Liang Song-Wu, Chen Gang, Luo Yi-Ge, Chen Peng, Gu Jin-Han, Xu Qiong-Qian, Dang Yi-Wu, Qin Li-Ting, Lu Hui-Ping, Huang Wen-Ting, Huang Zhi-Guang, Gao Li, Chen Jia-Bo
Department of Pediatric Surgery, The First Affiliated Hospital of Guangxi Medical University, Nanning, China.
Department of Pathology, The First Affiliated Hospital of Guangxi Medical University, Nanning, China.
Ann Surg Treat Res. 2020 Aug;99(2):118-126. doi: 10.4174/astr.2020.99.2.118. Epub 2020 Jul 31.
This study was performed to establish and validate a nomogram for predicting the overall survival in children with neuroblastoma.
The latest clinical data of neuroblastoma in Surveillance, Epidemiology, and End Results (SEER) database was extracted from 2000 to 2016. The cases included were randomly divided into training and validation cohorts. The survival curves were drawn with a Kaplan-Meier estimator to investigate the influences of certain single factors on overall survival. Also, least absolute shrinkage and selection operator regression was applied to further select the prognostic variables for neuroblastoma. Additionally, receiver operating characteristic (ROC) curves and calibration curves were used to evaluate the accuracy of the nomogram.
In total, 1,262 patients were collected and 8 independent prognostic factors were achieved, including patients' age, sex, race, tumor grade, radiotherapy, chemotherapy, tumor site, and tumor size. Then we constructed a nomogram by using the data of the training cohort with 886 cases. Subsequently, the nomogram was validated internally and externally with 886 and 376 cases, respectively. The internal validation revealed that the area under the curves (AUC) of ROC curves of 1-, 3-, and 5-year overall survival were 0.69, 0.78, and 0.81, respectively. Accordingly, the external validation also showed that the AUC of 1-, 3-, and 5-year overall survival were all ≥0.69. Both methods of validation demonstrated that the predictive calibration curves were consistent with standard curves.
The nomogram possess the potential to be a new tool in predicting the survival rate of neuroblastoma patients.
本研究旨在建立并验证一种用于预测神经母细胞瘤患儿总生存期的列线图。
从监测、流行病学和最终结果（SEER）数据库中提取2000年至2016年神经母细胞瘤的最新临床数据。纳入的病例被随机分为训练队列和验证队列。采用Kaplan-Meier估计法绘制生存曲线，以研究某些单因素对总生存期的影响。此外，应用最小绝对收缩和选择算子回归进一步选择神经母细胞瘤的预后变量。另外，使用受试者工作特征（ROC）曲线和校准曲线评估列线图的准确性。
共收集1262例患者，获得8个独立的预后因素，包括患者年龄、性别、种族、肿瘤分级、放疗、化疗、肿瘤部位和肿瘤大小。然后我们利用886例训练队列的数据构建了列线图。随后，分别用886例和376例病例对列线图进行内部和外部验证。内部验证显示，1年、3年和5年总生存期的ROC曲线下面积（AUC）分别为0.69、0.78和0.81。相应地，外部验证也显示1年、3年和5年总生存期的AUC均≥0.69。两种验证方法均表明预测校准曲线与标准曲线一致。
该列线图有潜力成为预测神经母细胞瘤患者生存率的新工具。
