Cervical Disease Diagnosis and Treatment Health Center, Fujian Maternity and Child Health Hospital, College of Clinical Medical for Obstetrics & Gynecology and Pediatrics, 74551Fujian Medical University, Fuzhou, China.
Department of Obstetrics, Fujian Maternity and Child Health Hospital, College of Clinical Medical for Obstetrics & Gynecology and Pediatrics, 74551Fujian Medical University, Fuzhou, China.
Technol Cancer Res Treat. 2022 Jan-Dec;21:15330338221110673. doi: 10.1177/15330338221110673.
This study aimed to develop a prognostic model based on the Surveillance, Epidemiology, and End Results (SEER) database to predict the overall survival (OS) of small cell carcinoma of the uterine cervix (SmCC). Between 1975 and 2016, a total of 401 patients were included, and their comprehensive sociodemographic and clinicopathological characteristics were collected. Univariate and multivariate Cox regression models were used to screen for independent prognostic factors. The identified factors were used to conduct a nomogram for predicting the OS of SmCC. The performance of the nomogram was determined using area under the receiver operating characteristic curve (AUC), concordance index (C-index), calibration curve, and decision curve analysis (DCA) metrics. The median survival time of all patients was about 24 months (95% confidence interval [95% CI] [1.50-2.17]). Age (hazard ratio [HR] = 1.693 for 45-59 vs 21-34, 95% CI [1.140-2.513], = .009; HR = 2.836 for 60-92 vs 21-34, 95% CI [1.851-4.345], < .001), positive nodes (HR = 2.384, 95% CI [1.437-3.955], < .001), regional nodes number ≥12 (HR = 0.500, 95% CI [0.282-0.886], = .018), and treatment method (HR = 0.409 for surgery vs no, 95% CI [0.267-0.628], < .001; HR = 0.649 for chemotherapy vs no, 95% CI [0.478-0.881)], = .006) were independent factors of OS. Young patients who had surgical resection or chemotherapy, negative lymph nodes, and regional lymph nodes ≥12 had a longer survival time. These clinical factors were utilized to construct a nomogram for predicting OS. The AUC and C-index were higher than 0.7, indicating the good discriminating ability of the nomogram. The calibrations were all around the 45-degree line, indicating excellent consistency between the prediction of the model and actual observations. The DCA plots supported the clinical utility of the nomogram. The constructed nomogram is expected to help predict the prognosis of SmCC and guide patient treatment.
本研究旨在基于监测、流行病学和最终结果（SEER）数据库开发一种预测子宫颈小细胞癌（SmCC）总生存期（OS）的预后模型。在 1975 年至 2016 年期间，共纳入了 401 例患者，并收集了他们全面的社会人口学和临床病理特征。使用单因素和多因素 Cox 回归模型筛选独立的预后因素。使用识别出的因素构建预测 SmCC OS 的列线图。通过接受者操作特征曲线（ROC）下面积（AUC）、一致性指数（C-index）、校准曲线和决策曲线分析（DCA）指标来确定列线图的性能。所有患者的中位生存时间约为 24 个月（95%置信区间[95%CI] [1.50-2.17]）。年龄（45-59 岁 vs 21-34 岁的风险比[HR] = 1.693，95%CI [1.140-2.513]， = .009；60-92 岁 vs 21-34 岁的 HR = 2.836，95%CI [1.851-4.345]， < .001）、阳性淋巴结（HR = 2.384，95%CI [1.437-3.955]， < .001）、区域淋巴结数≥12（HR = 0.500，95%CI [0.282-0.886]， = .018）和治疗方法（手术 vs 无手术的 HR = 0.409，95%CI [0.267-0.628]， < .001；化疗 vs 无化疗的 HR = 0.649，95%CI [0.478-0.881]）是 OS 的独立因素。年轻患者接受手术切除或化疗、淋巴结阴性和区域淋巴结≥12 者生存时间更长。这些临床因素被用于构建预测 OS 的列线图。AUC 和 C-index 均高于 0.7，表明该列线图具有良好的区分能力。校准曲线均接近 45 度线，表明模型预测与实际观察之间具有极好的一致性。DCA 图支持该列线图的临床实用性。所构建的列线图有望帮助预测 SmCC 的预后并指导患者治疗。
