Department of Orthopedic Surgery, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China.
Key Laboratory of Neuroregeneration of Jiangsu and Ministry of Education, Co-Innovation Center of Neuroregeneration, Nantong University, Nantong, China.
J Surg Oncol. 2020 Dec;122(8):1676-1684. doi: 10.1002/jso.26185. Epub 2020 Aug 29.
The establishment of precise and personalized prediction systems for chondroblastic osteosarcoma patients is important for guiding the treatment.
The univariate logrank test and multivariate Cox regression analysis were performed to identify independent prognostic factors for overall survival (OS) and cancer-specific survival (CSS). Nomograms were constructed to estimate the OS and CSS based on these factors. Internal and external validation was performed. The predictive power of the nomograms was determined by C-index and calibration plots.
A total of 401 chondroblastic osteosarcoma cases were identified. Univariate and multivariate analysis revealed that age at diagnosis, histological grade, tumor size, Surveillance, Epidemiology, and End Results stage, and surgical resection were independent prognostic factors for OS and CSS. The five factors were incorporated to construct the nomograms for estimating the 3- and 5-year OS and CSS. The C-index values for the internal validation of the OS and CSS nomogram were 0.732 and 0.746, respectively, and for the external validation were 0.780 and 0.808, respectively. The calibration curves revealed that the predicted OS and CSS could well match the actual survival rate.
The nomograms for predicting 3- and 5-year OS and CSS were constructed and were proved to be accurate and reliable by the internal and external validation.
建立精确和个性化的软骨母细胞性骨肉瘤患者预测系统对于指导治疗非常重要。
采用单因素 logrank 检验和多因素 Cox 回归分析确定总生存期(OS)和癌症特异性生存期(CSS)的独立预后因素。根据这些因素构建用于估计 OS 和 CSS 的列线图。进行内部和外部验证。通过 C 指数和校准图确定列线图的预测能力。
共确定了 401 例软骨母细胞性骨肉瘤病例。单因素和多因素分析显示,诊断时的年龄、组织学分级、肿瘤大小、监测、流行病学和结果阶段以及手术切除是 OS 和 CSS 的独立预后因素。将这五个因素纳入到用于估计 3 年和 5 年 OS 和 CSS 的列线图中。OS 和 CSS 列线图内部验证的 C 指数值分别为 0.732 和 0.746,外部验证的 C 指数值分别为 0.780 和 0.808。校准曲线表明,预测的 OS 和 CSS 能够很好地与实际生存率相匹配。
通过内部和外部验证,构建了用于预测 3 年和 5 年 OS 和 CSS 的列线图,证明其具有较高的准确性和可靠性。