The People's Hospital of Lishui, Lishui, Zhejiang, 323000, China.
Affiliated Hospital of Chengde Medical University, Chengde, Hebei 067000, China.
Technol Cancer Res Treat. 2022 Jan-Dec;21:15330338211066240. doi: 10.1177/15330338211066240.
Metastatic soft tissue sarcoma (STS) patients have a poor prognosis with a 3-year survival rate of 25%. About 30% of them present lung metastases (LM). This study aimed to construct 2 nomograms to predict the risk of LM and overall survival of STS patients with LM. The data of patients were derived from the Surveillance, Epidemiology, and End Results database during the period of 2010 to 2015. Logistic and Cox analysis was performed to determine the independent risk factors and prognostic factors of STS patients with LM, respectively. Afterward, 2 nomograms were, respectively, established based on these factors. The performance of the developed nomogram was evaluated with receiver operating characteristic curves, area under the curve (AUC) calibration curves, and decision curve analysis (DCA). A total of 7643 patients with STS were included in this study. The independent predictors of LM in first-diagnosed STS patients were N stage, grade, histologic type, and tumor size. The independent prognostic factors for STS patients with LM were age, N stage, surgery, and chemotherapy. The AUCs of the diagnostic nomogram were 0.806 in the training set and 0.799 in the testing set. For the prognostic nomogram, the time-dependent AUC values of the training and testing set suggested a favorable performance and discrimination of the nomogram. The 1-, 2-, and 3-year AUC values were 0.698, 0.718, and 0.715 in the training set, and 0.669, 0.612, and 0717 in the testing set, respectively. Furthermore, for the 2 nomograms, calibration curves indicated satisfactory agreement between prediction and actual survival, and DCA indicated its clinical usefulness. In this study, grade, histology, N stage, and tumor size were identified as independent risk factors of LM in STS patients, age, chemotherapy surgery, and N stage were identified as independent prognostic factors of STS patients with LM, these developed nomograms may be an effective tool for accurately predicting the risk and prognosis of newly diagnosed patients with LM.
转移性软组织肉瘤（STS）患者预后较差，3 年生存率为 25%。约 30%的患者出现肺转移（LM）。本研究旨在构建 2 个列线图，以预测 STS 患者 LM 风险和总生存情况。数据来自 2010 年至 2015 年期间监测、流行病学和最终结果数据库。使用逻辑和 Cox 分析分别确定 STS 患者 LM 的独立危险因素和预后因素。此后，根据这些因素分别建立了 2 个列线图。通过受试者工作特征曲线、曲线下面积（AUC）校准曲线和决策曲线分析（DCA）评估开发的列线图的性能。共有 7643 名 STS 患者纳入本研究。首次诊断为 STS 患者 LM 的独立预测因素为 N 分期、分级、组织学类型和肿瘤大小。STS 患者 LM 的独立预后因素为年龄、N 分期、手术和化疗。诊断列线图在训练集中的 AUC 为 0.806，在测试集中为 0.799。对于预后列线图，训练集和测试集的时间依赖性 AUC 值表明该列线图具有良好的性能和区分度。训练集中 1 年、2 年和 3 年的 AUC 值分别为 0.698、0.718 和 0.715，测试集中分别为 0.669、0.612 和 0717。此外，对于这 2 个列线图，校准曲线表明预测与实际生存之间存在良好的一致性，DCA 表明其具有临床实用性。在本研究中，分级、组织学、N 分期和肿瘤大小被确定为 STS 患者 LM 的独立危险因素，年龄、化疗、手术和 N 分期被确定为 STS 患者 LM 的独立预后因素，这些开发的列线图可能是准确预测新诊断 LM 患者风险和预后的有效工具。
