Zhou Lei, Huang Runzhi, Wei Ziheng, Meng Tong, Yin Huabin
Department of Orthopedics, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Shanghai Bone Tumor Institution, Shanghai, China.
Front Oncol. 2021 Feb 26;11:608323. doi: 10.3389/fonc.2021.608323. eCollection 2021.
Primary spine malignancies (PSMs) are relatively rare in bone tumors. Due to their rarity, the clinical characteristics and prognostic factors are still ambiguous. In this study, we aim to identify the clinical features and proposed prediction nomograms for patients with PSMs.
Patients diagnosed with PSMs including chordoma, osteosarcoma, chondrosarcoma, Ewing sarcoma, and malignant giant cell tumor of bone (GCTB) between 1975 and 2016 were selected from the Surveillance, Epidemiology, and End Results (SEER) database. The patient and tumor characteristics were described based on clinical information. The significant prognostic factors of overall survival (OS) and cancer-specific survival (CSS) were identified by the univariate and multivariate Cox analysis. Then, the nomograms for OS and CSS were established based on the selected predictors and their accuracy was explored by the Cox-Snell residual plot, area under the curve (AUC) of receiver operator characteristic (ROC) and calibration curve.
The clinical information of 1,096 patients with PSMs was selected from the SEER database between 1975 and 2016. A total of 395 patients were identified with full survival and treatment data between 2004 and 2016. Chordoma is the commonest tumor with 400 cases, along 172 cases with osteosarcoma, 240 cases with chondrosarcoma, 262 cases with Ewing sarcoma and 22 cases with malignant GCTB. The univariate and multivariate analyses revealed that older age (Age > 60), distant metastasis, chemotherapy, and Surgery were independent predictors for OS and/or CSS. Based on these results, the nomograms were established with a better applicability (AUC for CSS: 0.784; AUC for OS: 0.780).
This study provides the statistics evidence for the clinical characteristics and predictors for patients with PSMs based on a large size population. Additionally, precise prediction nomograms were also established with a well-applicability.
原发性脊柱恶性肿瘤（PSMs）在骨肿瘤中相对少见。由于其罕见性，其临床特征和预后因素仍不明确。在本研究中，我们旨在确定PSMs患者的临床特征并提出预测列线图。
从监测、流行病学和最终结果（SEER）数据库中选取1975年至2016年间诊断为PSMs的患者，包括脊索瘤、骨肉瘤、软骨肉瘤、尤因肉瘤和骨恶性巨细胞瘤（GCTB）。根据临床信息描述患者和肿瘤特征。通过单因素和多因素Cox分析确定总生存（OS）和癌症特异性生存（CSS）的显著预后因素。然后，基于所选预测因素建立OS和CSS的列线图，并通过Cox-Snell残差图、受试者操作特征（ROC）曲线下面积（AUC）和校准曲线探索其准确性。
1975年至2016年间从SEER数据库中选取了1096例PSMs患者的临床信息。2004年至2016年间共确定395例患者有完整的生存和治疗数据。脊索瘤是最常见的肿瘤，有400例，骨肉瘤172例，软骨肉瘤240例，尤因肉瘤262例，恶性GCTB 22例。单因素和多因素分析显示，年龄较大（年龄>60岁）、远处转移、化疗和手术是OS和/或CSS的独立预测因素。基于这些结果，建立了适用性更好的列线图（CSS的AUC：0.784；OS的AUC：0.780）。
本研究基于大量人群为PSMs患者的临床特征和预测因素提供了统计学证据。此外，还建立了适用性良好的精确预测列线图。
