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预测上颌窦癌患者生存的预后模型和列线图。

Prognostic models and nomograms for predicting survival of patients with maxillary sinus carcinomas.

机构信息

Institute of Otolaryngology, Department of Otolaryngology-Head and Neck Surgery, Chinese PLA General Hospital, Beijing, China.

Department of Epidemiology Research, Toho University, Tokyo, Japan.

出版信息

Int Forum Allergy Rhinol. 2017 Jul;7(7):741-748. doi: 10.1002/alr.21950. Epub 2017 May 23.

Abstract

BACKGROUND

Maxillary sinus carcinoma is an uncommon malignancy. Most reports on prognosis of this disease are from single institutions and include few patients. We used data from the United States National Cancer Institute's Surveillance Epidemiology and End Results (SEER) program to construct models and nomograms for predicting outcomes of patients with maxillary sinus carcinomas.

METHODS

We used records from 668 patients with primary maxillary sinus carcinomas reported to the SEER program from 2004 to 2013 to build nomograms based on stratified multivariable Cox proportional hazard models for predicting 5-year overall survival (OS) and cause-specific survival (CSS). Model building was internally validated with the bootstrap approach.

RESULTS

Five-year survival was 39.7% (95% confidence interval [CI], 35.5% to 44.5%) and 46.8% (42.3% to 51.8%) for OS and CSS, respectively. The final Cox model included the variables of age at diagnosis, tumor size, histologic type, TNM stage, and surgery. Radiotherapy was a stratification factor in the models. The models demonstrated good accuracy for predicting survival with a bootstrap-corrected Somers D of 0.44 for both OS and CSS models. Calibration curves indicated acceptable model calibration.

CONCLUSION

We developed tools for predicting prognosis that incorporate TNM stage and other readily available variables for patients with maxillary sinus carcinomas. The model performance was validated as good. These models can help clinicians to offer improved patient counseling in terms of clinical outcomes and make optimal treatment plans.

摘要

背景

上颌窦癌是一种罕见的恶性肿瘤。大多数关于这种疾病预后的报告来自单一机构,且纳入的患者较少。我们使用美国国家癌症研究所的监测、流行病学和最终结果(SEER)计划的数据,构建了用于预测上颌窦癌患者预后的模型和列线图。

方法

我们使用 2004 年至 2013 年 SEER 计划报告的 668 例原发性上颌窦癌患者的记录,基于分层多变量 Cox 比例风险模型,构建预测 5 年总生存率(OS)和特异性生存率(CSS)的列线图。使用自举法对内部分值进行验证。

结果

5 年生存率分别为 39.7%(95%置信区间[CI]:35.5%至 44.5%)和 46.8%(95%CI:42.3%至 51.8%)。最终 Cox 模型包括诊断时的年龄、肿瘤大小、组织学类型、TNM 分期和手术。在模型中,放疗是一个分层因素。对于 OS 和 CSS 模型,模型的准确性都很好,bootstrap 校正后的 Somers D 为 0.44。校准曲线表明模型校准良好。

结论

我们开发了用于预测预后的工具,这些工具包含了 TNM 分期和其他易于获得的变量,用于上颌窦癌患者。模型性能验证良好。这些模型可以帮助临床医生提供更好的关于临床结果的患者咨询,并制定最佳的治疗计划。

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