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甲状腺癌骨转移患者总生存和癌症特异性生存的独立危险因素评估:预测列线图的构建与验证研究

Independent risk factors evaluation for overall survival and cancer-specific survival in thyroid cancer patients with bone metastasis: A study for construction and validation of the predictive nomogram.

作者信息

Tong Yuexin, Huang Zhangheng, Hu Chuan, Chi Changxing, Lv Meng, Li Pengfei, Zhao Chengliang, Song Youxin

机构信息

Department of Minimally Invasive Spine Surgery, Affiliated Hospital of Chengde Medical University, Chengde, Hebei Province.

Department of Orthopedic Surgery, The Affiliated Hospital of Qingdao University, Qingdao, Shandong Province.

出版信息

Medicine (Baltimore). 2020 Sep 4;99(36):e21802. doi: 10.1097/MD.0000000000021802.

Abstract

Bone is a frequent site for the occurrence of metastasis of thyroid cancer (TC). TC with bone metastasis (TCBM) is associated with skeletal-related events (SREs), with poor prognosis and low overall survival (OS). Therefore, it is necessary to develop a predictive nomogram for prognostic evaluation. This study aimed to construct an effective nomogram for predicting the OS and cancer-specific survival (CSS) of TC patients with BM. Those TC patients with newly diagnosed BM were retrospectively examined over a period of 6 years from 2010 to 2016 using data from the Surveillance, Epidemiology and End Results (SEER) database. Demographics and clinicopathological data were collected for further analysis. Patients were randomly allocated into training and validation cohorts with a ratio of ∼7:3. OS and CSS were retrieved as research endpoints. Univariate and multivariate Cox regression analyses were performed for identifying independent predictors. Overall, 242 patients were enrolled in this study. Age, histologic grade, histological subtype, tumor size, radiotherapy, liver metastatic status, and lung metastatic status were determined as the independent prognostic factors for predicting the OS and CSS in TCBM patients. Based on the results, visual nomograms were separately developed and validated for predicting 1-, 2-, and 3-year OS and CSS in TCBM patients on the ground of above results. The calibration, receiver operating characteristic (ROC) curve and decision curve analysis (DCA) also demonstrated the reliability and accuracy of the clinical prediction model. Our predictive model is expected to be a personalized and easily applicable tool for evaluating the prognosis of TCBM patients, and may contribute toward making an accurate judgment in clinical practice.

摘要

骨是甲状腺癌(TC)转移的常见部位。伴有骨转移的甲状腺癌(TCBM)与骨相关事件(SREs)相关,预后较差,总生存期(OS)较短。因此,有必要开发一种预测列线图用于预后评估。本研究旨在构建一种有效的列线图,用于预测伴有骨转移的TC患者的总生存期(OS)和癌症特异性生存期(CSS)。利用监测、流行病学和最终结果(SEER)数据库的数据,对2010年至2016年期间新诊断为骨转移的TC患者进行了为期6年的回顾性研究。收集人口统计学和临床病理数据进行进一步分析。患者以约7:3的比例随机分配到训练组和验证组。将总生存期(OS)和癌症特异性生存期(CSS)作为研究终点。进行单因素和多因素Cox回归分析以确定独立预测因素。总体而言,本研究共纳入242例患者。年龄、组织学分级、组织学亚型、肿瘤大小、放疗、肝转移状态和肺转移状态被确定为预测TCBM患者总生存期(OS)和癌症特异性生存期(CSS)的独立预后因素。基于这些结果,分别开发并验证了可视化列线图,用于预测TCBM患者1年、2年和3年的总生存期(OS)和癌症特异性生存期(CSS)。校准、受试者操作特征(ROC)曲线和决策曲线分析(DCA)也证明了临床预测模型的可靠性和准确性。我们的预测模型有望成为评估TCBM患者预后的个性化且易于应用的工具,并可能有助于在临床实践中做出准确判断。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8e99/7478775/3bcde0a61074/medi-99-e21802-g004.jpg

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