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预测骶骨/骨盆软骨肉瘤(SC)患者总生存期和癌症特异性生存期的预后列线图:一项基于人群的倾向评分匹配研究

Prognostic Nomograms to Predict Overall Survival and Cancer-specific Survival in Sacrum/Pelvic Chondrosarcoma (SC) Patients: A Population-based Propensity Score-matched Study.

作者信息

Zheng Xuan-Qi, Huang Jin-Feng, Chen Dong, Lin Jia-Liang, Wu Ai-Min

机构信息

Department of Orthopaedics, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Zhejiang Provincial Key Laboratory of Orthopaedics, Wenzhou, Zhejiang Province, China.

出版信息

Clin Spine Surg. 2021 Apr 1;34(3):E177-E185. doi: 10.1097/BSD.0000000000001089.

Abstract

STUDY DESIGN

A longitudinal cohort study.

OBJECTIVE

The objective of this study was to evaluate the prognostic factors and determine the difference between different surgery scopes. Nomograms were constructed and validated to predict overall survival (OS) and cancer-specific survival (CSS) of sacrum/pelvic chondrosarcoma (SC) patients.

SUMMARY OF BACKGROUND DATA

Chondrosarcoma is a bone malignancy which is reported to be resistant to both chemotherapy and radiotherapy. Therefore, surgery is the most preferred treatment method. However, this remains a great challenge due to the complex anatomy of the area.

MATERIALS AND METHODS

Data from the Surveillance, Epidemiology, and End Results (SEER) database of patients with conventional SC between 1998 and 2016 was retrieved for analysis. Cox analysis was used to estimate the mortality hazards ratios among patients. Propensity score matching was used to compare different surgery scope. Nomograms were constructed to predict the OS and CSS of patients with SC.

RESULTS

A total of 377 patients were included in this study. The cutoff value for tumor size was considered to be 118 mm. The concordance indices (C-index) value for nomogram predictions of CSS were 0.871. Following propensity score matching, 158 patients were selected for the second time and its result showed no significant difference between the scope of surgery.

CONCLUSIONS

Tumor size was considered to be closely related to the outcome of SC. There is no significant difference in the scope of surgery and limb salvage can be considered. The nomograms can precisely predict OS and CSS in patients with SC. These could help clinicians to perform survival assessments and identify patients at high risk.

LEVEL OF EVIDENCE

Level IV.

摘要

研究设计

一项纵向队列研究。

目的

本研究的目的是评估预后因素并确定不同手术范围之间的差异。构建并验证列线图以预测骶骨/骨盆软骨肉瘤(SC)患者的总生存期(OS)和癌症特异性生存期(CSS)。

背景数据总结

软骨肉瘤是一种骨恶性肿瘤,据报道对化疗和放疗均耐药。因此,手术是最优选的治疗方法。然而,由于该区域解剖结构复杂,这仍然是一个巨大的挑战。

材料与方法

检索1998年至2016年间常规SC患者的监测、流行病学和最终结果(SEER)数据库中的数据进行分析。采用Cox分析估计患者的死亡风险比。使用倾向评分匹配来比较不同的手术范围。构建列线图以预测SC患者的OS和CSS。

结果

本研究共纳入377例患者。肿瘤大小的临界值被认为是118毫米。CSS列线图预测的一致性指数(C-index)值为0.871。倾向评分匹配后,再次选择158例患者,结果显示手术范围之间无显著差异。

结论

肿瘤大小被认为与SC的预后密切相关。手术范围无显著差异,可以考虑保肢。列线图可以精确预测SC患者的OS和CSS。这些有助于临床医生进行生存评估并识别高危患者。

证据级别

四级。

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