Department of International Medical Services, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China.
Department of Breast Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China.
Int J Clin Oncol. 2021 Feb;26(2):387-398. doi: 10.1007/s10147-020-01813-8. Epub 2020 Oct 28.
Small bowel adenocarcinoma (SBA) is a rare malignant tumor with a poor prognosis. Most patients with SBA are diagnosed with advanced-stage disease. Due to the lack of randomized controlled trials and prospective studies, it is difficult to predict the prognosis of patients with SBA. Thus, this study aimed to establish a prognostic nomogram for evaluating the prognosis of SBA patients.
The clinical features and follow-up data of all patients diagnosed with SBA during 2004-2016 were summarized from the Surveillance, Epidemiology, and End Results (SEER) database. We separated these patients into training and validation groups. Multivariate Cox regression analyses were performed to identify independent prognostic variables for predicting cancer-specific survival (CSS) and overall survival (OS). According to the independent risk factors, we established nomograms and used the calibration curves to evaluate the accuracy.
The data of 3301 patients with SBA were collected from the SEER database. The multivariate analysis showed that age, marital status, tumor site, grade, TNM stage and surgical history were associated with CSS and OS (P < 0.05). Based on these results, we established nomograms of CSS and OS that can predict the 3- and 5-year survival rates of SBA patients (C-index > 0.7). The calibration curves showed that the predicted survival was very close to the actual survival.
We analyzed the independent risk factors for prognosis of SBA patients, and established nomograms to predict the 3- and 5-year survival rates of OS and CSS. These new prognostic tools can help clinicians to predict the survival of patients with SBA, further to guide treatment strategy.
小肠腺癌（SBA）是一种预后较差的罕见恶性肿瘤。大多数 SBA 患者在诊断时已处于晚期。由于缺乏随机对照试验和前瞻性研究，很难预测 SBA 患者的预后。因此，本研究旨在建立一种预测 SBA 患者预后的列线图。
从监测、流行病学和最终结果（SEER）数据库中总结了 2004-2016 年间所有诊断为 SBA 的患者的临床特征和随访数据。我们将这些患者分为训练组和验证组。采用多变量 Cox 回归分析确定预测癌症特异性生存（CSS）和总生存（OS）的独立预后变量。根据独立风险因素，我们建立了列线图，并使用校准曲线来评估准确性。
从 SEER 数据库中收集了 3301 例 SBA 患者的数据。多变量分析显示，年龄、婚姻状况、肿瘤部位、分级、TNM 分期和手术史与 CSS 和 OS 相关（P<0.05）。基于这些结果，我们建立了 CSS 和 OS 的列线图，可以预测 SBA 患者 3 年和 5 年的生存率（C 指数>0.7）。校准曲线显示，预测的生存率与实际生存率非常接近。
我们分析了 SBA 患者预后的独立风险因素，并建立了列线图来预测 OS 和 CSS 的 3 年和 5 年生存率。这些新的预后工具可以帮助临床医生预测 SBA 患者的生存情况，进一步指导治疗策略。
