Suppr超能文献

难以耐受手术或拒绝手术的老年原发性脊柱肿瘤患者的临床特征、预后因素及预测模型

Clinical characteristics, prognostic factors, and predictive model for elderly primary spinal tumor patients who are difficult to tolerate surgery or refuse surgery.

作者信息

Huang Zhangheng, Zhao Zhen, Wang Yu, Wu Ye, Guo Chuan, Kong Qingquan

机构信息

Department of Orthopedics, Orthopedic Research Institute, West China Hospital, Sichuan University, Chengdu, Sichuan, China.

出版信息

Front Oncol. 2022 Nov 10;12:991599. doi: 10.3389/fonc.2022.991599. eCollection 2022.

Abstract

BACKGROUND

As a rare tumor, surgery is the best treatment for primary spinal tumors. However, for elderly patients who cannot undergo surgery, the prognosis is often difficult to evaluate. The purpose of this study was to identify the risk factors that may lead to death and predict the prognosis of elderly patients with primary spinal tumors who have not undergone surgical treatment.

METHODS

In this study, 426 patients aged 60 years or older diagnosed with a primary spinal tumor between 1975 and 2015 were selected and included from the Surveillance, Epidemiology, and End Results database. A retrospective analysis was performed by using the Cox regression algorithm to identify independent prognostic factors. A nomogram model was developed based on the results. Multiple evaluation methods (calibration curve, receiver operating characteristic curve, and decision curve analyses) were used to evaluate and validate the performance of the nomogram.

RESULTS

A nomogram was developed, with age, histological type, and stage as independent prognostic factors. The results indicated that the prognostic risk tended to increase significantly with age and tumor spread. Osteosarcoma was found to have the most prominent risk prognosis in this patient group, followed by chondrosarcoma and chordoma. The area under the curve and the C-index of the model were both close to or greater than 0.7, which proved the high-differentiation ability of the model. The calibration curve and decision curve analyses showed that the model had high predictive accuracy and application value.

CONCLUSIONS

We successfully established a practical nomogram to assess the prognosis of elderly patients with primary spinal tumors who have not undergone surgical treatment, providing a scientific basis for clinical management.

摘要

背景

作为一种罕见肿瘤,手术是原发性脊柱肿瘤的最佳治疗方法。然而,对于无法接受手术的老年患者,其预后往往难以评估。本研究的目的是确定可能导致死亡的危险因素,并预测未接受手术治疗的老年原发性脊柱肿瘤患者的预后。

方法

在本研究中,从监测、流行病学和最终结果数据库中选取并纳入了1975年至2015年间诊断为原发性脊柱肿瘤的426例60岁及以上患者。采用Cox回归算法进行回顾性分析,以确定独立的预后因素。基于结果建立了列线图模型。使用多种评估方法(校准曲线、受试者工作特征曲线和决策曲线分析)来评估和验证列线图的性能。

结果

建立了一个以年龄、组织学类型和分期为独立预后因素的列线图。结果表明,预后风险往往随着年龄和肿瘤扩散而显著增加。在该患者组中,骨肉瘤的预后风险最为突出,其次是软骨肉瘤和脊索瘤。模型的曲线下面积和C指数均接近或大于0.7,证明了模型具有较高的区分能力。校准曲线和决策曲线分析表明,该模型具有较高的预测准确性和应用价值。

结论

我们成功建立了一个实用的列线图,用于评估未接受手术治疗的老年原发性脊柱肿瘤患者的预后,为临床管理提供了科学依据。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e6f2/9686326/533805db3ace/fonc-12-991599-g001.jpg

相似文献

4
A Novel Nomogram for Predicting Cancer-Specific Survival in Patients With Spinal Chordoma: A Population-Based Analysis.
Technol Cancer Res Treat. 2021 Jan-Dec;20:15330338211036533. doi: 10.1177/15330338211036533.
9
A Web-Based Prediction Model for Overall Survival of Elderly Patients With Malignant Bone Tumors: A Population-Based Study.
Front Public Health. 2022 Jan 11;9:812395. doi: 10.3389/fpubh.2021.812395. eCollection 2021.

本文引用的文献

2
A Novel Nomogram for Predicting Cancer-Specific Survival in Patients With Spinal Chordoma: A Population-Based Analysis.
Technol Cancer Res Treat. 2021 Jan-Dec;20:15330338211036533. doi: 10.1177/15330338211036533.
3
The Clinical Characteristics and Prediction Nomograms for Primary Spine Malignancies.
Front Oncol. 2021 Feb 26;11:608323. doi: 10.3389/fonc.2021.608323. eCollection 2021.
4
Cancer Statistics, 2021.
CA Cancer J Clin. 2021 Jan;71(1):7-33. doi: 10.3322/caac.21654. Epub 2021 Jan 12.
5
Predict overall survival of spinal conventional chordoma: Development and assessment of a new predictive nomogram.
Clin Neurol Neurosurg. 2020 Oct;197:106174. doi: 10.1016/j.clineuro.2020.106174. Epub 2020 Aug 22.
6
Age-induced accumulation of methylmalonic acid promotes tumour progression.
Nature. 2020 Sep;585(7824):283-287. doi: 10.1038/s41586-020-2630-0. Epub 2020 Aug 19.
7
Conditional Survival Analysis for Spinal Chondrosarcoma Patients After Surgical Resection.
Spine (Phila Pa 1976). 2020 Aug 15;45(16):1110-1117. doi: 10.1097/BRS.0000000000003494.
8
Distinction and Potential Prediction of Lung Metastasis in Patients with Malignant Primary Osseous Spinal Neoplasms.
Spine (Phila Pa 1976). 2020 Jul 1;45(13):921-929. doi: 10.1097/BRS.0000000000003421.
10
Surgical strategies for primary malignant tumors of the thoracic and lumbar spine.
Orthop Traumatol Surg Res. 2020 Feb;106(1S):S53-S62. doi: 10.1016/j.otsr.2019.05.028. Epub 2019 Dec 13.

文献AI研究员

20分钟写一篇综述,助力文献阅读效率提升50倍。

立即体验

用中文搜PubMed

大模型驱动的PubMed中文搜索引擎

马上搜索

文档翻译

学术文献翻译模型,支持多种主流文档格式。

立即体验