea; Gastric Cancer Center, Yonsei Cancer Hospital, Seoul, Republic of Korea; Robot and MIS Center, Severance Hospital, Yonsei University Health System, Seoul, Republic of Korea.
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38
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Yuan SQ, Wu WJ, Qiu MZ, Wang ZX, Yang LP, Jin Y, Yun JP, Gao YH, Li YH, Zhou ZW, Wang F, Xu RH. Development and Validation of a Nomogram to Predict the Benefit of Adjuvant Radiotherapy for Patients with Resected Gastric Cancer. J Cancer 2017; 8:3498-3505. [PMID: 29151934 PMCID: PMC5687164 DOI: 10.7150/jca.19879] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2017] [Accepted: 09/07/2017] [Indexed: 12/18/2022] Open
Abstract
Background: The US guidelines for gastric cancer (GC) recommend adjuvant radiotherapy (ART) combined with 5-fluorouracil as a standard treatment for patients with resected locally advanced GC. However, patient selection criteria for optimizing the use of adjuvant therapies are lacking. In this study, we developed and validated a nomogram to predict the individualized overall survival (OS) benefit of ART among patients with resected ≥stage IB GC. Patients and Methods: The 2002-2006 Surveillance, Epidemiology, and End Results (SEER) data of 5,206 patients with resected GC were used as a training set for the development of a nomogram. The 2007-2008 SEER data of 1,986 patients with resected GC were used as validation data. Results: In the multivariate analysis weighted by inverse propensity score, the efficacy of ART varied by the ratio of positive to examined nodes (Pinteraction <0.01). The magnitude of this difference was included in the nomogram with associated prognosticators to predict the 3- and 5-year OS with and without ART. The nomogram showed significant prognostic superiority to the 8th TNM staging in the training set (Concordance index, 0.68 versus 0.65; P<0.01) and the validation set (Concordance index, 0.68 versus 0.64; P<0.01). Moreover, the calibration was accurate, and the actual efficacy of ART was positively correlated with the nomogram-estimated survival benefit from ART (Pinteraction <0.01 and Pinteraction =0.02 in the training set and the validation set, respectively). Conclusion: The nomogram can aid individualized clinical decision making by estimating the 3- and 5-year OS and potential benefits of ART among patients with resected GC.
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Affiliation(s)
- Shu-Qiang Yuan
- Department of Gastric Surgery, Sun Yat-sen University Cancer Center; State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine, Guangzhou, 510060, China
| | - Wen-Jing Wu
- Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Medical Research Center, Sun Yat-sen University Memorial Hospital, Guangzhou, 510120, China
- Department of Breast Oncology, Sun Yat-sen University Memorial Hospital, Guangzhou, 510120, China
| | - Miao-Zhen Qiu
- Department of Medical Oncology, Sun Yat-sen University Cancer Center; State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine, Guangzhou, 510060, China
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD 21231, USA
| | - Zi-Xian Wang
- Department of Medical Oncology, Sun Yat-sen University Cancer Center; State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine, Guangzhou, 510060, China
| | - Lu-Ping Yang
- Department of Medical Oncology, Sun Yat-sen University Cancer Center; State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine, Guangzhou, 510060, China
| | - Ying Jin
- Department of Medical Oncology, Sun Yat-sen University Cancer Center; State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine, Guangzhou, 510060, China
| | - Jing-Ping Yun
- Department of Pathology, Sun Yat-sen University Cancer Center; State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine, Guangzhou, 510060, China
| | - Yuan-Hong Gao
- Department of Radiotherapy, Sun Yat-sen University Cancer Center; State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine, Guangzhou, 510060, China
| | - Yu-Hong Li
- Department of Medical Oncology, Sun Yat-sen University Cancer Center; State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine, Guangzhou, 510060, China
| | - Zhi-Wei Zhou
- Department of Gastric Surgery, Sun Yat-sen University Cancer Center; State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine, Guangzhou, 510060, China
| | - Feng Wang
- Department of Medical Oncology, Sun Yat-sen University Cancer Center; State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine, Guangzhou, 510060, China
| | - Rui-Hua Xu
- Department of Medical Oncology, Sun Yat-sen University Cancer Center; State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine, Guangzhou, 510060, China
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Li Y, Zhao Z, Liu X, Ju J, Chai J, Ni Q, Ma C, Gao T, Sun M. Nomograms to estimate long-term overall survival and tongue cancer-specific survival of patients with tongue squamous cell carcinoma. Cancer Med 2017; 6:1002-1013. [PMID: 28411370 PMCID: PMC5430099 DOI: 10.1002/cam4.1021] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2016] [Revised: 12/28/2016] [Accepted: 01/03/2017] [Indexed: 12/14/2022] Open
Abstract
The aim of this study was to construct nomograms to predict long-term overall survival (OS) and tongue cancer-specific survival (TCSS) of tongue squamous cell carcinoma (TSCC) patients based on clinical and tumor characteristics. Clinical, tumor, and treatment characteristics of 12,674 patients diagnosed with TSCC between 2004 and 2013 were collected from the Surveillance, Epidemiology, and End Results database. These patients were then divided into surgery and nonsurgery cohorts, and nomograms were developed for each of these groups. The step-down method and cumulative incidence function were used for model selection to determine the significant prognostic factors associated with OS and TCSS. These prognostic variables were incorporated into nomograms. An external cohort was used to validate the surgery nomograms. Seven variables were used to create the surgery nomograms for OS and TCSS, which had c-indexes of 0.709 and 0.728, respectively; for the external validation cohort, the c-indexes were 0.691 and 0.711, respectively. Nine variables were used to create the nonsurgery nomograms for OS and TCSS, which had c-indexes of 0.750 and 0.754, respectively. The calibration curves of the 5- and 8-year surgery and nonsurgery nomograms showed excellent agreement between the probabilities and observed values. By incorporating clinicopathological and host characteristics in patients, we are the first to establish nomograms that accurately predict prognosis for individual patients with TSCC. These nomograms ought to provide more personalized and reliable prognostic information, and improve clinical decision-making for TSCC patients.
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Affiliation(s)
- Yun Li
- State Key Laboratory of Military StomatologyNational Clinical Research Center for Oral DiseasesShaanxi Clinical Research Center for Oral DiseasesDepartment of Oral and Maxillofacial SurgerySchool of StomatologyFourth Military Medical UniversityXi'anChina
| | - Zhenyan Zhao
- State Key Laboratory of Military StomatologyNational Clinical Research Center for Oral DiseasesShaanxi Clinical Research Center for Oral DiseasesDepartment of Oral and Maxillofacial SurgerySchool of StomatologyFourth Military Medical UniversityXi'anChina
| | - Xiaoxiao Liu
- Department of StomatologyFengtai HospitalPeking University First HospitalBeijingChina
| | - Jun Ju
- State Key Laboratory of Military StomatologyNational Clinical Research Center for Oral DiseasesShaanxi Clinical Research Center for Oral DiseasesDepartment of Oral and Maxillofacial SurgerySchool of StomatologyFourth Military Medical UniversityXi'anChina
- Department of Otolaryngology Head Neck SurgeryNavy General HospitalBeijingChina
| | - Juan Chai
- State Key Laboratory of Military StomatologyNational Clinical Research Center for Oral DiseasesShaanxi Clinical Research Center for Oral DiseasesDepartment of Oral and Maxillofacial SurgerySchool of StomatologyFourth Military Medical UniversityXi'anChina
| | - Qianwei Ni
- State Key Laboratory of Military StomatologyNational Clinical Research Center for Oral DiseasesShaanxi Clinical Research Center for Oral DiseasesDepartment of Oral and Maxillofacial SurgerySchool of StomatologyFourth Military Medical UniversityXi'anChina
| | - Chao Ma
- State Key Laboratory of Military StomatologyNational Clinical Research Center for Oral DiseasesShaanxi Clinical Research Center for Oral DiseasesDepartment of Oral and Maxillofacial SurgerySchool of StomatologyFourth Military Medical UniversityXi'anChina
| | - Tao Gao
- State Key Laboratory of Military StomatologyNational Clinical Research Center for Oral DiseasesShaanxi Clinical Research Center for Oral DiseasesDepartment of Oral and Maxillofacial SurgerySchool of StomatologyFourth Military Medical UniversityXi'anChina
| | - Moyi Sun
- State Key Laboratory of Military StomatologyNational Clinical Research Center for Oral DiseasesShaanxi Clinical Research Center for Oral DiseasesDepartment of Oral and Maxillofacial SurgerySchool of StomatologyFourth Military Medical UniversityXi'anChina
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