Li Ruo-He, Zhou Qiang, Li A-Bing, Zhang Hong-Zhen, Lin Zhong-Qin
Department of Nursing.
Department of Orthopedic Surgery, Wenzhou Hospital of Integrated Traditional Chinese and Western Medicine, 75 Jinxiu Road, Wenzhou.
Medicine (Baltimore). 2020 May 22;99(21):e20165. doi: 10.1097/MD.0000000000020165.
Soft tissue sarcoma (STS) of the extremities are a rare tumor. Metastases develop in about 40%-50% of patients, most of whom die from their disease. We sought to identify potential risk factors associated with metastatic diseases upon presentation for patients with STS and established a reliable nomogram model to predict distant metastasis of STS at presentation. The current study retrospectively analyzed 3884 STS of the extremities or trunk patients from the Surveillance, Epidemiology, and End Results (SEER) database between 2010 and 2015. Based on patient registration, all patients were randomly allocated to training sets and validation sets (2:1). Then, univariate and binary logistic regression analysis was used to determine the significantly correlated predictors of metastasis. Finally, the nomogram model was established, using these predictors and validated it. 311 (8.21%) of the cases experienced distant metastatic disease was present at the time of presentation. The nomogram was developed from age, histology subtype, primary site, tumor size, grade and depth. Encouragingly, the nomogram showed favorable calibration with C-index 0.790 in the training set and 0.801 in validation set. The DCA showed that the novel model was clinically useful. This nomogram model had a high precision to predict the metastasis of soft tissue sarcoma of the extremities. We expect this model could be used in different clinical consultation and established risk assessment.
四肢软组织肉瘤(STS)是一种罕见肿瘤。约40%-50%的患者会发生转移,其中大多数患者死于该疾病。我们试图确定初诊时与STS患者转移性疾病相关的潜在风险因素,并建立一个可靠的列线图模型来预测初诊时STS的远处转移。本研究回顾性分析了2010年至2015年间监测、流行病学和最终结果(SEER)数据库中3884例四肢或躯干STS患者。根据患者登记情况,将所有患者随机分配到训练集和验证集(2:1)。然后,采用单因素和二元逻辑回归分析来确定转移的显著相关预测因素。最后,使用这些预测因素建立列线图模型并进行验证。311例(8.21%)病例在初诊时出现远处转移性疾病。该列线图根据年龄、组织学亚型、原发部位、肿瘤大小、分级和深度制定。令人鼓舞的是,该列线图在训练集中C指数为0.790,在验证集中为0.801,显示出良好的校准。决策曲线分析(DCA)表明该新模型具有临床实用性。该列线图模型在预测四肢软组织肉瘤转移方面具有较高的准确性。我们期望该模型可用于不同的临床会诊和建立风险评估。