Wang Lijie, Zhang Jinling, Wang Jingtao, Xue Hao, Deng Lin, Che Fengyuan, Heng Xueyuan, Zheng Xuejun, Lu Zilong, Yang Liuqing, Tan Qihua, Xu Yeping, Zhang Yanchun, Ji Xiaokang, Li Gang, Yang Fan, Xue Fuzhong
Department of Epidemiology and Health Statistics, School of Public Health, Cheeloo College of Medicine, Shandong University, 44 Wenhua West Road, Jinan, Shandong Province China.
Institute for Medical Dataology, Shandong University, Jinan, China.
Health Inf Sci Syst. 2023 May 4;11(1):23. doi: 10.1007/s13755-023-00223-0. eCollection 2023 Dec.
Prognostic models of glioma have been the focus of many studies. However, most of them are based on Western populations. Additionally, because of the complexity of healthcare data in China, it is important to select a suitable model based on existing clinical data. This study aimed to develop and independently validate a nomogram for predicting the overall survival (OS) with newly diagnosed grade II/III astrocytoma after surgery.
Data of 472 patients with astrocytoma (grades II-III) were collected from Qilu Hospital as training cohort while data of 250 participants from Linyi People's Hospital were collected as validation cohort. Cox proportional hazards model was used to construct the nomogram and individually predicted 1-, 3-, and 5-year survival probabilities. Calibration ability, and discrimination ability were analyzed in both training and validation cohort.
Overall survival was negatively associated with histopathology, age, subtotal resection, multiple tumors, lower KPS and midline tumors. Internal validation and external validation showed good discrimination (The C-index for 1-, 3-, and 5-year survival were 0.791, 0.748, 0.733 in internal validation and 0.754, 0.735, 0.730 in external validation, respectively). The calibration curves showed good agreement between the predicted and actual 1-, 3-, and 5-year OS rates.
This is the first nomogram study that integrates common clinicopathological factors to provide an individual probabilistic prognosis prediction for Chinese Han patients with astrocytoma (grades II-III). This model can serve as an easy-to-use tool to advise patients and establish optimized surveillance approaches after surgery.
The online version contains supplementary material available at 10.1007/s13755-023-00223-0.
胶质瘤的预后模型一直是众多研究的焦点。然而,它们大多基于西方人群。此外,由于中国医疗数据的复杂性,基于现有临床数据选择合适的模型很重要。本研究旨在开发并独立验证一种列线图,用于预测新诊断的II/III级星形细胞瘤术后的总生存期(OS)。
收集齐鲁医院472例星形细胞瘤(II - III级)患者的数据作为训练队列,同时收集临沂市人民医院250例参与者的数据作为验证队列。采用Cox比例风险模型构建列线图,并分别预测1年、3年和5年生存概率。在训练队列和验证队列中分析校准能力和区分能力。
总生存期与组织病理学、年龄、次全切除、多发肿瘤、较低的KPS评分和中线肿瘤呈负相关。内部验证和外部验证均显示出良好的区分能力(内部验证中1年、3年和5年生存的C指数分别为0.791、0.748、0.733,外部验证中分别为0.754、0.735、0.730)。校准曲线显示预测的和实际的1年、3年和5年总生存率之间具有良好的一致性。
这是第一项整合常见临床病理因素的列线图研究,为中国汉族星形细胞瘤(II - III级)患者提供个体概率性预后预测。该模型可作为一种易于使用的工具,为患者提供建议并在术后建立优化的监测方法。
在线版本包含可在10.1007/s13755-023-00223-0获取的补充材料。