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基于 SEER 数据库的肺转移性肾细胞癌患者预后列线图模型研究。

Prognostic nomogram for patients with lung metastatic renal cell carcinoma: a SEER-based study.

机构信息

Department of Urology, Affiliated Zhongda Hospital of Southeast University, Nanjing, China; Surgical Research Center, Institute of Urology, Southeast University Medical School, Nanjing, China; Department of Urology, Nanjing Lishui District People's Hospital, Zhongda Hospital Lishui Branch, Southeast University, Nanjing, China.

Department of Urology, Affiliated Zhongda Hospital of Southeast University, Nanjing, China.

出版信息

Ann Palliat Med. 2021 Mar;10(3):2791-2804. doi: 10.21037/apm-20-1488. Epub 2021 Feb 7.

Abstract

BACKGROUND

Our study aimed to establish a clinically practical and reliable prognostic nomogram based on the important prognostic factors to predict the prognosis of patients with lung metastatic renal cell carcinoma (RCC).

METHODS

Clinical data of patients with lung metastatic RCC between 2010 and 2015 were collected from the SEER database. Prognostic nomogram was established using R software to predict the OS and CSS probability for individual patients. Consistency index (C-index), calibration curve and decision curve analysis (DCA) were used to assess the predictive performance of the nomogram, and to calibrated the nomogram for 1-, 2-, and 3-year cancer-specific survival (CSS) and overall survival (OS).

RESULTS

1,563 patients were enrolled in this study. All patients were randomly divided into the primary cohort (937) and the validation cohort (626). Multivariate Cox regression showed that age, histology, N-stage, T-stage, surgery and radiotherapy were independent risk factor of OS, and histology, N-stage, T-stage, surgery were CSS related factors in patients with lung metastatic RCC in the primary cohort. The C-index of the nomogram OS was 0.662 and the C-index of CSS was 0.658 in the primary cohort. In the validation cohort, the C-index of the nomogram CSS and OS were 0.685 and 0.694, respectively. Moreover, the calibration curves showed good consistency between nomogram predictions and actual 1-, 2-, and 3-year OS and CSS rates in the primary and external verification cohorts.

CONCLUSIONS

The prognostic nomogram constructed in this study can provide an individualized treatment and risk assessment for survival in patients with lung metastatic RCC.

摘要

背景

本研究旨在基于重要的预后因素,建立一个临床实用且可靠的预后列线图,以预测肺转移性肾细胞癌(RCC)患者的预后。

方法

从 SEER 数据库中收集了 2010 年至 2015 年肺转移性 RCC 患者的临床数据。使用 R 软件建立预后列线图,以预测个体患者的 OS 和 CSS 概率。一致性指数(C-index)、校准曲线和决策曲线分析(DCA)用于评估列线图的预测性能,并对列线图进行校准,以预测 1、2 和 3 年的癌症特异性生存率(CSS)和总生存率(OS)。

结果

本研究共纳入 1563 例患者。所有患者被随机分为主要队列(937 例)和验证队列(626 例)。多变量 Cox 回归显示,年龄、组织学、N 分期、T 分期、手术和放疗是 OS 的独立危险因素,而组织学、N 分期、T 分期、手术是主要队列中肺转移性 RCC 患者 CSS 的相关因素。该列线图 OS 的 C-index 为 0.662,CSS 的 C-index 为 0.658。在验证队列中,列线图 CSS 和 OS 的 C-index 分别为 0.685 和 0.694。此外,校准曲线显示,在主要和外部验证队列中,列线图预测与实际 1、2 和 3 年 OS 和 CSS 率之间具有良好的一致性。

结论

本研究构建的预后列线图可为肺转移性 RCC 患者提供个体化的治疗和生存风险评估。

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