Department of Neurosurgery, Affiliated Taikang Xianlin Drum Tower Hospital, Medical School of Nanjing University, Nanjing, China.
Department of Medical Imaging, Affiliated Drum Tower Hospital, Medical School of Nanjing University, Nanjing, China.
World Neurosurg. 2021 Jul;151:e810-e820. doi: 10.1016/j.wneu.2021.04.122. Epub 2021 May 5.
Oligodendroglioma is a rare primary malignant brain tumor that has highly variable clinical outcomes. The aim of this study was to investigate demographics, outcomes, and prognostic factors of all oligodendroglioma cases from the Surveillance, Epidemiology, and End Results database to build a clinical prognosis model to predict survival time of patients with oligodendroglioma.
Cases diagnosed between 1975 and 2016 were selected from the Surveillance, Epidemiology, and End Results database. Age, sex, race, insurance, year of diagnosis, marital status, tumor location, tumor size, summary stage, surgery method, and use of radiotherapy and chemotherapy were evaluated with respect to overall survival by univariate and multivariate analysis. A nomogram predicting 5- and 10-year survival probability for oligodendroglioma was constructed and validated.
After data cleaning, 4568 patients with oligodendroglioma were included. At the time of last follow-up, mean survival times among grade II and grade III oligodendrogliomas were 74 and 39 months, respectively. In multivariate analysis, radiotherapy, age, tumor site, summary stage, and surgery demonstrated independent associations with survival in both cohorts. Race and radiotherapy demonstrated independent associations with survival in grade II oligodendroglioma. Sex and chemotherapy demonstrated independent associations with survival in grade III oligodendroglioma. Independent factors in either cohort were selected to build a clinical nomogram. The C-index for the nomogram was 0.738 (95% confidence interval 0.718-0.757). The calibration curves of 5- and 10-year survival rates showed good agreement between the nomogram predictions and actual observations.
This study was the first to develop a nomogram for predicting overall survival of patients with oligodendroglioma to help clinicians predict patient prognosis accurately and conduct further treatment.
少突胶质细胞瘤是一种罕见的原发性恶性脑肿瘤，其临床表现差异较大。本研究旨在通过调查监测、流行病学和最终结果数据库中所有少突胶质细胞瘤病例的人口统计学、结局和预后因素，构建一个临床预后模型，以预测少突胶质细胞瘤患者的生存时间。
从监测、流行病学和最终结果数据库中选择 1975 年至 2016 年间诊断的病例。通过单因素和多因素分析，评估年龄、性别、种族、保险、诊断年份、婚姻状况、肿瘤位置、肿瘤大小、总结分期、手术方法以及放疗和化疗的使用与总生存的关系。构建并验证了一个预测少突胶质细胞瘤 5 年和 10 年生存率的列线图。
经过数据清理，共纳入 4568 例少突胶质细胞瘤患者。在最后一次随访时，2 级和 3 级少突胶质细胞瘤的平均生存时间分别为 74 个月和 39 个月。多因素分析显示，放疗、年龄、肿瘤部位、总结分期和手术在两个队列中均与生存独立相关。种族和放疗与 2 级少突胶质细胞瘤的生存独立相关。性别和化疗与 3 级少突胶质细胞瘤的生存独立相关。在任一队列中，独立因素被选入构建临床列线图。该列线图的 C 指数为 0.738（95%置信区间 0.718-0.757）。5 年和 10 年生存率的校准曲线显示，列线图预测与实际观察之间具有良好的一致性。
本研究首次构建了一个预测少突胶质细胞瘤患者总生存率的列线图，以帮助临床医生准确预测患者预后，并进行进一步治疗。
