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基于 SEER 的回顾性研究:预测肾切除术治疗肾嫌色细胞癌患者总生存和癌症特异生存的列线图。

Nomograms for predicting overall and cancer-specific survival of patients with chromophobe renal cell carcinoma after nephrectomy: a retrospective SEER-based study.

机构信息

Department of Urology, Shengjing Hospital of China Medical University, Shenyang, Liaoning, China.

Department of Urology, Shengjing Hospital of China Medical University, Shenyang, Liaoning, China

出版信息

BMJ Open. 2022 Sep 1;12(9):e062129. doi: 10.1136/bmjopen-2022-062129.

Abstract

OBJECTIVE

We aimed to construct and validate nomograms to predict overall survival (OS) and cancer-specific survival (CSS) for patients with chromophobe renal cell carcinoma (chRCC) after nephrectomy.

DESIGN

This study is a retrospective cohort study.

SETTING AND PARTICIPANTS

There were 2810 patients with chRCC from Surveillance, Epidemiology and End Results database diagnosed between 2010 and 2015 included in the study who were randomly divided into a training cohort (n=1970) and a validation cohort (n=840). Another single-centre external validation cohort containing 124 patients from our hospital was also involved in our study.

PRIMARY AND SECONDARY OUTCOME MEASURES

OS and CSS.

RESULTS

Nomograms for OS and CSS include four and five variables, respectively, from the result of least absolute shrinkage and selection operator regression analyses. Nomograms reveal the accurate discrimination by the area under the curve of receiver operating characteristic (ROC) curves and C-indexes, with a C-index value of 0.777 (95% CI 0.728 to 0.826), 0.810 (95% CI 0.747 to 0.873) and 0.863 (95% CI 0.773 to 0.953) for the training cohort, the internal validation cohort and the external validation cohort in the nomogram for OS; and a C-index value of 0.884 (95% CI 0.829 to 0.939), 0.868 (95% CI 0.772 to 0.964) and 0.862 (95% CI 0.760 to 0.964) for the training cohort, the internal validation cohort and the external validation cohort in the nomogram for CSS. It was also proven that there was a high degree of conformance between the predicted and observation results by calibration plots. In addition, the comparison of ROC curves and C-indexes between nomograms and seventh tumour, node and metastasis stage demonstrated that nomograms were better in accuracy and efficacy ability.

CONCLUSIONS

We successfully constructed two accurate and effective nomograms to predict OS and CSS for patients with chRCC after nephrectomy, which can help clinical doctors choose individual treatment strategies for chRCC patients.

摘要

目的

我们旨在构建并验证列线图,以预测接受肾切除术的肾嫌色细胞癌(chRCC)患者的总生存期(OS)和癌症特异性生存期(CSS)。

设计

本研究为回顾性队列研究。

设置和参与者

本研究纳入了 2010 年至 2015 年间监测、流行病学和最终结果(SEER)数据库中诊断为 chRCC 的 2810 例患者,他们被随机分为训练队列(n=1970)和验证队列(n=840)。另外,我们还纳入了来自我院的单中心外部验证队列,其中包含 124 例患者。

主要和次要结局测量

OS 和 CSS。

结果

最小绝对收缩和选择算子回归分析结果的列线图中包含四个和五个变量,分别用于 OS 和 CSS。列线图通过接受者操作特征(ROC)曲线下面积和 C 指数显示出准确的判别能力,训练队列、内部验证队列和外部验证队列的 C 指数值分别为 0.777(95%CI 0.728 至 0.826)、0.810(95%CI 0.747 至 0.873)和 0.863(95%CI 0.773 至 0.953);OS 列线图的 C 指数值分别为 0.884(95%CI 0.829 至 0.939)、0.868(95%CI 0.772 至 0.964)和 0.862(95%CI 0.760 至 0.964);CSS 列线图的 C 指数值分别为 0.884(95%CI 0.829 至 0.939)、0.868(95%CI 0.772 至 0.964)和 0.862(95%CI 0.760 至 0.964)。校准图也证明了预测结果与观察结果之间具有高度一致性。此外,与第七版肿瘤、淋巴结和转移分期的 ROC 曲线和 C 指数的比较表明,列线图在准确性和效能方面更优。

结论

我们成功构建了两个准确有效的列线图,以预测接受肾切除术的 chRCC 患者的 OS 和 CSS,这有助于临床医生为 chRCC 患者选择个体化的治疗策略。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2c72/9438212/5600daafb642/bmjopen-2022-062129f01.jpg

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